Lead, reproduction and development

Lead remains a significant occupational health and public health problem. Excessive lead exposure, not only to men exposed at work, but also from lead based paint in older housing and from soil, still persists in the community. From the perspective of human reproduction, lead is known to cause a number of adverse outcomes in both men and women. Reported effects in men include reduced libido, effects on spermatogenesis (reduced motility and numbers, increased normal morphology), chromosomal damage, infertility, abnormal prostatic function and changes in serum testosterone. Most of these effects have been seen in lead exposed workers, and some are at levels presently considered 'acceptable'. Effects in women include infertility, miscarriage, premature membrane rupture, pre-eclampsia, pregnancy hypertension and premature delivery. Again, recent research findings indicate that lead may be toxic at levels previously thought to have no effect. The evidence implicating a possible teratogenic effect of lead is much less clear. While there is some indication of an association of lead with the production of anomalies, any dose-response relationship or causal mechanism has yet to be established. Therefore, while lead does affect human reproduction, the question: Is lead a teratogen? is yet to be answered.