title: Reproductive outcome in a cohort of male and female rubber workers: a registry study.
abstract: OBJECTIVE
  To investigate whether blue-collar employment in the Swedish rubber industry from 1973 onwards had a negative impact on reproductive health.
  
  
  METHODS
  Pairs of mother and child, and triads of father-mother-child were obtained through linkage of a cohort of 18,518 rubber factory employees with the Swedish Population Registry. Birth outcomes were obtained from the Medical Birth Register for 17,918 children. For each child, parental employment as blue-collar rubber worker during the pregnancy and sperm maturation period was obtained from work-place records. Children to female food industry workers, in all 33,256, constituted an external reference group.
  
  
  RESULTS
  The sex ratio was reversed, with odds ratio (OR) for having a girl was 1.15 (95% CI 1.02, 1.31) when the mother was exposed. When both parents were exposed, the OR was even higher, 1.28 (95% CI 1.02, 1.62). An increased risk of multiple births was observed when both parents were exposed, with OR 2.42 (95% CI 1.17, 5.01). Children with both maternal and paternal exposure had a reduced birth weight compared to the external reference cohort. After adjustment for smoking (available for births from 1983 onwards), ethnicity and sex, the difference between children (singletons, live births) with maternal and paternal exposure and external referents was -142 g (95% CI -229, -54). The adjusted OR for having a small-for-gestational-age child was 2.15 (95% CI 1.45, 3.18) when the mother was a rubber worker during the pregnancy.
  
  
  CONCLUSIONS
  There were clear indications that reproductive outcome was adversely affected in rubber workers. The findings warrant further investigation with refinement of exposure indices and inclusion of other endpoints of reproductive health.
authors.affiliation: Department of Occupational and Environmental Medicine, Lund University Hospital, Lund, Sweden. kristina.jakobsson@med.lu.se
authors.forename: Kristina
authors.initials: K
authors.lastname: Jakobsson
authors.forename: Zoli
authors.initials: Z
authors.lastname: Mikoczy
mesh_terms: D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D001724:Birth Weight / Q000187:drug effects; D002617:Chemical Industry; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects*; D018812:Paternal Exposure / Q000009:adverse effects; D012042:Registries; D012098:Reproduction / Q000187:drug effects* / Q000502:physiology; D012408:Rubber; D012744:Sex Ratio; D013548:Sweden / Q000453:epidemiology; D017132:Workplace
chemical_list: D000395:Air Pollutants, Occupational; D012408:Rubber