Langlois Peter H, Hoyt Adrienne T, Desrosiers Tania A, Lupo Philip J, Lawson Christina C, Waters Martha A, Rocheleau Carissa M, Shaw Gary M, Romitti Paul A, Gilboa Suzanne M, Malik Sadia
Texas Center for Birth Defects Research and Prevention, Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA.
Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA.
Occup Environ Med. 2014 Aug;71(8):529-35. doi: 10.1136/oemed-2013-101833. Epub 2014 Jun 3.
While some of the highest maternal exposures to polycyclic aromatic hydrocarbons (PAHs) occur in the workplace, there is only one previous study of occupational PAH exposure and adverse pregnancy outcomes. We sought to extend this literature using interview data combined with detailed exposure assessment.
Data for 1997-2002 were analysed from mothers of infants without major birth defects in the National Birth Defects Prevention Study, a large population-based case-control study in the USA. Maternal telephone interviews yielded information on jobs held in the month before conception through delivery. From 6252 eligible control mothers, 2803 completed the interview, had a job, met other selection criteria, and were included in the analysis. Two industrial hygienists independently assessed occupational exposure to PAHs from the interview and reviewed results with a third to reach consensus. Small for gestational age (SGA) was the only adverse pregnancy outcome with enough exposed cases to yield meaningful results. Logistic regression estimated crude and adjusted ORs.
Of the 2803 mothers, 221 (7.9%) had infants who were SGA. Occupational PAH exposure was found for 17 (7.7%) of the mothers with SGA offspring and 102 (4.0%) of the remaining mothers. Almost half the jobs with exposure were related to food preparation and serving. After adjustment for maternal age, there was a significant association of occupational exposure with SGA (OR=2.2, 95% CI 1.3 to 3.8).
Maternal occupational exposure to PAHs was found to be associated with increased risk of SGA offspring.
虽然孕妇接触多环芳烃(PAHs)水平最高的情况有些发生在工作场所,但之前仅有一项关于职业性PAH暴露与不良妊娠结局的研究。我们试图通过结合访谈数据与详细暴露评估来拓展这方面的文献。
对美国一项基于人群的大型病例对照研究——国家出生缺陷预防研究中无重大出生缺陷婴儿的母亲在1997 - 2002年的数据进行分析。通过对母亲的电话访谈获取从受孕前到分娩当月所从事工作的信息。在6252名符合条件的对照母亲中,2803名完成了访谈、有工作、符合其他入选标准并被纳入分析。两名工业卫生学家根据访谈独立评估职业性PAH暴露情况,并与第三名专家共同审核结果以达成共识。小于胎龄儿(SGA)是唯一有足够数量暴露病例从而能得出有意义结果的不良妊娠结局。采用逻辑回归估计粗比值比(OR)和校正后的OR。
在2803名母亲中,221名(7.9%)的婴儿为小于胎龄儿。在有SGA后代的母亲中,17名(7.7%)被发现有职业性PAH暴露,其余母亲中有102名(4.0%)有职业性PAH暴露。几乎一半的暴露工作与食品制备和服务有关。在对母亲年龄进行校正后,职业暴露与SGA存在显著关联(OR = 2.2,95%可信区间为1.3至3.8)。
发现母亲职业性接触PAHs与SGA后代风险增加有关。