Doyle P, Roman E, Beral V, Brookes M
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, UK.
Occup Environ Med. 1997 Dec;54(12):848-53. doi: 10.1136/oem.54.12.848.
To investigate the association between spontaneous abortion and work within dry cleaning units in the United Kingdom where the solvent perchloroethylene is used.
A retrospective occupational study of reproductive outcome in 7305 women aged 16 and 45 years, who were currently or previously employed in dry cleaning or laundry units in the United Kingdom. Data on workplace exposures and reproductive outcome were obtained by postal survey. A sample of reported spontaneous abortions was validated from medical records. Machine operator versus non-operator was used as a surrogate for exposure to perchloroethylene in dry cleaning units as no data on individual doses were available for women in this study.
The response rate was higher for current workers of dry cleaning units (78%), than for past workers of dry cleaning units (46%). Similarly, the response for current laundry workers (65%) was higher than that for past laundry workers (40%). Overall, the reproductive characteristics of the respondents were similar to expectation. Examination of exposure at the time of pregnancy, however, showed that the rate of spontaneous abortion varied according to the type of work the women did during the pregnancy or in the three months before conception: being lowest for pregnancies not exposed to either dry cleaning or laundry work (10.9%), higher for those exposed to laundry work (13.4%), and higher still for those exposed to dry cleaning work (14.8%). Within the group of pregnancies exposed to dry cleaning, the proportion was higher if the woman reported that she worked as an operator at the time of the pregnancy (17.1%) rather than as a non-operator (11.6%). Adjusted odds ratios for the period 1980-95 showed that the risk was over 50% higher in operators than non-operators (p = 0.04). The physical demands of the two jobs are likely to be similar. A higher risk was found when work as a dry cleaning operator was compared with no work in either dry cleaning or laundry units during pregnancy. Exposure to dry cleaning as a non-operator was not associated with any excess risk.
Women who worked in dry cleaning shops at the time of their pregnancy or in the three months before who described themselves as operators were about half as likely again to report that their pregnancy ended in a spontaneous abortion than women who described themselves as non-operators.
调查在英国使用溶剂全氯乙烯的干洗店工作与自然流产之间的关联。
对7305名年龄在16至45岁之间、目前或曾经受雇于英国干洗店或洗衣店的女性的生殖结局进行回顾性职业研究。通过邮政调查获取工作场所暴露情况和生殖结局的数据。从医疗记录中验证了所报告自然流产的样本。由于本研究中无法获取女性个体剂量的数据,因此将干洗店中的机器操作员与非操作员作为接触全氯乙烯的替代指标。
干洗店在职员工的回复率(78%)高于干洗店离职员工(46%)。同样,洗衣店在职员工的回复率(65%)高于洗衣店离职员工(40%)。总体而言,受访者的生殖特征与预期相似。然而,对怀孕时的暴露情况进行检查发现,自然流产率根据女性在孕期或受孕前三个月所从事的工作类型而有所不同:未接触干洗或洗衣工作的孕期女性自然流产率最低(10.9%),接触洗衣工作的女性自然流产率较高(13.4%),接触干洗工作的女性自然流产率更高(14.8%)。在接触干洗工作的孕期女性群体中,如果女性报告在孕期从事操作员工作,其比例更高(17.1%),而非操作员的比例为(11.6%)。1980 - 1995年期间的校正比值比显示操作员的风险比非操作员高出50%以上(p = 0.04)。这两份工作的体力要求可能相似。与孕期未在干洗店或洗衣店工作相比,干洗操作员工作的风险更高。非操作员接触干洗工作与任何额外风险均无关联。
在孕期或受孕前三个月在干洗店工作且自称是操作员的女性,报告其怀孕以自然流产告终的可能性大约是自称非操作员女性的两倍。