Exposure to anesthetic gases and congenital anomalies in offspring of female registered nurses.
BACKGROUND
Studies of offspring of mothers exposed to anesthetic gases have shown associations with congenital anomalies reported by the mothers, but rarely in studies with objectively ascertained outcomes. We conducted a retrospective cohort study to examine associations between registry-ascertained congenital anomalies in offspring and anesthetic gas exposure of mothers employed as nurses.


METHODS
A cohort of registered nurses in British Columbia, Canada, was linked to records of births and congenital anomalies from 1990 to 2000. Exposures were assessed via a survey of anesthetic gas use in all hospitals in the province and records of nurses' jobs, departments, and hospitals.


RESULTS
Departments most frequently reporting anesthetic gas use were operating rooms, post-anesthetic recovery rooms, and maternity units. In the cohort of 15,317 live-borne children of 9,433 mothers, 1,079 had congenital anomalies. Anomalies were associated with ever and probable maternal exposure to halogenated gases (ORs: 1.49, 95% CI: 1.04-2.13; and 2.61, 95% CI: 1.31-5.18, respectively) and to nitrous oxide (ORs: 1.42, 95% CI: 1.05-1.94; and 1.82, 95% CI: 1.11-2.99). Anomalies most frequently associated with exposure were those of the heart (OR, halogenated gases: 2.31, 95% CI: 1.07-4.97) and integument (OR, halogenated gases: 3.56, 95% CI: 1.53-8.32; OR, nitrous oxide: 3.02, 95% CI: 1.37-6.64). Gases most frequently associated with anomalies were halothane (predominantly used early in the study period), isoflurane, and sevoflurane (predominantly used later in the period).


CONCLUSIONS
In this study, where both exposures and outcomes were assessed objectively, certain congenital anomalies were associated with estimated anesthetic gas exposure.
Teschke
Kay
K
University of British Columbia, Vancouver, Canada. kay.teschke@ubc.ca
Abanto
Zenaida
Z
Arbour
Laura
L
Beking
Kris
K
Chow
Yat
Y
Gallagher
Richard P
RP
Jong
Ben
B
Le
Nhu D
ND
Ratner
Pamela A
PA
Spinelli
John J
JJ
Dimich-Ward
Helen
H
D000465:Algorithms; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D001955:British Columbia; D016001:Confidence Intervals; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D018811:Maternal Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D009729:Nursing / Q000706:statistics & numerical data*; D016273:Occupational Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D016017:Odds Ratio; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*
D018685:Anesthetics, Inhalation