August 23, 2022 – Carmen MesserlianAssistant Professor of Reproductive, Perinatal, and Pediatric Environmental Epidemiology, studies how the world around us, from chemical exposures at trauma at climate change-may affect reproductive health and development. She directs the Scientific Early Life Environmental Health and Development Program (SEED) at the Harvard TH Chan School of Public Health. Here she talks about her work.
Q: What led you to study the factors that can impact reproductive health and human development?
A: My curiosity about reproductive health and human development was sparked over 20 years ago while I was training and working as an emergency room nurse at the Montreal Children’s Hospital. My first patient was an eight-year-old girl who came to the emergency room very, very sick. We had to save his life. Later that day, he was diagnosed with leukemia. I followed his progress in the oncology ward for months. I also worked in the inpatient child psychiatry unit where I cared for a young boy who, at the age of nine, had suffered so much trauma that he had to live in hospital. He was my patient in the unit for an entire year! He was born on the streets of Montreal to a homeless, drug-addicted mother. As a newborn, he was addicted and came into the world with a host of disadvantages that were amplified by early traumas and experiences that caused severe behavioral and emotional problems.
These two innocent children and their suffering marked me all my life. Not a week goes by that I don’t think of these children. Their stories and my experience caring for them and thousands of others like them, untold. This is what inspires and motivates me to strive to understand and study early exposures and environments that can cause disease in children and how we can prevent adverse effects. All I do is try to understand when and how exposures in mothers and fathers before they conceive pregnancies, or when they are pregnant, impact their chances of getting pregnant, having a healthy pregnancy and deliver a healthy baby who can live to their full potential. These are the questions we answer in the SEED program, which includes a scientific team of more than 25 people.
Q: Can you give some examples of research you are working on?
A: The exposures that I look at are not just the chemicals that we are exposed to from things like plastics and the built environment, or the air that we breathe from the natural environment, but also the social environment. The environment, to me, is broadly defined to include the natural, built and social environments we are exposed to throughout life. For example, my team and I are currently studying how early exposures to trauma, sexual abuse, or other forms of early stress can impact our lifelong reproductive health. It’s amazing to realize that our social environment, and what you experience as a child, is one exposure that can impact your chances of getting pregnant, carrying a baby to term, having a post-natal experience. healthy partum or to have a healthy child.
Early exposures can also impact your reproductive health as you age, through perimenopause and menopause and beyond for women, and also throughout life for men. In children and adolescents, exposure to certain chemicals, foods, social environments, or stress can affect the rate at which your body matures – they can speed up or delay the progress of puberty. These changes can affect both fertility and overall health throughout life. In women, the number of years we menstruate can affect the health of our brain, heart and bones. Environmental exposures can influence our menstrual cycles, our fertility potential, and the age at which we reach menopause. Past life factors that impact age at menarche or accelerate our reproductive aging process can lead to changes in our fertility and the age at which women reach menopause. We also have work showing that women who enter menopause earlier have more precipitous cognitive decline, their brains age differently, and they have an increased risk of age-related diseases. These are some of the hypotheses we are investigating using observational epidemiological designs coupled with genetic and epigenetic data.
We also have a new document on the impact of climate change on reproductive health. Species on earth are being strained and stressed by climate change. It’s not just pollution, droughts, storms and wildfires that are having a devastating impact, it’s also that our evolutionary capacity to reproduce is being sorely tested. The more hostile our environment, the more difficult it is to have healthy offspring. In the SEED program, we examine how air pollution affects the risk of cerebral palsy, how climatic factors such as heat affect eggs and sperm, how climatic conditions affect our ability to care for our children in a adequate. For example, California has experienced severe drought and wildfires. Are you going to walk your five-month-old baby in these conditions? No. How does staying indoors affect your baby’s health and development? The pandemic is an example of how our environment and changes in the way society functions can have a huge influence on the health of our children and their exposures throughout life.
Q: What are the recommendations on how people can protect themselves from hazardous exposures that may affect their ability to conceive, sustain a pregnancy, or have a healthy child?
A: Do not use scented or colored products on your skin or in your home, such as cleaning products, detergents, dryer sheets, soaps, deodorants, face and body creams or car air fresheners . These products contain phthalates and phenols. Phthalates have been shown to harm reproductive health and affect the brain, immune system, reproductive health and baby’s development during pregnancy, and phenols have been linked to decreased brain and heart health and immune function, adverse birth outcomes and pregnancy loss. Even small steps can help. So instead of wearing cologne seven days a week, use it five days a week or three and apply it to your clothes, not your skin. Replace scented or colored products with ones that are more eco-friendly, plant-based and free of chemicals of concern. There are affordable choices that can help reduce your exposure. Small, incremental changes over time in your home, personal care products, and diet can lead to big changes in your body’s overall exposure.
The other thing we can do is focus on nutrition. If you can afford to buy organic food once in a while or all the time, you can reduce your exposure to harmful pesticides. Eat more fresh fruits and vegetables, less processed foods, less meat, more vegetable protein. Also try to reduce the amount of takeout or prepared foods you get in paper, plastic or cardboard containers. Food packaging and food contact materials are laden with PFAS chemicals. Do not cook food in so-called “microwavable” plastic or any other plastic. Instead, use wood, glass or metal in your kitchen. Water filtration is an important household strategy. Filtration isn’t perfect, but it can reduce some of the most common and harmful contaminants.
I want to get this kind of information into people’s hands in a tangible and relevant way. To achieve this, my team has produced a series of educational prevention leaflets for the public that can be downloaded from our website. It can take decades for policy changes at the federal and state levels to reduce the amounts of harmful chemicals in the environment. In the meantime, I am interested in bottom-up approaches. Therein lies the power – working with groups of expectant fathers and mothers, teenagers, fertility doctors who have access to patients trying to get pregnant, obstetricians/gynecologists who counsel people who have just had a miscarriage , physicians working in pediatric and adolescent health – trying to educate them about harmful exposures in our environment. My goal is not to get a high impact paper. This is the impact of paper. I want to be known as the “people’s teacher”. I want my work to matter to the people I try to reach and I want to change the way we take care of our reproductive health. We work on real issues that make a difference in the world.
– Karen Feldscher