Abstract
This study aimed to investigate the effects of blood lead levels (BLLs) and lead and cadmium exposure on endometriosis (EM). The study cohort consisted of female workers who underwent a lead-associated special medical examination between 1 January 2000 and 31 December 2004 (n = 26,542). The standard admission rate (SAR) and admission odds ratio (OR) for EM were calculated using the general population and noise-exposed groups, respectively, for the same period as the reference standards. The SAR for EM was 1.24 (95% confidence interval (CI): 1.03–1.48) in lead-exposed workers and 1.44 (95% CI: 1.11–1.85) in workers with BLLs < 5 μg/dL when compared with that of the general population. Admission ORs of EM in lead-exposed workers and those with BLLs < 5 μg/dL were statistically higher than those of noise-exposed workers (OR, 1.40; 95% CI, 1.15–1.70 and OR, 1.48; 95% CI, 1.11–1.98, respectively). The relative excess risk due to interaction of lead and cadmium was 0.33. Lead exposure was associated with EM admission. EM admission in lead-exposed workers with BLLs < 5 μg/dL was statistically higher than that of the general population and noise-exposed workers. Co-exposure to lead and cadmium has a synergistic effect with EM.
Highlights
Endometriosis (EM) is a common, often chronic, inflammatory condition characterized by the presence of endometrium outside the uterus, mainly in the pelvic organs and tissues [1]
This study aimed to investigate the relationship (1) between lead exposure and blood lead levels (BLLs) and EM admission and (2) between EM admission through co-exposure to lead and cadmium using a cohort of lead-exposed female workers and their hospitalization data
The standard admission rate (SAR) for EM in workers with BLLs < 5 μg/dL was 1.44 when compared with that of the general population
Summary
Endometriosis (EM) is a common, often chronic, inflammatory condition characterized by the presence of endometrium outside the uterus, mainly in the pelvic organs and tissues [1]. EM is an oestrogen-dependent gynaecologic disease with lasting implications for some women’s fertility, somatic health, and overall quality of life. It is commonly associated with pelvic pain, menorrhagia, dyspareunia, and infertility [2]. The prevalence of endometriotic disease has shown to be approximately 5% of the reproductive age, with a peak between 25 and 35 years of age [2]. A 0.1% annual incidence of EM among women aged 15–49 years has been reported [3]. Missmer and Cramer reported that the prevalence of EM in asymptomatic women seeking sterilization is 2–18%; in those admitted with pelvic pain, it is 5–21%, whereas it is 5–50% in infertile women [4]
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