Smith E M, Hammonds-Ehlers M, Clark M K, Kirchner H L, Fuortes L
Department of Preventive Medicine and Environmental Health, University of Iowa, College of Medicine, Iowa City 52242, USA.
J Occup Environ Med. 1997 Feb;39(2):138-47. doi: 10.1097/00043764-199702000-00011.
This study examined the association between occupational chemical and radiation exposures and risk of medically diagnosed infertility in 281 women compared with 216 fertile women. After adjustment for age and exposures that occurred before case/referent ascertainment, there was an increased risk of infertility among those women exposed to volatile organic solvents (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.11 to 2.71), chemical dusts (OR, 2.66; CI, 1.17 to 6.05), pesticides (OR, 3.02; CI, 1.10 to 8.29), and video display terminals (OR, 2.21, CI, 1.22, to 4.01). Among the medically diagnosed causes of infertility, the adjusted risk associated with having an ovulatory factor increased among those women exposed to solvents (OR, 1.75; CI, 1.03 to 2.98), dusts (OR, 3.00; CI, 1.19 to 7.52), or pesticides (OR, 3.82; 1.28 to 11.42). Solvents and dusts also were associated with a higher risk of tubal-factor infertility (solvents; OR, 1.95; CI, 1.08 to 3.52; dusts: OR, 2.87; CI, 1.05 to 7.88) and endometriosis (solvents: OR, 2.13; CI, 0.96 to 4.72; dusts: OR, 3.63; CI, 0.99 to 13.28). Video display terminal exposure was more likely to be found among those women diagnosed with endometriosis (OR, 3.69; CI, 1.50 to 9.13) and cervical-factor infertility (OR, 2.65; CI, 0.99 to 7.12). Results suggest that among women with a medically confirmed diagnosis, fertility may be adversely affected by a variety of occupational chemical exposures.
本研究调查了281名医学诊断为不孕的女性与216名可育女性相比,职业化学物质和辐射暴露与医学诊断不孕风险之间的关联。在对年龄以及病例/对照确定之前发生的暴露进行调整后,暴露于挥发性有机溶剂的女性不孕风险增加(优势比[OR],1.74;95%置信区间[CI],1.11至2.71),化学粉尘(OR,2.66;CI,1.17至6.05),农药(OR,3.02;CI,1.10至8.29),以及视频显示终端(OR,2.21,CI,1.22至4.01)。在医学诊断的不孕原因中,暴露于溶剂(OR,1.75;CI,1.03至2.98)、粉尘(OR,3.00;CI,1.19至7.52)或农药(OR,3.82;1.28至11.42)的女性中,与排卵因素相关的调整后风险增加。溶剂和粉尘还与输卵管因素不孕的较高风险相关(溶剂:OR,1.95;CI,1.08至3.52;粉尘:OR,2.87;CI,1.05至7.88)以及子宫内膜异位症(溶剂:OR,2.13;CI,0.96至4.72;粉尘:OR,3.63;CI,0.99至13.28)。视频显示终端暴露在诊断为子宫内膜异位症(OR,3.69;CI,1.50至9.13)和宫颈因素不孕(OR,2.65;CI,0.99至7.12)的女性中更常见。结果表明,在医学确诊的女性中,生育能力可能受到多种职业化学暴露的不利影响。