Marshall E G, Gensburg L J, Deres D A, Geary N S, Cayo M R
Division of Occupational Health and Environmental Epidemiology, New York State Department of Health, Albany 12203, USA.
Arch Environ Health. 1997 Nov-Dec;52(6):416-25. doi: 10.1080/00039899709602220.
The authors used a case-control design to evaluate the risk of central nervous system and musculoskeletal birth defects relative to exposure to solvents, metal, and pesticide contaminants from hazardous waste sites. Cases included 473 central-nervous-system-defect births and 3305 musculoskeletal-defect births to residents of 18 counties in New York State; controls comprised 12,436 randomly chosen normal births. For each address at birth, the authors assigned a probability of exposure to solvents, metals, and pesticides from hazardous waste sites in the study area (n = 643). They also rated residences by proximity to air releases from industrial facilities and by contamination of community water supplies. Compared with individuals for whom a low probability of exposure existed, mothers who resided in areas assigned a medium or high probability of exposure to hazardous waste contaminants did not show an increased risk of either type of birth defects. After adjusting for mother's race and age, prenatal care initiation, and population density, the resulting relative risks were as follows: central nervous system defects and exposure to solvents, 0.8 (95% confidence interval [CI] = .4, .6); central nervous system and metals, 1.0 (95% CI = 0.7, 1.7); musculoskeletal defects and solvents, 0.9 (95% CI = 0.5, 1.3); and musculoskeletal defects and pesticides, .8 (95% CI = .5, 1.3). With respect to central nervous system defects, there was an elevated risk associated with living near industrial facilities that emitted solvents (odds ratio = 1.3 [95% CI = 1.0, 1.7]) or metals (OR = 1.4, [95% CI = 1.0, 1.8]) into the air. The low proportion of individuals who had a medium or high probability of residential exposure to hazardous waste-site contaminants limited the investigation of particular pathways, disease subgroups, and/or geographic areas. Associations between central nervous system defects and industrial releases of solvents and metals need to be investigated further.
作者采用病例对照设计,评估了接触危险废物场地中的溶剂、金属和农药污染物与中枢神经系统及肌肉骨骼出生缺陷风险之间的关系。病例包括纽约州18个县居民中473例中枢神经系统缺陷出生病例和3305例肌肉骨骼缺陷出生病例;对照为12436例随机选取的正常出生病例。对于每个出生地址,作者确定了研究区域(共643个)中接触危险废物场地中的溶剂、金属和农药的概率。他们还根据与工业设施空气排放源的距离以及社区供水污染情况对住所进行了评级。与接触概率较低的个体相比,居住在被认定为接触危险废物污染物概率为中或高的地区的母亲,两种类型的出生缺陷风险均未增加。在对母亲的种族、年龄、产前护理开始时间和人口密度进行调整后,得出的相对风险如下:中枢神经系统缺陷与接触溶剂,0.8(95%置信区间[CI]=0.4,0.6);中枢神经系统与金属,1.0(95%CI=0.7,1.7);肌肉骨骼缺陷与溶剂,0.9(95%CI=0.5,1.3);肌肉骨骼缺陷与农药,0.8(95%CI=0.5,1.3)。关于中枢神经系统缺陷,居住在向空气中排放溶剂(优势比=1.3[95%CI=1.0,1.7])或金属(OR=1.4,[95%CI=1.0,1.8])的工业设施附近,风险有所升高。居住接触危险废物场地污染物概率为中或高的个体比例较低,限制了对特定途径、疾病亚组和/或地理区域的调查。中枢神经系统缺陷与工业溶剂和金属排放之间的关联需要进一步研究。