Paredes Alpaca Rudy Ivan, Forastiere Francesco, Pirani Monica
Servizio di prevenzione e sicurezza negli ambienti di lavoro, Distretto di Vignola, Azienda unità sanitaria locale di Modena.
Epidemiol Prev. 2013 Nov-Dec;37(6):367-75.
to assess the effects of low levels of lead exposure on reproductive health (miscarriage, fertility, multiple births, sex ratio at birth, incidence of some diseases during pregnancy), following a cohort of female workers exposed to lead in the ceramic tile industry in the Municipalities of Scandiano (RE) and Sassuolo (MO), Northern Italy.
a cohort of 2,067 female workers was considered. These workers repeatedly underwent blood lead levels testing at the Toxicology Laboratory of Scandiano (RE) in the period 1998-2004. Follow-up was performed for each subject for the 12 months following any blood lead testing. Data on miscarriages and live births were obtained through a linkage with hospital discharge records. Results were compared with the frequency of events in the general female population in the Emilia-Romagna Region (Northern Italy). The frequency of multiple births was also examined, as well as the ratio of male-to-female infants and maternal diseases during pregnancy. An internal analysis within the cohort was conducted to evaluate the associations with increasing lead levels.
the women under study accumulated 5,722 person-years of observation. The age distribution of study subjects was not different from the one observed in the Region. Thirty-one miscarriages and 212 live births were recorded. The miscarriage rate (5.42‰) among the study subjects was not different from the regional reference, while the fertility rate (37.05‰) was lower (RR: 0.72; 95%CI 0.63-0.83). The frequency of multiple births (1.9%) was similar to the regional rate (1.2%). Eighty-six females (40.57%) and 126 males (59.43%) were born, compared to regional percentages of 49% females and 51% males. Of all the indicators examined, only miscarriage showed a positive trend among women exposed to lead. In addition, women exposed to lead had a higher frequency of hypertension during pregnancy (RR: 1.34; 95%CI 1.07-1.68), problems with the amniotic cavity (RR: 1.16; 95%CI 1.02-1.33), and prolonged pregnancy (RR: 1.37; 95%CI 1.09-1.73).
the cohort of female subjects under study showed rate of miscarriage similar to the general population and a lower fertility rate. There were a higher percentage of male births and an increase of some conditions during pregnancy possibly related to lead exposure.
在意大利北部斯坎迪亚诺（雷焦艾米利亚省）和萨索洛（摩德纳省）瓷砖行业中，对一组接触铅的女性工人进行队列研究，以评估低水平铅暴露对生殖健康（流产、生育能力、多胎妊娠、出生性别比、孕期某些疾病的发病率）的影响。
纳入2067名女性工人队列。这些工人在1998 - 2004年期间于斯坎迪亚诺（雷焦艾米利亚省）毒理学实验室反复进行血铅水平检测。对每位受试者在每次血铅检测后的12个月进行随访。通过与医院出院记录建立联系获取流产和活产的数据。将结果与艾米利亚 - 罗马涅地区（意大利北部）普通女性人群的事件发生频率进行比较。还检查了多胎妊娠的频率、男婴与女婴的比例以及孕期母亲疾病情况。在队列内部进行分析以评估与铅水平升高的关联。
研究中的女性累积观察人年数为5722人年。研究对象的年龄分布与该地区观察到的年龄分布无差异。记录到31例流产和212例活产。研究对象中的流产率（5.42‰）与地区参考值无差异，而生育率（37.05‰）较低（相对危险度：0.72；95%置信区间0.63 - 0.83）。多胎妊娠的频率（1.9%）与地区发生率（1.2%）相似。出生的女性为86名（40.57%），男性为126名（59.43%），而地区百分比为女性49%，男性51%。在所有检查的指标中，只有流产在接触铅的女性中呈上升趋势。此外，接触铅的女性孕期高血压的发生率更高（相对危险度：1.34；95%置信区间1.07 - 1.68），羊膜腔问题发生率更高（相对危险度：1.16；95%置信区间1.02 - 1.33），以及过期妊娠发生率更高（相对危险度：1.37；95%置信区间1.09 - 1.73）。
所研究的女性队列显示流产率与普通人群相似，生育率较低。男婴出生比例较高，孕期某些情况增加，可能与铅暴露有关。
