Endometriosis and Organochlorinated Environmental Pollutants: A Case–Control Study on Italian Women of Reproductive Age

Maria Grazia Porpora, Emanuela Medda, Annalisa Abballe, Simone Bolli, Isabella De Angelis, Alessandro di Domenico, Annamaria Ferro, Anna Maria Ingelido, Antonella Maggi, A. Maggi, Pierluigi Benedetti Panici, Elena De Felip
Environmental health perspectives · 2009 · vol. 117(7) , pp. 1070–1075 · doi:10.1289/ehp.0800273 · PMID:19654915 · W2073304812
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This case-control study found increased serum concentrations of certain PCBs and p,p'-DDE were associated with a higher risk of endometriosis in Italian women.

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Abstract

BACKGROUND: Endometriosis is a common gynecologic disease characterized by the ectopic growth of endometrial tissue. In industrialized countries, it affects approximately 10% of women of reproductive age. Its etiology is unclear, but a multifactorial origin is considered to be most plausible. Environmental organochlorinated persistent pollutants, in particular dioxins and polychlorinated biphenyls (PCBs), have been hypothesized to play a role in the disease etiopathogenesis. However, results of studies carried out on humans are conflicting. OBJECTIVE: We evaluated the exposure to organochlorinated persistent pollutants as a risk factor for endometriosis. METHODS: We conducted a case-control study in Rome on 158 women comprising 80 cases and 78 controls. In all women, serum concentrations of selected non-dioxin-like PCBs (NDL-PCBs) and dioxin-like PCBs (DL-PCBs), 1,1-dichloro-2,2,-bis(4-chlorophenyl)-ethene (p,p'-DDE), and hexachlorobenzene (HCB) were determined by ion-trap mass spectrometry. DR-CALUX bioassay was employed to assess the 2,3,7,8-tetrachlorodibenzo-p-dioxin toxicity equivalent (TEQ) concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and DL-PCBs. RESULTS: We found an increased risk of endometriosis for DL-PCB-118 [odds ratio (OR) = 3.79; 95% confidence interval (CI), 1.61-8.91], NDL-PCB-138 (OR = 3.78; 95% CI, 1.60-8.94), NDL-PCB-153 (OR = 4.88; 95% CI, 2.01-11.0), NDL-PCB-170 (OR = 3.52; 95% CI, 1.41-8.79), and the sum of DL-PCBs and NDL-PCBs (OR = 5.63; 95% CI, 2.25-14.10). No significant associations were observed with respect to HCB or to the sum of PCDDs, PCDFs, and DL-PCBs given as total TEQs. CONCLUSIONS: The results of this study show that an association exists between increased PCB and p,p'-DDE serum concentrations and the risk of endometriosis.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Environmental Pollutants Hydrocarbons, Chlorinated Adult Benzofurans Benzofurans Benzofurans Case-Control Studies Dibenzofurans, Polychlorinated Endometriosis Endometrium Endometrium Environmental Pollutants Environmental Pollutants Female Hexachlorobenzene Hexachlorobenzene Hexachlorobenzene Humans Hydrocarbons, Chlorinated

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