Hanke Wojciech, Jurewicz Joanna
Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lódź, Poland.
Int J Occup Med Environ Health. 2004;17(2):223-43.
The epidemiological studies presented in this paper refer to the association between agricultural occupation of parents and the incidence of infertility, congenital malformations, miscarriage, low birthweight, small-for-gestational-age (SGA) birth, preterm delivery and stillbirth. The results of the analyses showed that employment in agriculture increases the risk of specific morphological abnormalities in sperm, including the decreased sperm count per ejaculate and declined percentage of viable sperm. In general, no effect of exposure to pesticides on sexual hormones was observed. The data on the effect of employment in agriculture on the time to pregnancy are unequivocal, but most of them suggest that there is a relationship between the decreased fecundability ratio and pesticide exposure. Nor does the research on the sex ratio of offspring provide explicit results. The analyses indicate that parental employment in agriculture could increase the risk of congenital malformations in the offsprings, particularly such as orofacial cleft, birthmarks in the form of hemangioma as well as musculoskeletal and nervous system defects. The data on the effect of occupational exposure to pesticides on birthweight are inconsistent. Although most of epidemiological studies do not reveal a significantly increased risk of SGA, a slower pace of fetal development corresponding to SGA in the population of women exposed to pyrethroids has been recently reported. There are also some indications that exposure to pesticides may contribute to stillbirth and female infertility. The literature review suggests a great need to increase awareness of workers who are occupationally exposed to pesticides about their potential negative influence on fertility and pregnancy outcome. In the light of existing although still limited evidence of adverse effects of pesticide exposure on fertility during the preconceptual period, it is necessary to reduce the exposure to pesticides.
本文所呈现的流行病学研究涉及父母从事农业工作与不孕、先天性畸形、流产、低出生体重、小于胎龄儿(SGA)出生、早产和死产发生率之间的关联。分析结果表明,从事农业工作会增加精子出现特定形态异常的风险,包括每次射精的精子数量减少以及活精子百分比下降。总体而言,未观察到接触农药对性激素有影响。关于从事农业工作对受孕时间影响的数据并不明确,但大多数数据表明生育力比率下降与接触农药之间存在关联。关于后代性别比例的研究也未得出明确结果。分析表明,父母从事农业工作可能会增加后代先天性畸形的风险,尤其是诸如口腔面部裂、血管瘤形式的胎记以及肌肉骨骼和神经系统缺陷。关于职业接触农药对出生体重影响的数据并不一致。尽管大多数流行病学研究未发现SGA风险显著增加,但最近有报道称,在接触拟除虫菊酯的女性人群中,胎儿发育速度与SGA相应减缓。也有一些迹象表明,接触农药可能导致死产和女性不孕。文献综述表明,非常有必要提高职业接触农药的工人对其对生育和妊娠结局潜在负面影响的认识。鉴于现有(尽管仍然有限)的证据表明孕前接触农药会对生育产生不利影响,有必要减少农药接触。