Environmental and Occupational Exposures

Publications under ‘Environmental Exposures’ examine the associations of environmental exposures with fertility and reproductive outcomes. 

Rosofsky A, Janulewicz P, Thayer KA, McClean M, Wise LA, Calafat AM, Mikkelsen EM, Taylor KW, Hatch EE. Exposure to multiple chemicals in a cohort of reproductive-age Danish women. Environ Res 2017; 154: 73-85.

Exposure to environmental chemicals is ubiquitous among reproductive-aged Danish women. Better understanding of the health effects of chemical exposures during pregnancy is needed.

Wesselink AK, Wise LA, Hatch EE, Mikkelsen EM, Sørensen HT, Riis AH, McKinnon CJ, Rothman KJ. Seasonal patterns in fecundability in North America and Denmark: a preconception cohort study. Hum Reprod 2020; 35(3): 565-572.

The probability of conceiving may vary by season: couples were most likely to conceive in the late fall and least likely to conceive in the late spring. This association was strongest at southern latitudes.

Wesselink AK, Kirwa K, Hatch EE, Hystad P, Szpiro AA, Kaufman JD, Levy JI, Mikkelsen EM, Quraishi SM, Rothman KJ, Wise LA. Residential proximity to major roads and fecundability in a preconception cohort. Environ Epi. In press.

Women who live close to major roads and who have a higher density of major roads around their home had lower fecundability than women who lived far from major roads.

Wesselink AK, Wang TR, Ketzel M, et al. Air pollution anWesselink, A. K., Wang, T. R., Ketzel, M., Mikkelsen, E. M., Brandt, J., Khan, J., Hertel, O., Laursen, A., Johannesen, B. R., Willis, M. D., Levy, J. I., Rothman, K. J., Sørensen, H. T., Wise, L. A., & Hatch, E. E. (2022). Air pollution and fecundability: Results from a Danish preconception cohort study. Paediatric and perinatal epidemiology, 36(1), 57–67. https://doi.org/10.1111/ppe.12832d fecundability: Results from a Danish preconception cohort study. Paediatr Perinat Epidemiol. 2022;36(1):57-67.

Among Danish pregnancy planners, we estimated concentrations of several air pollutants at each participant’s residential address. We found that participants with higher levels of particulate matter around their homes took longer to conceive relative to participants with low levels. Other air pollutants, including nitrogen dioxide, sulfur dioxide, carbon monoxide, and ozone were not strongly related to time-to-pregnancy.

Wise, L. A., Wang, T. R., Mikkelsen, E. M., Wesselink, A. K., Calafat, A. M., Wegienka, G., Geller, R. J., Coleman, C. M., Willis, M. D., Marsh, E. E., Schildroth, S., Botelho, J. C., Messerlian-Lambert, G., & Hatch, E. E. (2023). Per- and Polyfluoroalkyl Substances and Anti-Müllerian Hormone Concentrations in Two Preconception Cohort Studies. Environmental health perspectives, 131(10), 107703. https://doi.org/10.1289/EHP12592

Although there was little overall association between PFAS and AMH concentrations, we observed inverse associations among nulliparous participants and positive associations among parous participants, though CIs were wide.

Bond, J. C., Coleman, C. M., Yland, J. J., Wesselink, A. K., Wang, T., Willis, M., Hatch, E. E., Rothman, K. J., Savitz, D., Eisenberg, M. L., & Wise, L. A. (2024). Preconception sleep duration, non-daytime work schedules, and incidence of spontaneous abortion: a prospective cohort study. Human reproduction (Oxford, England), 39(2), 413–424. https://doi.org/10.1093/humrep/dead249

Incidence of SAB had little association with female sleep duration and a modest positive association with male short sleep duration, female work at night, and discrepant work schedules among partners. Our findings are consistent with previous research indicating that some types of female employment schedules may be associated with SAB incidence. This is the first study to indicate a relationship between SAB and male employment schedules, indicating that discrepant work schedules within a couple might be relevant.

Sabbath, E. L., Willis, M. D., Wesselink, A. K., Wang, T. R., McKinnon, C. J., Hatch, E. E., & Wise, L. A. (2024). Association between job control and time to pregnancy in a preconception cohort. Fertility and sterility, 121(3), 497–505. https://doi.org/10.1016/j.fertnstert.2023.11.022

Lower job control, a work-related stressor, may adversely influence time to pregnancy. Because job control is a condition of work (i.e., not modifiable by individuals), these findings may strengthen arguments for improving working conditions as a means of improving worker health, including fertility.

Wesselink, A. K., Kirwa, K., Hystad, P., Kaufman, J. D., Szpiro, A. A., Willis, M. D., Savitz, D. A., Levy, J. I., Rothman, K. J., Mikkelsen, E. M., Laursen, A. S. D., Hatch, E. E., & Wise, L. A. (2024). Ambient air pollution and rate of spontaneous abortion. Environmental research, 246, 118067. https://doi.org/10.1016/j.envres.2023.118067

We found a positive association of ambient PM_2.5 concentrations with spontaneous abortion in Canada, but not the USA. NO₂ and O₃ concentrations were not appreciably associated with rate of SAB. Results were relatively consistent across season and weeks of gestation. Protection of pregnant individuals from air pollution is an important measure to safeguard maternal and fetal health.

Willis, M. D., Campbell, E. J., Selbe, S., Koenig, M. R., Gradus, J. L., Nillni, Y. I., Casey, J. A., Deziel, N. C., Hatch, E. E., Wesselink, A. K., & Wise, L. A. (2024). Residential Proximity to Oil and Gas Development and Mental Health in a North American Preconception Cohort Study: 2013-2023. American journal of public health, 114(9), 923–934. https://doi.org/10.2105/AJPH.2024.307730

Among North American pregnancy planners, closer proximity to OGD was associated with adverse preconception mental health symptomatology. 

Wesselink, A. K., Claus Henn, B., Fruh, V., Geller, R. J., Coleman, C. M., Schildroth, S., Sjodin, A., Bethea, T. N., Noel, N. L., Baird, D. D., Wegienka, G., & Wise, L. A. (2024). Persistent endocrine-disrupting chemicals and incident uterine leiomyomata: A mixtures analysis. The Science of the total environment, 951, 175871. https://doi.org/10.1016/j.scitotenv.2024.175871

Uterine leiomyomata (UL; fibroids) are hormone-dependent neoplasms that can cause significant gynecologic morbidity. Studies have documented associations between concentrations of persistent endocrine-disrupting chemicals (EDCs) and UL incidence; however, few have assessed the effects of EDC mixtures on UL. In this prospective ultrasound study, a mixture of persistent EDCs was not appreciably associated with incident UL during 10 years of follow-up, but individual EDCs were associated with UL in opposite directions.

Wesselink, A. K., Gause, E. L., Spangler, K. D., Hystad, P., Kirwa, K., Willis, M. D., Wellenius, G. A., & Wise, L. A. (2024). Exposure to Ambient Heat and Risk of Spontaneous Abortion: A Case-Crossover Study. Epidemiology (Cambridge, Mass.), 35(6), 864–873. https://doi.org/10.1097/EDE.0000000000001774

Our study provides evidence of an association between high outdoor temperatures and the incidence of spontaneous abortion.

Wesselink, A.K., Johannesen, B.R., Wang, T.R., Ketzel, M., Mikkelsen, E.M., Brandt, J., Khan, J., Hertel, O., Laursen, A.S.D., Willis, M.D., Levy, J.I., Rothman, K.J., Sørensen, H.T., Wise, L.A. and Hatch, E.E. (2025), Residential Exposure to PM_2.5 Constituents and Fecundability in a Danish Preconception Cohort. Paediatr Perinat Epidemiol. https://doi.org/10.1111/ppe.13174

In this Danish preconception cohort study, PM_2.5 constituents derived from biomass and transportation-related combustion may drive the association between PM_2.5 concentrations and fecundability.

Schildroth, S., Bond, J. C., Wesselink, A. K., Abrams, J., Calafat, A. M., Cook Botelho, J., White, K. O., Wegienka, G., Hatch, E. E., & Wise, L. A. (2025). Associations between per- and polyfluoroalkyl substances (PFAS) and female sexual function in a preconception cohort. Environmental research, 266, 120556. https://doi.org/10.1016/j.envres.2024.120556

We investigated associations between serum PFAS concentrations and female sexual function among U.S. pregnancy planners. Some PFAS were associated with poorer sexual function among U.S. pregnancy planners, but future studies are needed to clarify the extent to which PFAS influences female sexual health.