Occupational exposure to ethylene oxide during pregnancy and association with adverse reproductive outcomes
Occupational exposure to ethylene oxide during pregnancy and association with adverse reproductive outcomes
复制标题
DOI：
10.1007/s00420-006-0163-y
复制
发表时间：
2007-07-01
影响因子：
3
通讯作者：
Rees, David
中科院分区：
文献类型：
--
作者：
Gresie-Brusin, Daniela F.;Kielkowski, Danuta;Rees, David
目的探讨妊娠期环氧乙烷暴露与不良生殖结局的关系。方法分析：(1)研究期间（2004年）在南非豪登省使用环氧乙烷的医院消毒部门工作的妇女中发生的单胎妊娠；(2)这些妇女在1992年1月1日之后最后一次被确认的怀孕；(3)最后一次记录的怀孕发生在母亲有工作的时候。不良生殖结局定义为发生自然流产、死产或流产（联合流产+死产）。通过问卷调查从母亲那里收集有关妊娠演变和结局的信息。关于怀孕期间接触环氧乙烷的信息有三个来源，即实地调查、问卷收集的数据和研究期间消毒装置内环氧乙烷水平的测量（个人抽样和静态抽样）。结果本研究纳入了69%的豪登省使用环氧乙烷对医疗设备进行消毒的医院。在这些绝育单位工作的妇女的参与率为97%，研究人群包括98名单胎妊娠。对环氧乙烷的测量表明，灭菌器的操作人员仍有可能过度暴露于环氧乙烷。高暴露于环氧乙烷的妊娠与低暴露于环氧乙烷的妊娠相比，自然流产（POR = 20.8, 95% CI = 2.1-199）和流产（POR = 8.6, 95% CI = 1.8-43.7）的风险显著增加。没有发现接触环氧乙烷和死产之间的联系。结论妊娠期接触环氧乙烷可增加自然流产和流产的风险。
Objective To investigate the association between exposure to ethylene oxide during pregnancy and adverse reproductive outcomes. Methods Singleton pregnancies were analysed that: (1) had occurred in women working at the time of the study (2004) in hospital sterilising units using ethylene oxide in Gauteng province, South Africa; (2) was the last recognised pregnancy of these women after the 1 January 1992; and (3) this last recorded pregnancy had occurred while the mother was employed. An adverse reproductive outcome was defined as the occurrence of a spontaneous abortion, still birth or pregnancy loss (combined abortion + still birth). Information on the evolution and outcome of the pregnancy was gathered from the mother using a questionnaire. Information on exposure to ethylene oxide during pregnancy was obtained from three sources, namely walk-through surveys, questionnaire-collected data and measurements of the levels of ethylene oxide in sterilising units at the time of the study (personal and static sampling). Results The study enrolled 69% of the hospitals in Gauteng using ethylene oxide to sterilise medical equipment. The participation rate for women employed in these sterilising units was 97%, and the study population consisted of 98 singleton pregnancies. Measurements of ethylene oxide showed that operators of sterilisers were still potentially over- exposed. There was a significantly increased risk of spontaneous abortion (POR = 20.8, 95% CI = 2.1-199) and pregnancy loss (POR = 8.6, 95% CI = 1.8-43.7) for pregnancies highly exposed to ethylene oxide compared to low exposed pregnancies. No associations were found between exposure to ethylene oxide and stillbirth. Conclusions An increased risk of spontaneous abortion and pregnancy loss was found to be associated with exposure to ethylene oxide during pregnancy.