Geschwind S A, Stolwijk J A, Bracken M, Fitzgerald E, Stark A, Olsen C, Melius J
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT.
Am J Epidemiol. 1992 Jun 1;135(11):1197-207. doi: 10.1093/oxfordjournals.aje.a116226.
Concern about environmental pollutants has increased; however, it remains unclear whether chronic exposures to toxic chemicals in the environment occur at doses sufficient to produce adverse health effects in humans. To date, community studies have not adequately addressed this question. In this study, the authors linked two existing data bases of the New York State Department of Health to evaluate the relation between congenital malformations and residential proximity to hazardous waste sites in New York State. A total of 9,313 newborns with congenital malformations and 17,802 healthy controls living in proximity to 590 hazardous waste sites in 1983 and 1984 were evaluated. After the authors controlled for several possible confounding factors, results indicated that maternal proximity to hazardous waste sites may carry a small additional risk of bearing children with congenital malformations (odds ratio (OR) = 1.12, 95% confidence interval (Cl) 1.06-1.18). Higher malformation rates were associated with both a higher exposure risk (no exposure risk: OR = 1.00; low exposure risk: OR = 1.09, 95% Cl 1.04-1.15; high exposure risk: OR = 1.63, 95% Cl 1.34-1.99) and documentation of off-site chemical leaks (not exposed: OR = 1.00; exposed, but no leaks at site: OR = 1.08, 95% Cl 1.02-1.15; exposed, and leaks found at site: OR = 1.17, 95% Cl 1.08-1.27). The increased rates detected may be important in terms of their public health implications. Further research is necessary to strengthen causal inferences regarding the teratogenicity, of waste site exposure.
人们对环境污染物的担忧日益增加；然而，目前尚不清楚长期接触环境中的有毒化学物质是否会达到足以对人类健康产生不良影响的剂量。迄今为止，社区研究尚未充分解决这个问题。在本研究中，作者将纽约州卫生部的两个现有数据库相链接，以评估先天性畸形与纽约州危险废物场地附近居民之间的关系。对1983年和1984年居住在590个危险废物场地附近的9313名患有先天性畸形的新生儿和17802名健康对照进行了评估。在作者控制了几个可能的混杂因素后，结果表明，母亲居住在危险废物场地附近可能会增加生育先天性畸形儿童的额外风险（优势比（OR）=1.12，95%置信区间（Cl）1.06 - 1.18）。较高的畸形率与较高的暴露风险（无暴露风险：OR = 1.00；低暴露风险：OR = 1.09，95% Cl 1.04 - 1.15；高暴露风险：OR = 1.63，95% Cl 1.34 - 1.99）以及场外化学物质泄漏的记录有关（未暴露：OR = 1.00；暴露但场地无泄漏：OR = 1.08，95% Cl 1.02 - 1.15；暴露且场地发现泄漏：OR = 1.17，95% Cl 1.08 - 1.27）。检测到的发病率增加就其对公共卫生的影响而言可能很重要。有必要进行进一步研究，以加强关于废物场地暴露致畸性的因果推断。
