Bukowski J A
Occupational and Public Health Division, ExxonMobil Biomedical Sciences, Inc., 1545 Route 22 East, Annandale, NJ 08801-0971, USA.
Regul Toxicol Pharmacol. 2001 Apr;33(2):147-56. doi: 10.1006/rtph.2000.1448.
This review examines the epidemiological evidence for adverse reproductive outcomes from those occupational studies that present toluene-specific findings. Clinical investigations of the reproductive effects of toluene abuse are also examined. Six occupational studies reported associations between toluene and spontaneous abortion, two between toluene and congenital malformation, and three between toluene and reduced fertility. The spontaneous abortion studies provided the most suggestive evidence for an association with toluene. However, the potential for bias in some of these studies, the relatively homogeneous nature of the populations examined (e.g., four of the six studies evaluated similar groups of Finnish workers), and the multiple chemicals to which most workers were simultaneously exposed suggest cautious interpretation of these findings. Also, spontaneous abortion has generally not been observed as a major problem among highly exposed women who abuse toluene during pregnancy. The results of the occupational studies should be considered "hypothesis generating". Truly prospective studies with individually monitored data on toluene exposure and early fetal loss are needed to more definitively investigate this issue.
本综述考察了那些呈现甲苯特定研究结果的职业研究中关于不良生殖结局的流行病学证据。同时也审视了甲苯滥用对生殖影响的临床调查。六项职业研究报告了甲苯与自然流产之间的关联，两项报告了甲苯与先天性畸形之间的关联，三项报告了甲苯与生育力降低之间的关联。自然流产研究为甲苯关联提供了最具启发性的证据。然而，其中一些研究存在偏倚的可能性、所研究人群相对同质的性质（例如，六项研究中的四项评估了类似的芬兰工人群体）以及大多数工人同时接触的多种化学物质，这表明对这些发现的解读需谨慎。此外，在孕期滥用甲苯的高暴露女性中，自然流产通常并未被视为一个主要问题。职业研究的结果应被视为“产生假设”。需要进行真正的前瞻性研究，对甲苯暴露和早期胎儿丢失进行个体监测数据，以便更确切地调查这个问题。
