Association between maternal occupational exposure to organic solvents and congenital heart defects, National Birth Defects Prevention Study, 1997-2002.
OBJECTIVE
To examine the relation between congenital heart defects (CHDs) in offspring and estimated maternal occupational exposure to chlorinated solvents, aromatic solvents and Stoddard solvent during the period from 1 month before conception through the first trimester.


METHODS
The study population included mothers of infants with simple isolated CHDs and mothers of control infants who delivered from 1997 through 2002 and participated in the National Birth Defects Prevention Study. Two methods to assess occupational solvent exposure were employed: an expert consensus-based approach and a literature-based approach. Multiple logistic regression was used to calculate adjusted ORs and 95% CIs for the association between solvent classes and CHDs.


RESULTS
2951 control mothers and 2047 CHD case mothers were included. Using the consensus-based approach, associations were observed for exposure to any solvent and any chlorinated solvent with perimembranous ventricular septal defects (OR 1.6, 95% CI 1.0 to 2.6 and OR 1.7, 95% CI 1.0 to 2.8, respectively). Using the literature-based approach, associations were observed for: any solvent exposure with aortic stenosis (OR 2.1, 95% CI 1.1 to 4.1) and Stoddard solvent exposure with d-transposition of the great arteries (OR 2.0, 95% CI 1.0 to 4.2), right ventricular outflow tract obstruction defects (OR 1.9, 95% CI 1.1 to 3.3) and pulmonary valve stenosis (OR 2.1, 95% CI 1.1 to 3.8).


CONCLUSIONS
The authors found evidence of associations between occupational exposure to solvents and several types of CHDs. These results should be interpreted in light of the potential for misclassification of exposure.
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. sgilboa@cdc.gov
Suzanne M
SM
Gilboa
Tania A
TA
Desrosiers
Christina
C
Lawson
Philip J
PJ
Lupo
Tiffany J
TJ
Riehle-Colarusso
Patricia A
PA
Stewart
Edwin
E
van Wijngaarden
Martha A
MA
Waters
Adolfo
A
Correa
D000293:Adolescent; D000328:Adult; D001024:Aortic Valve Stenosis / Q000209:etiology; D016022:Case-Control Studies; D005260:Female; D006330:Heart Defects, Congenital / Q000209:etiology*; D006345:Heart Septal Defects, Ventricular / Q000209:etiology; D006801:Humans; D006838:Hydrocarbons / Q000009:adverse effects*; D006843:Hydrocarbons, Chlorinated / Q000009:adverse effects*; D007231:Infant, Newborn; D016015:Logistic Models; D018811:Maternal Exposure / Q000009:adverse effects*; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications; D011666:Pulmonary Valve Stenosis / Q000209:etiology; D012307:Risk Factors; D012997:Solvents / Q000009:adverse effects*; D014188:Transposition of Great Vessels / Q000209:etiology; D014694:Ventricular Outflow Obstruction / Q000209:etiology; D055815:Young Adult
D006838:Hydrocarbons; D006843:Hydrocarbons, Chlorinated; D012997:Solvents; C012559:Stoddard solvent