Natalie H. Aneck-Hahn

Semenology training programs: 8 years' experience

OBJECTIVE To evaluate the immediate effect of hands-on training on the quality of technical skills of laboratory technicians. DESIGN Retrospective analytical study. SETTING Academic institutions and private infertility clinics. PARTICIPANTS One hundred and ten laboratory technicians. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) First, 110 participants from 16 African countries attended 5-day semenology workshops at Tygerberg Hospital. During these workshops the methodology as described by the World Health Organization manual for the analysis of human semen, namely, sperm concentration, motility, vitality, and morphology, formed part of the curriculum. Second, two experienced morphology readers from the Tygerberg group presented 23 1-day sperm morphology workshops in nine other countries. RESULT(S) The semenology workshops indicated a significant improvement in the evaluation of sperm concentration only, whereas pretraining and posttraining results for motility did not differ. Vitality reports did not differ from those of the experienced worker in the first place. Calculation by means of a linear regression model showed a significant decrease in the mean posttraining scores from the pretraining scores for the sperm morphology courses. CONCLUSION(S) Training improved technical skills for the evaluation of morphology and sperm concentration. The evaluation of graded sperm motility seems to be more difficult to teach over a short period.

Changes in retinol-binding protein concentrations and thyroid homeostasis with nonoccupational exposure to DDT.

Background The insecticide dichlorodiphenyltrichloroethane (DDT) has been used for malaria vector control in the northern and eastern parts of the Vhembe District of Limpopo Province, South Africa, since 1945. Bioaccumulation of DDT raises concern because it reportedly affects thyroid function. Objective Our objective was to investigate the association between DDT uptake (as reflected in plasma concentrations) and thyroid homeostasis while considering related factors. Methods We compared dietary intake, serum retinol-binding protein (RBP), transthyretin (TTR) and albumin concentrations, and liver and thyroid function between cases with evidence of a body burden of DDT in the circulation (concentration of any DDT isomer ≥ 0.02 μg/g lipid; n = 278) and controls (concentration of all DDT isomers < 0.02 μg/g lipid; n = 40) in a cross-sectional study. Further analyses were performed to assess the relevance of changes in RBP status associated with DDT uptake. Results RBP concentrations below the reference range were more prevalent in cases (54% vs. 10% in controls; χ2 = 27.4; p < 0.001), which could not be explained by nutrient intake. We observed significantly lower thyroid hormone concentrations among cases (p ≤ 0.01). We also observed a significant linear trend for serum concentrations of free thyroxine and free triiodothyronine (p < 0.001) and a significant quadratic trend for serum thyroid-stimulating hormone (p = 0.025) and TTR (p < 0.001) across the control group and case groups with normal and relatively low RBP concentrations. Relatively low RBP concentrations were associated with significantly higher DDT and 1,1-dichloro-2,2-bis(p-chlorophenyl) ethylene (DDE) isomer concentrations and with a higher DDE/DDT ratio (p ≤ 0.01), which signifies long-term exposure. Inadequate intake of vitamin A and zinc were observed in 84% and 58%, respectively, of the total study population. Conclusion RBP concentrations appear to decrease in the presence of long-term DDT uptake, which may have deleterious effects on thyroid function and vitamin A nutritional status. This is of major concern in a population with poor vitamin A and zinc intake.

Preliminary assessment of oestrogenic activity in water sources in Rietvlei Nature Reserve, Gauteng, South Africa

A preliminary assessment was made of oestrogenic activity in water sources in the Rietvlei Nature Reserve, from which water is supplied to the metropolitan area of Pretoria. Single samples were extracted from seven sites using a solid phase C18 cartridge and the extracts assessed for oestrogenic activity using the Recombinant Yeast Screen bio-assay. Estradiol equivalents ranged from 0.31–2.1 ng l−1, which are comparable to those reported for rivers near Paris (1.0–32 ng l−1) and for environmental water in Korea (0.5 pg l−1 and 7.4 ng l−1). The oestrogenic activity found in Rietvlei water samples is supported by a report of intersex in catfish, Clarias gariepinus, in the reserve. Further studies are required to determine whether this phenomenon is consistent, to determine the chemical(s) responsible for this activity and to characterise the potential effects on human, aquatic, and wildlife health in the area.

Effect of rotation on the generation of reactive oxygen species in human semen

Summary. Rotation of semen after liquefaction is a standard procedure in an Andrology laboratory. During rotation under aerobic conditions the semen is exposed to oxygen. Oxygen toxicity induces lipid peroxidation which is responsible for the loss of sperm function. The generation of reactive oxygen species was significantly increased after rotation. This may have a detrimental effect on sperm function during assisted reproduction.

Endocrine Disruptors and Health Effects in Africa: A Call for Action

Background: Africa faces a number of unique environmental challenges. Unfortunately, it lacks the infrastructure needed to support the comprehensive environmental studies that could provide the scientific basis to inform environmental policies. There are a number of known sources of endocrine-disrupting chemicals (EDCs) and other hazardous chemicals in Africa. However, a coordinated approach to identify and monitor these contaminants and to develop strategies for public health interventions has not yet been made. Objectives: This commentary summarizes the scientific evidence presented by experts at the First African Endocrine Disruptors meeting. We describe a “call to action” to utilize the available scientific knowledge to address the impact of EDCs on human and wildlife health in Africa. Discussion: We identify existing knowledge gaps about exposures to EDCs in Africa and describe how well-designed research strategies are needed to address these gaps. A lack of resources for research and a lag in policy implementation slows down intervention strategies and poses a challenge to advancing future health in Africa. Conclusion: To address the many challenges posed by EDCs, we argue that Africans should take the lead in prioritization and evaluation of environmental hazards, including EDCs. We recommend the institution of education and training programs for chemical users, adoption of the precautionary principle, establishment of biomonitoring programs, and funding of community-based epidemiology and wildlife research programs led and funded by African institutes and private companies. https://doi.org/10.1289/EHP1774

Pesticide residues and estrogenic activity in fruit and vegetables sampled from major fresh produce markets in South Africa

ABSTRACT Food is likely to be one of the major pathways through which people are exposed to endocrine-disrupting chemicals. With the exception of residual effects, there are concerns that a number of naturally occurring and synthetic chemicals exert adverse effects upon endocrine systems in wildlife and humans. The current study reports selected pesticide concentrations and the total estrogenic activity of fruit and vegetables using the recombinant yeast oestrogen screen (YES) and T47D-KBluc reporter gene assays. A total of 53 food samples (27 fruit and 26 vegetables) from Johannesburg and Tshwane fresh produce markets (in South Africa) were analysed. Of these, 17 contained one to three different pesticide residues with concentrations ranging between 0.01 and 0.68 mg kg–1, whereas in the rest of the samples no residues were detected. All pesticides detected except in one sample were below the maximum residue level (MRL), but others were unauthorised for use in specified fruit and vegetables. Estrogenic activity was detected in 26.4% (14 samples) of the samples tested, and the estradiol equivalents ranged from 0.007 to 2 pg g–1. Although the estrogenic activity was low, it may contribute to adverse health effects. Continuous monitoring for pesticides in fruit and vegetables is important in view of the unauthorised pesticides detected in produce from South Africa and the endocrine-disrupting chemical activity found.

DDT exposure levels and semen quality of young men from a malaria area in South Africa

Background The organochlorine pesticide DDT (1,1,1-trichloro-2,2-bis (chlorodiphenyl)ethane) has been used for malaria vector control in Limpopo Province, South Africa, since 1945. It is one of the Persistent Organic Pollutants (POPs) that are noted for their toxicity, persistence and bio-accumulative characteristics. Evidence of health effects in laboratory animals and wildlife are found in the scientific literature and include altered hormone activity [1]. DDT is still being used in many parts of the developing world for malaria vector control. Indoor spraying programmes in the Limpopo province include houses that are not painted on the inside. Exposure to DDT can be direct (spraying of houses) or indirect (through the food chain). DDT has got estrogenic properties and its degradation product, p,p’DDE, is an anti-androgen [2]. In response to mounting concerns about the endocrine disrupting influence of environmental chemicals on human health, this epidemiological study was initiated in a malaria area where DDT is still used. The aim of the study was to investigate the DDT/DDE exposure levels, effects on seminal parameters and possible adverse effects on human sperm genetic integrity in a non-occupationally exposed population of young health men, living in a malaria area.

Estrogenic activity, selected plasticizers and potential health risks associated with bottled water in South Africa

Potential endocrine disrupting chemicals (EDCs) are present in bottled water from various countries. In South Africa (SA), increased bottled water consumption and concomitant increases in plastic packaging create important consequences for public health. This study aimed to screen SA bottled water for estrogenic activity, selected target chemicals and assessing potential health risks. Ten bottled water brands were exposed to 20 °C and 40 °C over 10 days. Estrogenic activity was assessed using the recombinant yeast estrogen screen (YES) and the T47D-KBluc reporter gene assay. Solid phase extracts of samples were analyzed for bis(2-ethylhexyl) adipate (DEHA), selected phthalates, bisphenol-A (BPA), 4-nonylphenol (4-NP), 17β-estradiol (E2), estrone (E1), and ethynylestradiol (EE2) using gas chromatography-mass spectrophotometry. Using a scenario-based health risk assessment, human health risks associated with bottled water consumption were evaluated. Estrogenic activity was detected at 20 °C (n = 2) and at 40 °C (n = 8). Estradiol equivalent (EEq) values ranged from 0.001 to 0.003 ng/L. BPA concentrations ranged from 0.9 ng/L to 10.06 ng/L. Although EEqs and BPA concentrations were higher in bottled water stored at 40 °C compared to 20 °C, samples posed an acceptable risk for a lifetime of exposure. Irrespective of temperature, bottled water from SA contained chemicals with acceptable health risks.

Endocrine disrupting chemicals in commercially available cling film brands in South Africa

ABSTRACT Cling films comprise of plasticizers which are known endocrine disrupting chemicals (EDCs). Cling films are commonly used for food packaging and EDCs may leach into food, increasing exposure, leading to adverse health outcomes. We determined the levels of common selected EDCs expected in commercial cling film brands sold in South Africa. We tested for para-nonylphenol (p-NP), bisphenol A (BPA), bis(2-ethylhexyl) adipate (DEHA), and phthalates [di-2-ethyhexyl phthalate (DEHP) and dibutylphthalate (DBP)]. We selected eight brands of cling film and used standard chromatography methods to extract compounds. We found p-NP in one brand (2.06 µg/kg) and BPA in two brands (1.48 and 1.61 µg/kg). Five brands contained DEHP (2.1–2.59 mg/kg), DBP (0.62–1.21 mg/kg) and DEHA (165.89–674.07 mg/kg). Levels of DEHA and DEHP in the cling film are associated with potential human health risks. The maximum level of DEHA ranged from 1.6 to 16 times the safe level, with a calculated hazard quotient of 1.4. The two cling film brands made from low density polyethylene (LDPE), both endorsed by the Cancer Association of South Africa (CANSA), had target chemicals below the detection limit.

Alterations in male reproductive hormones in relation to environmental DDT exposure

DDT [1, 1, 1-trichloro-2,2-bis (p-chlorophenyl)-ethane] compounds are used for indoor residual spraying (IRS) to control malaria mosquitoes. DDT is an endocrine disruptor chemical in experimental conditions, but little is known of adverse effects related to living conditions with continual uptake across a time span by all possible means of exposure. Based on estrogenic and/or anti-androgenic effects found in animal studies, we hypothesized that chronic DDT/DDE exposures in men may be associated with changes in male reproductive hormones. We tested this hypothesis by compared the magnitude and direction of associations between DDT and DDE (1,1-dichloro-2,2-bis(p-chlorophenyl) ethylene) concentrations and male reproductive hormones in samples collected from IRS and non-IRS areas. We sampled a cross-section of 535 men (aged 18-40 years). Men living in IRS villages had significantly higher DDT and DDE concentrations compared with men from non-IRS villages. Men with DDT or DDE uptake (as reflected in detectable plasma concentrations) had significantly higher total-, free and bio-available testosterone (T), and lower follicle stimulating hormone (FSH) concentrations; lower luteinizing hormone (LH) concentrations were only evident with DDT uptake. To establish a dose-dependent effect, four sub-categories were defined. Men with the highest DDT (74-519 μg/g) and DDE (173-997 μg/g) concentrations had significantly higher total-, free and bio-available T, and lower FSH concentrations compared with subjects with non-detectable isomer concentrations. Estradiol concentrations were significantly higher in men with DDT and DDE concentrations in both the third (DDE: 27-172 μg/g; DDT: 5-73 μg/g) and fourth (DDE: 173-997 μg/g; DDT: 74-519 μg/g) categories. Men from IRS villages were significantly more likely to have higher total and bioavailable T as well as higher estradiol concentrations OR = 2.5 (95% CI 1.2, 3.2); OR 2.5 (95% CI 1.6, 4.0) and OR = 2.3 (95% CI 1.3, 4.1) compared to men from non-IRS villages, after controlling for age, BMI, personal use of pesticides, and smoking. Men living in IRS villages with life-long exposure (17.6 (±6) years) at the current residence with multiple exposure modalities incurred the highest degree of physiological imbalance over and above circulating isomer concentrations. Further studies are needed to elucidate the health implications of these findings.