Wong E Y, Ray R M, Gao D-L, Wernli K J, Li W, Fitzgibbons E D, Camp J E, Astrakianakis G, Heagerty P J, De Roos A J, Holt V L, Thomas D B, Checkoway H
Department of Environmental and Occupational Health Sciences, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98195-7234, USA.
Occup Environ Med. 2009 Mar;66(3):161-8. doi: 10.1136/oem.2008.039065. Epub 2008 Sep 19.
To investigate possible associations between miscarriage and occupational exposures in the Shanghai textile industry.
A retrospective cohort study of miscarriages among 1752 women in the Shanghai textile industry was conducted. Reproductive history was self-reported by women and occupational work histories were collected from factory personnel records. Occupational exposures were assigned by linking work history information to an industry-specific job-exposure matrix informed by factory-specific textile process information and industrial hygiene assessments. Estimates of cotton dust and endotoxin exposure were also assigned. Odds ratios (OR) and 95% CI were estimated by multivariate logistic regression, with adjustment for age at pregnancy, educational level, smoking status of the woman and her spouse, use of alcohol, and woman's year of birth.
An elevation in risk of a spontaneously aborted first pregnancy was associated with exposure to synthetic fibres (OR 1.89, 95% CI 1.20 to 3.00) and mixed synthetic and natural fibres (OR 3.31, 95% CI 1.30 to 8.42). No increased risks were observed for women working with solvents, nor were significant associations observed with quantitative cotton dust or endotoxin exposures. Associations were robust and similar when all pregnancies in a woman's reproductive history were considered.
Occupational exposure to synthetic fibres may cause miscarriages, and this possibility should be the subject of further investigation.
调查上海纺织行业流产与职业暴露之间可能存在的关联。
对上海纺织行业的1752名女性流产情况进行了一项回顾性队列研究。女性自行报告生育史，从工厂人事记录中收集职业工作史。通过将工作史信息与特定行业的工作暴露矩阵相关联来确定职业暴露，该矩阵由特定工厂的纺织工艺信息和工业卫生评估提供。还确定了棉尘和内毒素暴露的估计值。通过多因素逻辑回归估计比值比（OR）和95%置信区间（CI），并对怀孕时的年龄、教育程度、女性及其配偶的吸烟状况、饮酒情况以及女性的出生年份进行了调整。
首次自然流产风险的升高与合成纤维暴露（OR 1.89，95% CI 1.20至3.00）以及合成纤维与天然纤维混合暴露（OR 3.31，95% CI 1.30至8.42）有关。接触溶剂的女性未观察到风险增加，定量棉尘或内毒素暴露也未观察到显著关联。当考虑女性生育史中的所有妊娠时，关联是稳健且相似的。
职业性接触合成纤维可能导致流产，这一可能性应作为进一步调查的主题。
