Matte T D, Mulinare J, Erickson J D
Division of Environmental Hazards and Health Effects, Centers for Disease Control, Atlanta, GA.
Am J Ind Med. 1993 Jul;24(1):11-23. doi: 10.1002/ajim.4700240103.
Health care workers may be occupationally exposed to known and suspected teratogens including viruses, anesthetic gases, sterilants, mercury, and x-radiation. To assess the risk of congenital defects among offspring of health care workers, we analyzed parental occupational histories for 4,915 case babies with congenital defects, registered during the years 1968-1980 by the Metropolitan Atlanta Congenital Defects Program (MACDP) registry, and for 3,027 control babies born without defects during the same period. Offspring of mothers employed in a nursing occupation during the periconceptional period had a modest excess risk of having at least one congenital defect (relative risk [RR] = 1.42; 95% confidence interval [CI] 1.06-1.88); the offspring were at statistically significant increased risk of having anencephaly or spina bifida (RR = 2.00; 95% CI 1.01-4.30), coarctation of the aorta (RR = 2.06; 95% CI 1.10-3.82), genital system defects (RR = 1.61; 95% CI 1.03-2.53), and urinary system defects (RR = 3.43; 95% CI 1.41-8.34). These associations were not confounded by maternal age, education, or alcohol consumption. Offspring of mothers employed in administrative or clerical jobs in the health care industry also had a modest excess risk of defects (RR = 1.35; 95% CI 0.96-1.90), including a statistically significant excess risk of limb defects. We also found associations between neural tube defects and potential exposure to anesthetic gases and to x-radiation, but each association was based on only three case babies of potentially exposed parents. We found no associations between defects and paternal health care employment, except for a few individual defects, and these were based on small numbers of exposed subjects. Only one of five previous studies reviewed found an increased risk of congenital defects among offspring of nurses, but three of the four negative studies had substantially smaller sample sizes than the present study. Detection bias may be a possible explanation for the apparent excess risk of certain defects among offspring of nurses.
医护人员可能会在职业中接触到已知和疑似致畸物，包括病毒、麻醉气体、消毒剂、汞和X射线辐射。为评估医护人员后代出现先天性缺陷的风险，我们分析了1968年至1980年期间由大亚特兰大先天性缺陷项目（MACDP）登记处登记的4915例患有先天性缺陷的病例婴儿以及同期出生的3027例无缺陷对照婴儿的父母职业史。在受孕期间从事护理职业的母亲的后代出现至少一种先天性缺陷的风险略有增加（相对风险[RR]=1.42；95%置信区间[CI]1.06 - 1.88）；这些后代患无脑儿或脊柱裂（RR = 2.00；95% CI 1.01 - 4.30）、主动脉缩窄（RR = 2.06；95% CI 1.10 - 3.82）、生殖系统缺陷（RR = 1.61；95% CI 1.03 - 2.53）和泌尿系统缺陷（RR = 3.43；95% CI 1.41 - 8.34）的风险在统计学上显著增加。这些关联不受母亲年龄、教育程度或饮酒情况的影响。在医疗保健行业从事行政或文书工作的母亲的后代也有略微增加的缺陷风险（RR = 1.35；95% CI 0.96 - .....
