title: Environmental and occupational exposure to bisphenol A and endometriosis: urinary and peritoneal fluid concentration levels.
abstract: OBJECTIVE
  The study aimed to give a first data set of bisphenol A (BPA) levels in the peritoneal fluid of patients suffering from endometriosis and to investigate the relationship between BPA exposure and endometriosis.
  
  
  METHODS
  A questionnaire investigating the occupational context, life environment, and habits was administered to 68 patients suffering from endometriosis and 60 endometriosis-free subjects (control group). Urine and peritoneal fluids samples were collected and analysed by GC/MSMS for BPA dosage.
  
  
  RESULTS
  Some of the investigated environmental/lifestyle risk factors (closeness to industries/activities at risk) were associated with an increase in endometriosis; smoking resulted as protective factor; others (use of food plastic boxes) did not seem to influence the onset of pathology. The association between the occupational exposure summarising all examined risk factors (working activity, personal protective equipment, seniority) and endometriosis was statistically significant (χ2= 5.252, p = 0.02). Contrasting results were obtained when specific activities were examined. Detectable urinary BPA levels were found in all analysed samples (patients: 1.17-12.68 pg/µl; mean ± SD, 5.31 ± 3.36 pg/µl; control group: 1.28-2.35 pg/µl; mean ± SD, 1.64 ± 0.49 pg/µl; median; 1.46 pg/µl), with a statistically significant difference between patients and controls, showing an association between BPA exposure and endometriosis. Only a few subjects from the control group supplied peritoneal fluid; hence, no comparison test with patients (range 0.39-1.46 pg/µl; mean ± SD, 0.67 ± 0.30 pg/µl; median, 0.58 pg/µl) was carried out.
  
  
  CONCLUSIONS
  Results highlight the potential association between BPA exposure and endometriosis, as well as the current lack of knowledge regarding occupational exposure to BPA and the need of epidemiological studies focused on single activities/occupations, such as housewives, cleaners, students.
authors.affiliation: Occupational Medicine Area-Hygiene, Occupational and Forensic Section, Department of Experimental Medicine, School of Medicine, Second University of Naples, Caserta, Italy.|Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples "Federico II", Via S. Pansini 5, II Policlinico, Ed. 20, 80131, Naples, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Simonelli
authors.affiliation: Occupational Medicine Area-Hygiene, Occupational and Forensic Section, Department of Experimental Medicine, School of Medicine, Second University of Naples, Caserta, Italy.|Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples "Federico II", Via S. Pansini 5, II Policlinico, Ed. 20, 80131, Naples, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Guadagni
authors.affiliation: Department of Women and Children and General and Specialized Surgery, Second University of Naples, Caserta, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: De Franciscis
authors.affiliation: Department of Women and Children and General and Specialized Surgery, Second University of Naples, Caserta, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Colacurci
authors.affiliation: Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples "Federico II", Via S. Pansini 5, II Policlinico, Ed. 20, 80131, Naples, Italy. maria.pieri@unina.it.
authors.forename: Maria
authors.identifier: http://orcid.org/0000-0002-4184-5718
authors.initials: M
authors.lastname: Pieri
authors.affiliation: Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples "Federico II", Via S. Pansini 5, II Policlinico, Ed. 20, 80131, Naples, Italy.
authors.forename: Pascale
authors.initials: P
authors.lastname: Basilicata
authors.affiliation: Occupational Medicine Area-Hygiene, Occupational and Forensic Section, Department of Experimental Medicine, School of Medicine, Second University of Naples, Caserta, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Pedata
authors.affiliation: Occupational Medicine Area-Hygiene, Occupational and Forensic Section, Department of Experimental Medicine, School of Medicine, Second University of Naples, Caserta, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Lamberti
authors.affiliation: Occupational Medicine Area-Hygiene, Occupational and Forensic Section, Department of Experimental Medicine, School of Medicine, Second University of Naples, Caserta, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Sannolo
authors.affiliation: Occupational Medicine Area-Hygiene, Occupational and Forensic Section, Department of Experimental Medicine, School of Medicine, Second University of Naples, Caserta, Italy.
authors.forename: Nadia
authors.initials: N
authors.lastname: Miraglia
mesh_terms: D000328:Adult; D001202:Ascitic Fluid / Q000737:chemistry; D001559:Benzhydryl Compounds / Q000032:analysis* / Q000633:toxicity; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D004715:Endometriosis / Q000139:chemically induced* / Q000652:urine; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis*; D005260:Female; D006801:Humans; D009784:Occupational Diseases / Q000139:chemically induced* / Q000652:urine; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D010636:Phenols / Q000032:analysis* / Q000633:toxicity; D012307:Risk Factors; D000098826:Bisphenol A Compounds
chemical_list: D001559:Benzhydryl Compounds; D015415:Biomarkers; D010636:Phenols; C006780:bisphenol A; D000098826:Bisphenol A Compounds
keywords: Bisphenol A; Endometriosis; Occupational exposure; Peritoneal fluid; Urinary levels