Occupational exposure pregnancy outcome

Lemasters GK (1993) Epidemiology methods to assess occupational exposures and pregnancy outcomes. Semin Perinatal, 17(1) 18-27. 

USB OP REGISTERED DATA IN STUDIES OF OCCUPATIONAL EXPOSURE AND PREGNANCY OUTCOME... 

Pig. 1. Study strategy in studies of occupational exposures and pregnancy outcome. 

TTP information. As with other NYS Angler Cohort studies, limitations include the reliance on self-reported exposure data and outcome data, and the lack of information on potential confounding factors such as occupational exposures, alcohol and caffeine consumption, and current smoking status. In addition, women with unplanned pregnancies were necessarily ruled out from the analysis Buck et al. (1997) noted that this may be a potential bias inherent in the study. 

In occupational exposure studies, paternal exposure to metallic Hg does not appear to cause infertility or malformations (Alcser et al. 1989 Lauwerys et al. 1985). However, a study of pregnancy outcomes among the wives of 152 Hg-exposed men revealed an increased incidence of spontaneous abortions (Cordier et al. 1991). Preconception paternal urinary Hg concentrations above 50 pg/L were associated with a doubling of the spontaneous abortion risk. 

In 1999, researchers reported a study of fetal outcome following maternal occupational exposure to common organic solvents in occupations, such as factory workers, laboratory technicians, artists, office workers, and so forth. The data showed that occupational exposure to common organic solvents during pregnancy is associated with a 10-fold increased risk of major fetal malformations.27 This is occupational exposure, not some dramatic accidental acute poisoning. By implication, subtle effects on the fetal nervous system, effects that shape emotional and intellectual behavior, are to be expected after maternal exposure to ambient concentrations of organic solvents ordinarily used in many workplaces. 

Nurtninen, T. (1995). Maternal pesticide exposure and pregnancy outcome. J. Occup. Med. 37, 935-940. 

The Motherisk Program at the Hospital for Sick Children was the first to prospectively evaluate pregnancy and fetal outcome following maternal occupational exposure to organic solvents with malformations being the primary outcome of interest. ... 

An adverse pregnancy outcome was recognized in the previous century in women occupationally exposed to lead, and reported in more recent studies of women with heavy lead exposure. In the earlier studies, first-trimester abortions and stillbirths were reported, with macrocephaly and seizures in livebirths. A lowered fertility rate has also been claimed. However at current UK levels of occupational lead exposure in females an adverse effect on pregnancy outcome or on fertility has not been documented. The evidence... 

Inclusion criteria consisted of human studies of any language which were 1) case control or cohort study in design 2) included maternal inhalational, occupational, organic solvent exposure 3) had an outcome of major malformation and/or spontaneous abortion and 4) included first trimester pregnancy exposure. Exclusion criteria consisted of animal studies, non-inhalational exposure, case reports, letters, editorials, review articles and studies... 

Second, the requirement of severe Pb exposures in mothers as necessary for lead reproductive and developmental toxicity is not a tenable premise. As noted in later chapters, embryo- and fetotoxicity is quite a sensitive endpoint in humans and occurs at relatively low systemic lead levels owing to ready transplacental movement of lead early in pregnancy (NAS/NRC, 1993 U.S. ATSDR, 1988 U.S. CDC, 1985, 1991, 2005 U.S. EPA, 1986, 2006). The occupational history of lead in the late nineteenth and early twentieth centuries establishes various adverse reproductive outcomes in pregnant women not themselves demonstrably debilitated by manifest lead poisoning (Legge, 1901 Oliver, 1911 U.S. EPA, 1986, 2006). 

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