title: Maternal periconceptional occupational exposure to pesticides and selected musculoskeletal birth defects.
abstract: This population-based U.S. study investigated the association between major musculoskeletal malformations and periconceptional maternal occupational pesticide exposure for a wide range of occupations. We conducted a multi-site case-control analysis using data from the National Birth Defects Prevention Study among employed women with due dates from October 1, 1997 through December 31, 2002. Cases included 871 live-born, stillborn, or electively terminated fetuses with isolated craniosynostosis, gastroschisis, diaphragmatic hernia, or transverse limb deficiencies. Controls included 2857 live-born infants without major malformations. Using self-reported maternal occupational information, an industrial hygienist used a job-exposure matrix and expert opinion to evaluate the potential for exposure to insecticides, herbicides or fungicides for each job held during one month pre-conception through three months post-conception. Exposures analyzed included any exposure (yes/no) to pesticides, to insecticides only, to both insecticides and herbicides (I+H) and to insecticides, herbicides and fungicides (I+H+F). We used logistic regression to evaluate the association between exposures and defects, controlling for infant and maternal risk factors. Occupational exposure to I+H+F was associated with gastroschisis among infants of women aged 20 years or older (adjusted odds ratio [aOR]=1.88; 95% confidence interval [CI]: 1.16-3.05), but not for women under age 20 (aOR=0.48; 95% CI: 0.20-1.16). We found no significant associations for the other defects. Additional research is needed to validate these findings in a separate population.
authors.affiliation: NYS Department of Health, Center for Environmental Health, Troy, NY, United States. Electronic address: clk03@health.state.ny.us.
authors.forename: Christine
authors.initials: C
authors.lastname: Kielb
authors.affiliation: NYS Department of Health, Center for Environmental Health, Troy, NY, United States; University at Albany School of Public Health, Rensselaer, NY, United States.
authors.forename: Shao
authors.initials: S
authors.lastname: Lin
authors.affiliation: NYS Department of Health, Center for Environmental Health, Troy, NY, United States; University at Albany School of Public Health, Rensselaer, NY, United States.
authors.forename: Michele
authors.initials: M
authors.lastname: Herdt-Losavio
authors.affiliation: University at Albany School of Public Health, Rensselaer, NY, United States.
authors.forename: Erin
authors.initials: E
authors.lastname: Bell
authors.affiliation: Upstate Medical University, SUNY, Syracuse, NY, United States.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Chapman
authors.affiliation: National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention (CDC), Cincinnati, OH, United States.
authors.forename: Carissa M
authors.initials: CM
authors.lastname: Rocheleau
authors.affiliation: National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention (CDC), Cincinnati, OH, United States.
authors.forename: Christina
authors.initials: C
authors.lastname: Lawson
authors.affiliation: National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention (CDC), Cincinnati, OH, United States.
authors.forename: Martha
authors.initials: M
authors.lastname: Waters
authors.affiliation: Stewart Exposure Assessments, LLC, Arlington, VA, United States.
authors.forename: Patricia
authors.initials: P
authors.lastname: Stewart
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, GA, United States.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Olney
authors.affiliation: University of Iowa School of Public Health, Iowa City, IA, United States.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Romitti
authors.affiliation: University of Iowa School of Public Health, Iowa City, IA, United States.
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Cao
authors.affiliation: NYS Department of Health, Center for Environmental Health, Troy, NY, United States; University at Albany School of Public Health, Rensselaer, NY, United States.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Druschel
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003398:Craniosynostoses / Q000209:etiology; D004785:Environmental Pollutants / Q000009:adverse effects*; D005260:Female; D005659:Fungicides, Industrial / Q000009:adverse effects*; D020139:Gastroschisis / Q000209:etiology*; D006540:Herbicides / Q000009:adverse effects*; D006548:Hernia, Diaphragmatic / Q000209:etiology; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D007306:Insecticides / Q000009:adverse effects*; D017880:Limb Deformities, Congenital / Q000209:etiology; D016015:Logistic Models; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D009790:Occupations; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D014481:United States; D055815:Young Adult
chemical_list: D004785:Environmental Pollutants; D005659:Fungicides, Industrial; D006540:Herbicides; D007306:Insecticides
keywords: Craniosynostosis; Diaphragmatic hernia; Gastroschisis; Maternal occupational exposure; Pesticides; Transverse limb deficiencies