ASSESSMENT OF REPRODUCTIVE DISORDERS AND BIRTH-DEFECTS IN COMMUNITIESNEAR HAZARDOUS CHEMICAL SITES .2. FEMALE REPRODUCTIVE DISORDERS

Members of the workgroup on female reproductive disorders discussed me thods to evaluate five principal functions: menstrual dysfunction, inf ertility, pregnancy loss, lactation disorders, and pregnancy complicat ions. To test each function, a nested strategy was considered, based o n progressive levels of effort available to conduct field investigatio ns. This strategy mas analogous to the three-tier classification of bi omarkers used by other workshops. The lowest level of effort, correspo nding to Tier 1, consists only of questionnaires, diaries, and reviews of maternal and infant medical records. The medium level of effort (T ier 2) collects data from questionnaires and diaries, and some biologi c specimens, Suggested laboratory analyses included measurement of pro gesterone in saliva and several glycoprotein hormones in urine that ev aluate menstrual dysfunction, infertility, and pregnancy loss. The hig hest level of effort (Tier 3) involves prospective collection of diary information and simultaneous collection of biological specimens. (C) 1997 Elsevier Science Inc.