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孕期职业性暴露于无机颗粒物与妊娠结局的关系:瑞典全国队列研究。

Occupational exposure to inorganic particles during pregnancy and birth outcomes: a nationwide cohort study in Sweden.

机构信息

Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

Division of Occupational and Environmental Medicine, Lunds Universitet, Lund, Sweden.

出版信息

BMJ Open. 2019 Feb 27;9(2):e023879. doi: 10.1136/bmjopen-2018-023879.

Abstract

OBJECTIVES

The aim of this study was to investigate if occupational exposure to inorganic particles or welding fumes during pregnancy is associated with negative birth outcomes.

DESIGN

A prospective national cohort study.

SETTING

All single births from 1994 to 2012 in Sweden. Information on birth weight, preterm birth, small for gestational age, smoking habits, nationality, age, occupation, absence from work and education was obtained from nationwide registers. Exposure to inorganic particles (mg/m) was assessed from a job exposure matrix.

PARTICIPANTS

This study included all single births by occupationally active mothers (995 843).

OUTCOME MEASURES

Associations between occupational exposures and negative birth outcomes in the form of low birth weight, preterm birth and small for gestational age.

RESULTS

Mothers who had high exposure to inorganic particles and had less than 50 days (median) of absence from work during pregnancy showed an increased risk of preterm birth (OR 1.18; 95% CI 1.07 to 1.30), low birth weight (OR 1.32; 95% CI 1.18 to 1.48) as well as small for gestational age (OR 1.20; 95% CI 1.04 to 1.39). The increased risks were driven by exposure to iron particles. No increased risks were found in association with exposure to stone and concrete particles. High exposure to welding fumes was associated with an increased risk of low birth weight (OR 1.22; 95% CI 1.02 to 1.45) and preterm birth (OR 1.24; 95% CI 1.07 to 1.42).

CONCLUSIONS

The results indicate that pregnant women should not be exposed to high levels of iron particles or welding fumes.

摘要

目的

本研究旨在探讨孕妇在妊娠期接触无机颗粒或焊接烟尘是否与不良出生结局有关。

设计

一项前瞻性全国队列研究。

地点

瑞典 1994 年至 2012 年期间所有的单胎妊娠。从全国性登记处获得了出生体重、早产、小于胎龄儿、吸烟习惯、国籍、年龄、职业、缺勤和教育等信息。通过职业暴露矩阵评估了无机颗粒(mg/m)的暴露情况。

参与者

本研究纳入了所有职业活跃母亲的单胎妊娠(995843 例)。

结局测量

评估了职业暴露与低出生体重、早产和小于胎龄儿等不良出生结局之间的关系。

结果

暴露于无机颗粒高、妊娠期间缺勤少于 50 天(中位数)的母亲,其早产(OR 1.18;95%CI 1.07 至 1.30)、低出生体重(OR 1.32;95%CI 1.18 至 1.48)和小于胎龄儿(OR 1.20;95%CI 1.04 至 1.39)的风险增加。这些风险增加是由铁颗粒暴露引起的。接触石材和混凝土颗粒与风险增加无关。高浓度接触焊接烟尘与低出生体重(OR 1.22;95%CI 1.02 至 1.45)和早产(OR 1.24;95%CI 1.07 至 1.42)的风险增加有关。

结论

研究结果表明,孕妇不应暴露于高水平的铁颗粒或焊接烟尘中。

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