Domestic Exposure to Chemicals in Household Products, Building Materials, Decoration, and Pesticides: Guidelines for Interventions During the Perinatal Period from the French National College of Midwives.

INTRODUCTION: We are exposed to numerous pollutants inside our homes. The perinatal period represents a particular window of vulnerability during which these exposures can have negative health effects over a more or less long term. The objective of this article is to formulate guidelines for health care professionals and intended for parents to reduce exposure to chemical pollutants at home, based on the scientific literature and already existing guidelines. METHODS: We have followed the methodological procedures set forth by the French authority for health (HAS) to establish guidelines to limit exposure to pollutants in homes. This narrative review of the scientific literature was conducted with two principal objectives: (1) to identify priority substances emitted within homes and that have a reprotoxic potential and (2) to identify measures to limit exposure to these residential pollutants. The guidelines were developed from the data in the literature and from advice already made available by diverse institutions about environmental health during the perinatal period. RESULTS: Domestic pollutants are numerous and come from both common (that is, shared, eg, painting, cleaning, and maintenance work) and specific (use of household pesticides) sources. Numerous pollutants are suspected or known to produce developmental toxicity, that is, to be toxic to children during developmental stages. Removing some products from the home, protecting the vulnerable (ie, pregnant women and young children) from exposure, and airing the home are among the preventive measures proposed to limit exposure to these chemical substances. CONCLUSION: Health care professionals can provide advice to parents during the perinatal period to diminish exposure to household pollutants. The lack of interventional studies nonetheless limits the level of evidence for most of these recommendations.

Intervention during the Perinatal Period: Synthesis of the Clinical Practice Guidelines from the French National College of Midwives.

These clinical practice guidelines from the French National College of Midwives (CNSF) are intended to define the messages and the preventive interventions to be provided to women and co-parents by the different professionals providing care to women or their children during the perinatal period. These guidelines are divided into 10 sections, corresponding to 4 themes: 1/ the adaptation of maternal behaviors (physical activity, psychoactive agents); 2/ dietary behaviors; 3/ household exposure to toxic substances (household uses, cosmetics); 4/ promotion of child health (breastfeeding, attachment and bonding, screen use, sudden unexplained infant death, and shaken baby syndrome). We suggest a ranking to prioritize the different preventive messages for each period, to take into account professionals' time constraints.