Schnorr T M, Grajewski B A, Hornung R W, Thun M J, Egeland G M, Murray W E, Conover D L, Halperin W E
Industrywide Studies Branch, National Institute for Occupational Safety and Health, Cincinnati, OH 45226.
N Engl J Med. 1991 Mar 14;324(11):727-33. doi: 10.1056/NEJM199103143241104.
The relation between spontaneous abortion and the use of video display terminals (VDTs) is of great public health concern. Previous investigators of this issue have reported inconsistent findings.
To determine whether electromagnetic fields emitted by VDTs are associated with an increased risk of spontaneous abortion, a cohort of female telephone operators who used VDTs at work was compared with a cohort of operators who did not use VDTs. To obtain reliable estimates of exposure, we determined the number of hours of VDT use per week from company records and measured electromagnetic fields at VDT workstations and, for purposes of comparison, at workstations without VDTs. Operators who used VDTs had higher abdominal exposure to very-low-frequency (15 kHz) electromagnetic fields (workstations without VDTs did not emit very-low-frequency energy). Abdominal exposure to extremely-low-frequency fields (45 to 60 Hz) was similar for both operators who used VDTs and those who did not. Among 2430 women interviewed, there were 882 pregnancies that met our criteria for inclusion in the study.
We found no excess risk of spontaneous abortion among women who used VDTs during the first trimester of pregnancy (odds ratio = 0.93; 95 percent confidence interval, 0.63 to 1.38), and no dose-response relation was apparent when we examined the women's hours of VDT use per week (odds ratio for 1 to 25 hours per week = 1.04; 95 percent confidence interval, 0.61 to 1.79; odds ratio for greater than 25 hours per week = 1.00; 95 percent confidence interval, 0.61 to 1.64). There continued to be no risk associated with the use of VDTs when we accounted for multiple pregnancies, conducted separate analyses of early abortion, late abortion, and all fetal losses, or limited our analyses to spontaneous abortions for which a physician was consulted.
The use of VDTs and exposure to the accompanying electromagnetic fields were not associated with an increased risk of spontaneous abortion in this study.
自然流产与视频显示终端(VDT)的使用之间的关系备受公众健康关注。此前对该问题的研究人员报告的结果并不一致。
为了确定VDT发出的电磁场是否与自然流产风险增加有关,将一组在工作中使用VDT的女性电话接线员与一组不使用VDT的接线员进行比较。为了获得可靠的暴露估计值,我们从公司记录中确定每周使用VDT的小时数,并在VDT工作站测量电磁场,为作比较,也在没有VDT的工作站测量。使用VDT的接线员腹部受到的极低频(15千赫)电磁场暴露更高(没有VDT的工作站不发出极低频能量)。使用VDT的接线员和不使用VDT的接线员腹部受到的极低频场(45至60赫兹)暴露相似。在接受访谈的2430名女性中,有882例妊娠符合我们纳入研究的标准。
我们发现,在妊娠头三个月使用VDT的女性中,自然流产风险并未增加(优势比=0.93;95%置信区间为0.63至1.38),并且当我们检查女性每周使用VDT的小时数时,未发现明显的剂量反应关系(每周使用1至25小时的优势比=1.04;95%置信区间为0.61至1.79;每周使用超过25小时的优势比=1.00;95%置信区间为0.61至1.64)。当我们考虑多胎妊娠、分别对早期流产、晚期流产和所有胎儿丢失进行分析,或将分析限于咨询过医生的自然流产时,使用VDT仍然没有风险。
在本研究中,VDT的使用以及伴随的电磁场暴露与自然流产风险增加无关。