title: Exposure to anesthetic gases and congenital anomalies in offspring of female registered nurses.
abstract: 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.
authors.affiliation: University of British Columbia, Vancouver, Canada. kay.teschke@ubc.ca
authors.forename: Kay
authors.initials: K
authors.lastname: Teschke
authors.forename: Zenaida
authors.initials: Z
authors.lastname: Abanto
authors.forename: Laura
authors.initials: L
authors.lastname: Arbour
authors.forename: Kris
authors.initials: K
authors.lastname: Beking
authors.forename: Yat
authors.initials: Y
authors.lastname: Chow
authors.forename: Richard P
authors.initials: RP
authors.lastname: Gallagher
authors.forename: Ben
authors.initials: B
authors.lastname: Jong
authors.forename: Nhu D
authors.initials: ND
authors.lastname: Le
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Ratner
authors.forename: John J
authors.initials: JJ
authors.lastname: Spinelli
authors.forename: Helen
authors.initials: H
authors.lastname: Dimich-Ward
mesh_terms: 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*
chemical_list: D018685:Anesthetics, Inhalation