An ounce of prevention is worth a pound of cure: time to focus on preconception workplace reproductive health.

Abstract

Few opportunities exist in environmental reproductive medicine where we can have a direct impact on offspring health. Prevention of adverse child health outcomes has received less attention than understanding their etiology. Yet, the preconception and early pregnancy periods afford a unique opportunity to intervene and limit early life exposures that may result in harm with potentially lifelong consequences. Workplace exposures—whose largest burden involves reproductive-aged women and men—have been hard to investigate largely because of the complexity of measurement and challenges with follow-up. Case–control designs lend themselves to studying rare and often devastating outcomes, including birth defects. In the study by Spinder et al. (2021), published in this issue of Human Reproduction, the authors tackle a complex area of birth defects research using a nested case–control design by leveraging two large independent cohorts—the European Concerted Action on Congenital Anomalies and Twins in Northern Netherlands (Eurocat NNL) and the Lifelines Cohort—both with overlapping catchments from The Netherlands—to determine the extent to which endocrine disrupting chemicals (EDCs) are associated with urogenital birth defects. Here, Spinder et al. use occupational data from these cohorts to address a significant gap in our knowledge. In so doing, the authors draw our attention to an often-forgotten area of occupational epidemiology—that fertility, pregnancy and offspring health of reproductive-aged women (and men) matter in the workplace.