Environment and Reproductive Health in China: Challenges and Opportunities

Although maternal and infant mortality has been reduced in China over the past several years, the country is still facing big challenges in reproductive health (Fang and Kaufmann 2008). In 2001, the prevalence of birth defects reported in China was higher than that in most developed One possible contributor to the reproductive health burden in China may be environmental pollution. The most populous country in the world, China has under gone rapid economic develop ment during the past 30 years. Nevertheless, this success also increases energy use and industrial waste, resulting in severely polluted air and water. Air quality in China is among the worst in the world, with air pollution levels in many cities well above permissible limits, and half of the water resources in China are considered too polluted for human use (Zhang et al. 2010a). Many industrial chemicals that have been released into the environment are endocrine disruptors that are associated with adverse effects on human reproductive health (Balabanic et al. 2011). Surveys in China have shown associations between environmental pollution and reproductive health, and specific environ mental pollutants have been correlated with increased prevalence of reproductive damage. For example, polychlorinated biphenyls (PCBs) were used mainly in eastern and central China; in a survey of birth defects in China, Zhu (2008) found that the prevalence of hypospadias declined gradually from east to west. In another study, Wang et al. (2008) investigated effects of pollution in the Black River in Henan Province, a river that flows through five counties and picks up > 90% of the local industrial waste water and domestic sewage. These authors found that the incidence of spontaneous abortion, malformations, low birth weight, and stillbirth was significantly higher for fertile women who lived by the river than for those who lived 5–10 km away from the river. In a cohort study in Tongliang county conducted in 2002–2007, Perera et al. (2008) found that after the shutdown of a nearby coal-fired power plant, the level of polycyclic aromatic hydro carbons (PAHs) generated by the plant was reduced and children's neuro behavioral develop ment was significantly improved. In China, the nation wide prevalence of birth defects in the last two decades has undergone the same increasing trend as environmental pollution. Areas in western China have lower prevalence of birth defects than do the coastal areas, where pollution is generally more severe (MOH 2011). From 1996 to 2009, …