Orr Maureen, Bove Frank, Kaye Wendy, Stone Melanie
Agency for Toxic Substances and Disease Registry (ATSDR), Division of Health Studies.
Int J Hyg Environ Health. 2002 Mar;205(1-2):19-27. doi: 10.1078/1438-4639-00126.
This case-control study evaluated the relationship between birth defects in racial or ethnic minority children born during 1983-1988 and the potential exposure of their mothers to contaminants at hazardous waste sites in California. Four categories of race or ethnicity were used: black/African American, Hispanic/Latino, American Indian/Alaska Native, and Asian/Pacific Islander. Case subjects were 13,938 minority infants with major structural birth defects (identified by the California Birth Defects Monitoring Program) whose mothers resided in selected counties at the time of delivery. The control group was composed of 14,463 minority infants without birth defects who were randomly selected from the same birth cohort as the case subjects. The potential for exposure was determined by whether the mother resided at the time of delivery in the same census tract as a hazardous waste site that was on the U.S. Environmental Protection Agency's National Priorities List (NPL). Racial/ethnic minority infants whose mothers had been potentially exposed to hazardous waste were at slightly increased risk for birth defects (odds ratio [OR] = 1.12, 95% confidence interval [CI] = 0.98-1.27) than were racial/ethnic minority infants whose mothers had not been potentially exposed. The greatest association was between potential exposure and neural tube defects (OR = 1.54, 95% CI = 0.93-2.55), particularly anencephaly (OR = 1.85, 95% CI = 0.91-3.75). The strongest association between birth defects and potential exposure was among American Indians/Alaska Natives (OR = 1.19, 95% CI = 0.62-2.27). Despite the limitations of this study, the consistency of these findings with previous studies suggests an association between environmental risk factors and birth defects. This is particularly relevant to minority populations. We recommend further investigation of birth defects among minority communities, particularly among American Indians/Alaska Natives. Special attention should also be paid to those defects and contaminants that consistently are associated with exposure to hazardous waste.
这项病例对照研究评估了1983年至1988年期间出生的种族或族裔少数群体儿童的出生缺陷与其母亲在加利福尼亚州危险废物场所可能接触污染物之间的关系。使用了四类种族或族裔：黑人/非裔美国人、西班牙裔/拉丁裔、美国印第安人/阿拉斯加原住民以及亚裔/太平洋岛民。病例组为13938名患有主要结构性出生缺陷的少数群体婴儿（由加利福尼亚州出生缺陷监测项目确定），其母亲在分娩时居住在选定的县。对照组由14463名无出生缺陷的少数群体婴儿组成，这些婴儿是从与病例组相同的出生队列中随机选取的。接触可能性通过母亲在分娩时是否居住在与美国环境保护局国家优先事项清单（NPL）上的危险废物场所相同的普查区来确定。母亲有可能接触危险废物的种族/族裔少数群体婴儿出现出生缺陷的风险略高于母亲未接触危险废物的种族/族裔少数群体婴儿（优势比[OR]=1.12，95%置信区间[CI]=0.98 - 1.27）。潜在接触与神经管缺陷之间的关联最为显著（OR = 1.54，95% CI = 0.93 - 2.55），尤其是无脑儿（OR = 1.85，95% CI = 0.91 - 3.75）。出生缺陷与潜在接触之间最强的关联存在于美国印第安人/阿拉斯加原住民中（OR = 1.19，95% CI = 0.62 - 2.27）。尽管本研究存在局限性，但这些发现与先前研究的一致性表明环境风险因素与出生缺陷之间存在关联。这对少数群体尤为重要。我们建议进一步调查少数群体社区中的出生缺陷情况，特别是美国印第安人/阿拉斯加原住民社区。还应特别关注那些始终与接触危险废物相关的缺陷和污染物。
