Savitz, David A. (1997). Offspring Sex Ratio as a Potential Monitor of Reproductive Disorders in Communities near Hazardous Chemical Sites: Reply. Reproductive Toxicology, 11(6)
Dr. James contends that alterations in the sex ratio should be added to the array of markers of reproductive toxicity used to monitor populations exposed to chemical hazards. As discussed by the Workgroup assembled by the Agency for Toxic Substances and Disease Registries that focused on reproductive disorders and birth defects (l), the ideal markers would be applicable to small populations, capable of identifying modest effects, and would be responsive specifically to the hazardous agents of concern (or other influences on those markers would be amenable to measurement and statistical control). In our evaluation, we favored the use of rather conventional indicators of infant health as the default approach when there was a general concern with hazardous agents (Tier I), but no clear indications regarding specific agents or outcomes. More refined measures (Tier 2) were to be applied when a particular hazardous agent was documented or a specific health problem was of concern. It seems that alteration in the sex ratio is intended primarily as a tool in Tier 1, to serve as a general marker of disruption in reproductive function, in that there are not specific exposures or other reproductive health events that would point towards altered sex ratio as the marker of choice.
Savitz, David A.