Gender Differences in Susceptibility to Environmental Factors A Priority Assessment (1998) / Chapter Skim
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Workshop Report
Workshop Report
Pages 3-24
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From page 3... ...
Various factors, such as genetics and hormones, may account for gender differences in susceptibility to environmental factors. In the development of approaches to disease prevention and heals promotion, to behavioral and medical interventions, or to He initiation of research strategies, many have come to realize that special consideration must be given to heals effects that are either gender-specific to or are ove~Tepresented in women because of environmental factors such as occupation, behavior, lifestyle, hobbies, reproductive status, or physical activity.
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Review the charge of the committee. The phrase "gender differences" implies assessing differences and similarities between men and women; however, discussions with relevant agency representatives indicated a need to focus on women's unique susceptibility.
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Relevant data sought by the committee revealed gaps in knowledge or offered resew information that displayed specific gender differences in disease initiation, progression, or outcome. WORKSHOP Because of the extensive information reviewed at the organizational meeting,, the committee designed the workshop to review broad aspects of environmental exposure that would be common among women.
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Presentations included issues related to environmental exposure in the workplace, environmental exposure and nutrition, and multiple environmental exposures over a woman's lifespan. The second panel focused on patterns of susceptibility, with presentations on various clinical and basic research studies.
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Subsequent to the workshop, the committee met to discuss the results of the meeting and to outline areas for recommendations and priorities. This report provides highlights of the workshop and a summary analysis of the research portfolios provided to the committee by the sponsoring agencies.
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have on differential health outcomes between populations of men and women; · ultraviolet radiation (men are more likely to work outdoors, but women are more likely to sunbathe) , dietary and environmental estrogens as variables of the hormonal cycle; also, changes in dietary behavior Hat increase exposure to phytoestrO7ens; methods for detoxifying, the body, such as chelation agents to bind and remove a toxicant, particularly if the detoxifying, process makes once-stored agents more bioavailable; e the role that race, ethnicity, and culture may have in establishing differential exposures between men and women of a given subpopulation or between women of different racial, ethnic, or cultural groups; · accessibility of the raw data from the National Health and Nutrition Examination Survey-III (NHANES-III)
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From page 9... ...
, occupational data, and environmental exposure measures. Others felt that researchers should be encouraged to submit proposals for secondary analyses of existing, NHANES data that include testable hypotheses.
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Environmental exposures often implicate biological, chemical, and physical agents. However, in addressin, the issue of gender differences in susceotibilitY to environmental exposures.
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Similarly, the def~nition of"susceptibility" could include all adverse outcomes except those that are directly related to hypersensitivity or allergy. Finally, the definition of "gender differences" can include aspects that are sophisticated enough to separate =,enetic and physiobiological differences between men and women from differences in environmental exposure, which in many cases result from the independent and interactive effects of socioeconomic status, employment patterns, and family, role and cultural experiences sometimes called inherent vs.
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Research should be based on a broader inclusion of factors in the definition of "environmental exposure." In addressing gender differences in environmental exposures, it is important to broaden the inclusion of factors in the definition of"environmental" to include not only chemicals, physical agents, and pathogens but also nutritional, 2Subsequent to the workshop, the committee was made aware of a listing of federal projects related to women and environmental factors, developed by the Office on Women's Health, of the Department of Health and Human Services. However, this listing did not specifically highlight research designated in this area.
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From page 13... ...
In developing areas for research on the human health consequences of exposure to harmful physical and chemical agents in the environment, the relevant domains that should be evaluated are occupational and nonoccupational exposures, residence, physiological parameters, physical activities, and nutrition and diet. In the development of behavioral and medical interventions or the initiation of intera=,ency research strategies and initiatives, special consideration must be ,iven to gender-specific outcomes determined by occupation, behavior, lifestyle, hobbies, reproductive status, and physical activities.
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4. Research should examine gender differences in susceptibility to environmental factors over the entire lifespan as well as during critical exposure periods such as fetal development.
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Further research is needed to develop more accurate animal models for a variety of over measurers of susceptibility studies.
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For example, although fewer men than women contract multiple sclerosis, the disease is more severe in men than women, and the 1 0-year mortality rate is higher. It may be Hat gender differences in neuroendocrine or immune responses, as well as differential exposures, will explain some of the gender differences in chronic diseases such as diabetes.
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Genetic polymorphisms and mutations play a potential role in ethnic as well as gender differences win regard to susceptibility to environmental factors. Research that identifies specific genes or combinations of genes that are reliable predictors of susceptibility could produce enormous benefits for both prevention and diagnosis.
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For these reasons, basic researchers should look for the broader implications of the mechanistic research conducted at the molecular, cellular, and animal levels. In particular, sponsoring agencies should encourage the development of animal models that are directly relevant to (1)
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19 Many of the research priorities described are interdisciplinary in nature and will require interdisciplinary peer review. Such interdisciplinary review groups are more challenging to conduct; hence, all sponsoring agencies should work together to meet the peer review challenge.
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The overall goal of the WHI is to reduce coronal heart disease, breast and colorectal cancer, and osteoporotic fractures among postmenopausal women through prevention/intervention strategies and risk factor identification. WHI is a 1 5-year effort that is budgeted for $625 million.
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The broader public health community should be encouraged to find ways to improve and broaden such utilization in the future. Large-scale health surveys and their databases, particularly longitudinal and cross-sectional data from study populations, contain potentially valuable information that could be used to study environmental issues.
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The National Cancer Institute supports a number of cancer registries whose resources are generally available to interested researchers. Additional resources of this sort are maintained by private nonprofit groups: the American Type Culture Collection, for example, collects human normal and tumor cell lines as well as microbial cell lines; the Human Biological Data Interchan ,e collects lon~,itudinal samples from families with autoimmune disorders.
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The committee believes Hat these recommendations, taken together, provide a good beginning for the identification of research priorities and interagency initiatives Hat are well within He mission of He various agencies involved. As additional resources become available, it is hoped Hat research priorities in this area can be implemented.
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