Occupational exposure in dentistry and miscarriage.
BACKGROUND
Information on the reproductive effects of chemical exposures in dental work is sparse or inconsistent.


OBJECTIVE
To investigate whether dental workers exposed to acrylate compounds, mercury amalgam, solvents or disinfectants are at an increased risk of miscarriage.


METHODS
The study was conducted among women dental workers and a comparison group of workers occupationally unexposed to dental restorative materials. Information on pregnancies was obtained from national registers and outpatient units of hospitals. Data on occupational exposure were obtained using postal questionnaires. The final study population included 222 cases of miscarriage and 498 controls (births). An occupational hygienist assessed exposure to acrylate compounds, disinfectants and solvents. Exposure to other agents was assessed on the basis of the questionnaire data. Odds ratios (ORs) and confidence intervals (CIs) were estimated using conditional logistic regression.


RESULTS
The ORs adjusted for confounding factors were increased for moderate-exposure and high-exposure categories of mercury amalgam (OR 2.0, 95% CI 1.0 to 4.1 and OR 1.3, 95% CI 0.6 to 2.5, respectively). The risk was slightly increased for the highest-exposure category of 2-hydroxyethylmethacrylate (OR 1.4, 95% CI 0.7 to 2.6) and polymethylmethacrylate dust (OR 1.4, 95% CI 0.8 to 2.4). A slightly increased risk was also detected for likely exposure to organic solvents (OR 1.4, 95% CI 0.8 to 2.3) and disinfectants (OR 1.5, 95% CI 0.9 to 2.7).


CONCLUSIONS
No strong association or consistent dose-response relationship was observed between exposure to chemical agents in dental work and the risk of miscarriage. A slightly increased risk was found for exposure to mercury amalgam, some acrylate compounds, solvents and disinfectants. These findings indicate that the possibility of a weak association between exposure to these agents and an increased risk of miscarriage cannot be excluded.
Lindbohm
Marja-Liisa
ML
Finnish Institute of Occupational Health, Helsinki, Finland. marja-liisa.lindbohm@ttl.fi
Ylöstalo
Pekka
P
Sallmén
Markku
M
Henriks-Eckerman
Maj-Len
ML
Nurminen
Tuula
T
Forss
Helena
H
Taskinen
Helena
H
D000022:Abortion, Spontaneous / Q000139:chemically induced* / Q000453:epidemiology; D000179:Acrylates / Q000633:toxicity; D000328:Adult; D003723:Dental Amalgam / Q000633:toxicity; D003727:Dental Auxiliaries / Q000706:statistics & numerical data; D003764:Dental Materials / Q000009:adverse effects*; D003813:Dentistry / Q000706:statistics & numerical data*; D003816:Dentists, Women / Q000706:statistics & numerical data; D004202:Disinfectants / Q000633:toxicity; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D009784:Occupational Diseases / Q000139:chemically induced* / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D011247:Pregnancy; D012997:Solvents / Q000633:toxicity
D000179:Acrylates; D003764:Dental Materials; D004202:Disinfectants; D012997:Solvents; D003723:Dental Amalgam