FW: JAMA, P&O and Birth Defects

Paul Prusakowski

Description

Title:

FW: JAMA, P&O and Birth Defects

Creator:

Paul Prusakowski

Date:

6/17/1999

Text:

This mesasge was forwarded to me for posting on the listserver.

-Paul P.


Abstracts - March 24/31, 1999

Pregnancy Outcome Following Gestational Exposure to Organic Solvents

                        A Prospective Controlled Study

                        Sohail Khattak, MD, FRCPC
                        Guiti K-Moghtader, BSc
                        Kristen McMartin, MSc
                        Maru Barrera, PhD
                        Debbie Kennedy, MD
                        Gideon Koren, MD, FRCPC

Context Numerous women of childbearing age are exposed occupationally to
organic solvents. Previous retrospective studies have reported conflicting
results regarding teratogenic risk.

Objective To evaluate pregnancy and fetal outcome following maternal
occupational exposure to organic solvents.

Design A prospective, observational, controlled study.

Setting An antenatal counseling service in Toronto, Ontario.

Patients One hundred twenty-five pregnant women who were exposed
occupationally to organic solvents and seen during the first trimester
between 1987 and 1996. Each pregnant woman who was exposed to organic
solvents was matched to a pregnant woman who was exposed to a
nonteratogenic agent on age (± 4 years), gravidity (±1), and smoking and
drinking status.

Main Outcome Measure Occurrence of major congenital malformations.

Results Significantly more major malformations occurred among fetuses of
women exposed to organic solvents than controls (13 vs 1; relative risk,
13.0; 95% confidence interval, 1.8-99.5).
Twelve malformations occurred among the 75 women who had symptoms
temporally associated with their exposure, while none occurred among 43
asymptomatic exposed women (P<.001). (One malformation occurred in a woman
for whom such information was missing.) More of these exposed women had
previous miscarriage while working with organic solvents than controls
(54/117 [46.2%] vs 24/125 [19.2%]; P<.001). However, exposed women who had
a previous miscarriage had rates of major malformation that were similar to
exposed women who had no previous miscarriage.

Conclusions Occupational exposure to organic solvents during pregnancy is
associated with an increased risk of major fetal malformations. This risk
appears to be increased among women who report symptoms associated with
organic solvent exposure. Women's exposure to organic solvents should be
minimized during pregnancy. Symptomatic exposure appears to predict higher
fetal risk for malformations.

JAMA. 1999;281:1106-1109





Week of March 24/31, 1999

Science News Update
American Medical Association Science News Updates are made available to the
public after 3 p.m. Central time (U.S.) on the first four Tuesdays of each
month. We also provide a list of previous news releases.

OCCUPATIONAL EXPOSURE OF PREGNANT WOMEN TO ORGANIC SOLVENTS PLACES FETUSES
AT RISK OF MALFORMATIONS

Women's exposure to organic solvents should be minimized during pregnancy

CHICAGO - Women exposed at work to organic solvents during pregnancy have
an increased risk of major fetal malformations, according to an article in
the March 24/31 issue of The Journal of the American Medical Association
(JAMA).

Sohail Khattak, M.D., F.R.C.P.C., of The Hospital for Sick Children and the
University of Toronto in Canada, and colleagues studied the occurrence of
fetal malformations in 125 pregnant women who were exposed to organic
solvents at work during the first trimester of pregnancy. There were also
125 women in a control group. According to the authors, this study is the
first to prospectively evaluate pregnancy and fetal outcome following
maternal occupational exposure to organic solvents.

The researchers found that there were 13 major malformations in the fetuses
of women exposed to organic solvents and one in the control group. Twelve
of the fetal malformations occurred among the 75 women who had symptoms
associated with their exposure to organic solvents - irritation of the eyes
or respiratory system, breathing difficulty and headaches - while none
occurred among the 43 women exposed to the organic solvents who did not
have symptoms. The information on exposure symptoms was not available for
one of the mothers of the malformed fetuses.

The authors write that many women of childbearing age are occupationally
exposed to organic solvents. The most important women-dominated occupations
with potential chemical exposures are health care professionals and work
tasks in the clothing and textile industries, all of which involve exposure
to organic solvents.

In this study, the women were employed as factory workers, laboratory
technicians, professional artists or graphic designers, printing industry
workers, chemists, painters, office workers working in the presence of
chemicals, car cleaners, veterinary technicians, orthotic manufacturers,
funeral home employees, carpenters and social workers who were exposed to
organic solvents.

The authors report that the organic solvents the women were most commonly
exposed to include aliphatic and aromatic hydrocarbons, phenols,
trichloroethylene, xylene, vinyl chloride, acetone and related compounds.
According to the authors, fat-soluble organic solvents can pass through
biological membranes, including the placenta.

According to the authors, previous reports of the effects of organic
solvents on the fetuses of pregnant women have been controversial. Reports
have included increased rates of miscarriage, central nervous system and
cardiovascular malformations and perinatal mortality. Reduced fertility
also has been reported in women exposed to organic solvents.

The major malformations varied but included deafness, clubfoot requiring
correction, spina bifida and heart abnormalities.

It is prudent to minimize women's exposure to organic solvents during
pregnancy, conclude the authors. Moreover, symptomatic exposure appears
to confer an unacceptable level of fetal exposure and should be avoided by
appropriate protection and ventilation. Health care professionals who
counsel families of reproductive age should inform their patients that some
types of employment may influence reproductive outcomes.
                        (JAMA. 1999;281:1106-1109)

Note: This study was supported by a grant from Physician Services Inc.,
Toronto.

Citation

Paul Prusakowski, “FW: JAMA, P&O and Birth Defects,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/211612.