Spinder Nynke, Bergman Jorieke E H, Boezen H Marike, Vermeulen Roel C H, Kromhout Hans, de Walle Hermien E K
Department of Epidemiology, University of Groningen, University Medical Center Groningen, HPC FA 40, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands.
Department of Genetics, University of Groningen, University Medical Center Groningen, HPC CB 51, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands.
Environ Health. 2017 Aug 4;16(1):83. doi: 10.1186/s12940-017-0294-5.
Previous studies suggest that periconceptional maternal occupational exposure to solvents and pesticides increase the risk of oral clefts in the offspring. Less is known about the effect of occupational exposure to metals, dust, and gases and fumes on development of oral clefts.
This case-malformed control study used data from a population-based birth defects registry (Eurocat) of children and foetuses born in the Northern Netherlands between 1997 and 2013. Cases were defined as non-syndromic oral clefts. The first control group had chromosomal/monogenic defects, and the second control group was defined as non-chromosomal/non-monogenic malformed controls. Maternal occupational exposure was estimated through linkage of mothers' occupation with a community-based Job Exposure Matrix (JEM). Multivariate logistic regression was used to estimate the effect of occupational exposures. Odds ratios were adjusted (aORs) for relevant confounders.
A total of 387 cases, 1135 chromosomal and 4352 non-chromosomal malformed controls were included in this study. Prevalence of maternal occupational exposures to all agents was 43.9% and 41.0%/37.7% among cases and controls, respectively. Oral clefts had significantly increased ORs of maternal occupational exposure to pesticides (aOR = 1.7, 95% confidence interval [CI] 1.0-3.1) and dust (aOR = 1.3, 95% CI 1.1-1.6) when using non-chromosomal controls. Subgroup analysis for CL(P) stratified by gender showed a significantly increased risk for male infants exposed to 'other solvents' and exposure to mineral dust for female infants.
Our study showed that maternal occupational exposure to pesticides and dust are risk factors for oral clefts in the offspring. Larger studies are needed to confirm this finding.
先前的研究表明,孕期母亲职业性接触溶剂和杀虫剂会增加后代患唇腭裂的风险。关于职业性接触金属、粉尘、气体和烟雾对唇腭裂发育的影响,人们了解较少。
本病例-畸形对照研究使用了1997年至2013年在荷兰北部出生的儿童和胎儿的基于人群的出生缺陷登记处(Eurocat)的数据。病例定义为非综合征性唇腭裂。第一对照组为染色体/单基因缺陷,第二对照组定义为非染色体/非单基因畸形对照。通过将母亲的职业与基于社区的工作接触矩阵(JEM)进行关联来估计母亲的职业接触情况。使用多变量逻辑回归来估计职业接触的影响。对相关混杂因素调整了比值比(aORs)。
本研究共纳入387例病例、1135例染色体畸形对照和4352例非染色体畸形对照。病例组和对照组中母亲职业接触所有物质的患病率分别为43.9%和41.0%/37.7%。使用非染色体对照时,唇腭裂患儿母亲职业接触杀虫剂(aOR = 1.7,95%置信区间[CI] 1.0 - 3.1)和粉尘(aOR = 1.3,95% CI 1.1 - 1.6)的OR值显著升高。按性别分层的CL(P)亚组分析显示,暴露于“其他溶剂”的男婴和暴露于矿物粉尘的女婴风险显著增加。
我们的研究表明,母亲职业性接触杀虫剂和粉尘是后代患唇腭裂的危险因素。需要更大规模的研究来证实这一发现。