title: Congenital malformations and maternal occupation: a registry based case-control study.
abstract: OBJECTIVE
  To investigate the relations between congenital malformations and maternal occupation during pregnancy with a registry based case-control study.
  
  
  METHODS
  Analysis was performed on data derived from the Florence Eurocat registry surveillance programme. The study included cases with isolated conditions, including chromosomal anomalies (n = 1351), cases with multiple anomalies registered during the 1980-91 period (n = 440), and babies with no congenital malformations recognised at birth who were born from 1982 to 1989 and selected as controls (n = 3223). 11 categories were defined, 10 including cases with isolated malformations and one for cases with multiple congenital anomalies. Four categories of maternal occupation were selected for the study. Odds ratio (OR) values were adjusted for maternal origin, maternal and paternal education, number of previous live births, illness during pregnancy, and maternal age when the group of chromosomal anomalies was analysed.
  
  
  RESULTS
  A notable and significant association between oral clefts and mothers involved in leather and shoe manufacturing was found (adjusted OR 3.9; 99% confidence interval (99% CI) 1.5 to 9.8) and the risk consistently increased when considering cases with isolated cleft palate separately (OR 5.4; 95% CI 1.8 to 13.4). Moreover, a significant risk was identified for the association between multiple anomalies and textile dye workers (adjusted OR 1.9; 99% CI 1.0 to 3.8).
  
  
  CONCLUSIONS
  This study indicates a notable, significant relation between maternal occupation as a pelt or leather worker and orofacial clefts in offspring. This finding is in agreement with the suggested inheritance models. The dilution effect due to studying large and heterogeneous groups of workers and occupations limits the value of the study; but it provides a good example of the use of a large database to search for teratogenic risk with the aid of malformation registries.
authors.affiliation: Unit of Epidemiology and Biostatistics, Institute of Clinical Physiology, Pisa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bianchi
authors.forename: D
authors.initials: D
authors.lastname: Cianciulli
authors.forename: A
authors.initials: A
authors.lastname: Pierini
authors.forename: A
authors.initials: A
authors.lastname: Seniori Costantini
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D000013:Congenital Abnormalities / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D018811:Maternal Exposure; D009056:Mouth Abnormalities / Q000453:epidemiology; D009790:Occupations; D016017:Odds Ratio; D011247:Pregnancy; D012042:Registries; D013633:Tanning; D013783:Textile Industry