Maternal occupational exposure to solvents and congenital malformations: a prospective study in the general population

Abstract

Objective: To study the relations between maternal occupational exposure to solvents during pregnancy and the risk of congenital malformations. Methods: A prospective population-based cohort, specifically designed to study the impact of maternal exposure to solvents on the risk of congenital malformations, began in 2002 in three districts of Brittany (France). 3421 pregnant women were recruited until the end of 2005 by physicians before 19 weeks of gestation and followed through birth. Information on pregnancy outcomes was obtained from the hospital. Occupational exposure to solvents at the beginning of pregnancy was assessed from the women's self-reported occupational exposures at inclusion and from a job-exposure matrix (JEM). Sociodemographic characteristics, lifestyle factors, medical history, diseases during pregnancy were obtained at inclusion and from hospital records. Analyses were restricted to working women (n = 3005). Logistic regressions were used to adjust for potential confounders. Results: 30.2% of the working women declared regular exposure to at least one product that may contain solvents. 21.3% of them were classified at least in the medium exposure category using the JEM. Occupations mainly classified as exposed by both assessment methods were hairdressers, nurses' aides, nurses and chemists/biologists. Significant associations were found between major congenital malformations and maternal occupational exposure to solvents, assessed by both selfreport odds ratio (OR = 2.48, 95% CI 1.4 to 4.4 for regular exposure vs no exposure) and the JEM (OR = 3.48, 95% CI 1.4 to 8.4 for highest level of exposure vs no exposure). A significant dose-response trend was observed with both assessment methods. Several subgroups of major malformations were associated with maternal exposure to solvents (oral clefts, urinary malformations and male genital malformations). Conclusion: This study provides further evidence of an association between exposure to solvents during pregnancy and the risk of major malformations.Many women workers are exposed to organic solvents, 1 which are widely used in a range of industrial products including paints, varnishes, inks and cleaning agents. Solvents belong to three main chemical families: oxygenated, petroleum and chlorinated solvents. Their main routes of exposure are dermal and respiratory. Despite their widespread use, their health effects on reproduction, especially their relation to congenital malformations, remain controversial.Several solvents have been shown to be teratogenic for animals.2 3 In mice, for example, toluene and xylene (petroleum solvents) have been associated with the occurrence of cleft palate, 2 and ethylene glycol monomethyl ether has been associated with the occurrence of neural tube defects. 3In humans, malformations and cytogenetic effects have been observed among the offspring of women exposed to glycol ethers during pregnancy.4 Some studies, 5-8 but not others, 9 report an excess risk of spontaneous abortion among women occupationally expo...

Seroprevalence and Influence of Torch Infections in High Risk Pregnant Women: A Large Study from South India

“…However, low maternal education showed a significant association with congenital malformations and BOH [24,25]. Maternal occupation has been implicated in the incidence of congenital malformations [26]. However, maternal occupation did not confer risk in Group 1 and Group 2 similar to other studies [25,27].…”

Spontaneous miscarriages and infant deaths among female farmers in rural South Africa

“…Occupational exposures and activities are increasingly linked to adverse reproductive outcomes in working populations (1)(2)(3)(4)(5)(6)(7)(8). Occupational exposures associated with adverse reproductive outcomes include increased risks for spontaneous miscarriages among (i) healthcare workers exposed to chemicals including disinfectants, antineoplastic, and anesthetic drugs and (ii) women in industry exposed to heavy metals and solvents (9).…”

Risk of congenital malformations among children of construction painters in Denmark: a nationwide cohort study

“…To our knowledge, this is the first study where the risk of congenital malformations in relation to occupational painting has been investigated by a register-based approach. Some previous studies have focused on maternal exposure to volatile organic compounds (VOC) and have shown an increased risk of congenital anomalies among the children (19)(20)(21).…”