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Antifertility and prenatal effects - 646 entries found

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CIS 07-897 DEMETER: Documents for the medical evaluation of reprotoxic products
DEMETER: Documents pour l'évaluation médicale des produits toxiques vis-ŕ-vis de la reproduction [in French]
This guide in the form of a CD-ROM provides guidance for medical practitioners, and particularly occupational physicians, on the evaluation of reproductive hazards resulting from exposures of men and women to toxic substances in the workplace. It contains sheets summarizing the current understanding of the reproductive toxicity of some sixty substances.
Institut national de recherche et de sécurité, 30 rue Olivier-Noyer, 75680 Paris Cedex 14, France, 2006. CD-ROM (requires a PC with Windows, a web browser and Acrobat reader). Price: EUR 20.00.

CIS 07-630 Hooiveld M., Haveman W., Roskes K., Bretveld R, Burstyn I., Roeleveld N.
Adverse reproductive outcomes among male painters with occupational exposure to organic solvents
The objective of this study was to assess the risk of reproductive disorders and birth defects in offspring of male painters exposed to organic solvents. Information on reproductive outcomes, occupational exposures and lifestyle habits was obtained through self-administered questionnaires filled in by 398 painters exposed in the period of three months before pregnancy and 302 carpenters with little or no exposure to solvents, both groups being selected at random among Dutch unionized construction workers. There was an increased risk of congenital malformations in the offspring of painters (odds ratio 6.2) compared to carpenters. There was a positive exposure-response trend based on estimated exposure to organic solvents and some indication of an increased risk of functional developmental disorders in offspring among painters with intermediate and high predicted exposure. There was also an indication of increased risk of low birth weight among the offspring of painters.
Occupational and Environmental Medicine, Aug. 2006, Vol.63, No.8, p.538-544. 31 ref.

CIS 07-420 Miraval S.
Carcinogenic, mutagenic and reprotoxic chemicals: Regulatory classification
Produits chimiques cancérogčnes, mutagčnes, toxiques pour la reproduction. Classification réglementaire [in French]
This booklet presents the list of substances that are classified as being carcinogenic, mutagenic or reprotoxic according to European Union regulations. Substances are listed in alphabetical order and by CAS registry number. The tables are preceded by definitions and classification criteria for the different types of substances.
Institut national de recherche et de sécurité, 30 rue Olivier-Noyer, 75680 Paris Cedex 14, France, Avr. 2006. 63p. Price: EUR 8.20. Downloadable version free of charge.$FILE/ed976.pdf [in French]

CIS 07-324 Lauria L., Ballard T.J., Caldora M., Mazzanti C., Verdecchia A.
Reproductive disorders and pregnancy outcomes among female flight attendants
This study examined reproductive health among female flight attendants. A cross-sectional health survey was carried out among an occupational cohort of current and former flight attendants using a postal questionnaire including items on pregnancy outcome, menstrual characteristics and infertility. The questionnaire was sent to 3036 women with a response rate of 64% (74% for current and 48% for former flight attendants). Spontaneous abortion rates were similar for pregnancies of women in service and not (12.6 and 11.4% respectively). Induced abortion rates were lower for in-service pregnancies (7.9%) compared with pregnancies of women not in service (21.1%). Menstrual irregularities in the year preceding the survey for women aged under 40 years were more frequent among current than former flight attendants (20.6% and 10.4% respectively). Fertility problems were reported by 20.6% of respondents. An association between infertility and irregular menstrual cycles was found (odds ratio 1.6).
Aviation, Space, and Environmental Medicine, May 2006, Vol.77, No.5, p.533-539. Illus. 35 ref.

CIS 07-319 Zhu J.L., Knudsen L.E., Andersen A.M.N., Hjollund N.H., Olsen J.
Laboratory work and pregnancy outcomes: A study within the National Birth Cohort in Denmark
To examine pregnancy outcomes in women doing laboratory work, this prospective cohort study of 1025 female laboratory technicians and 8037 female teachers (as reference) used data from the Danish National Birth Cohort (1997-2003). Laboratory technicians were asked about laboratory work tasks during pregnancy in an interview (at around 16 weeks of gestation). Pregnancy outcomes were obtained by linking the cohort to the national registers. Hazard ratios of late foetal loss and diagnosis of congenital malformations were calculated by using Cox regression, and odds ratios of preterm birth and small for gestational age were calculated by using logistic regression. The overall results did not indicate any high risk of reproductive failures in laboratory technicians. However, risks of preterm birth and congenital malformations were observed among subgroups with high exposures to radioisotopes and organic solvents.
Occupational and Environmental Medicine, Jan. 2006, Vol.63, No.1, p.53-58. 33 ref.

CIS 07-168 Yucra S., Rubio J., Gasco M., Gonzales C., Steenland K., Gonzales G.F.
Semen quality and reproductive sex hormone levels in Peruvian pesticide sprayers
To determine the association between occupational pesticide exposure and semen quality among sprayers using organophosphate (OPs) pesticides, 31 pesticide sprayers and 80 men who were not exposed were studied. Semen and blood samples were obtained one day after last pesticide application. Semen samples were analyzed for sperm concentration, percentage of sperm motility, percentage of normal morphology, and fructose and zinc concentrations. Blood samples were analyzed for sex hormones. Pesticide sprayers had significantly reduced age-adjusted seminal volume, percentage of motility, percentage of sperm with normal morphology, serum luteinizing hormone, serum testosterone levels, and seminal zinc concentration (a marker of prostate function), as well as significantly increased time of liquefaction, seminal pH, percentage of immature sperm morphology, and leukocyte concentration. These findings provide further evidence that occupational exposures to OP pesticides adversely affect semen quality and sex hormones.
International Journal of Occupational and Environmental Health, Oct.-Dec. 2006, Vol.12, No.4, p.355-361. Illus. 38 ref. [in English]

CIS 07-227 Barzilai-Pesach V., Sheiner E.K., Sheiner E., Potashnik G., Shoham-Vardi I.
The effect of women's occupational psychologic stress on outcome of fertility treatments
The objective of this study was to examine the association between women's occupational stress and the outcome of fertility treatments. A prospective cohort study was performed, involving a group of 75 working women who had attended fertility clinics in 1999 and 2000. Data on burnout, job strain and job satisfaction were collected by means of a structured questionnaire. Workload was assessed by the number of working hours and the existence of shift work. Women who perceived their job as more demanding were less likely to conceive (relative risk (RR) 0.6). Among women who conceived after receiving a fertility treatment, the actual workload measured in terms of hours worked per week was found to be significantly associated with a lower likelihood to successfully complete a pregnancy (RR 0.3).
Journal of Occupational and Environmental Medicine, Jan. 2006, Vol.48, No.1, p.56-61. 29 ref.

CIS 06-1343 Winker R., Rüdiger H.W.
Reproductive toxicology in occupational settings: An update
The aim of this literature review was to study the relationship between occupational exposures and fertility, developmental effects and genetic changes that lead to genetic malformations or to genetic disease. It aimed in particular to assess whether occupational exposures are responsible for 15% involuntarily childless couples, 10-20% spontaneous abortions and 3% birth defects. The review identified some substances and occupational settings that may affect fertility function, but no reliable evidence was found for developmental effects of work conditions. The decreasing fertility of women in Western countries can be better explained by the increasing female reproduction age rather than by occupational exposures. Also, the rates for spontaneous abortions and birth defects cannot be explained by industrial exposures at the workplace.
International Archives of Occupational and Environmental Health, Jan. 2006, Vol.79, No.1, p.1-10. Illus. 98 ref. [in English]


CIS 07-1109 Wennborg H., Magnusson L.L., Bonde J.P., Olsen J.
Congenital malformations related to maternal exposure to specific agents in biomedical research laboratories
The objective of this study was to evaluate the frequency of major congenital and neural crest malformations in the offspring of laboratory employees. It involved 3003 births among 1951 Swedish women laboratory workers. Exposure information was based on questionnaires, allowing women to be classified as being highly or weakly exposed. Odds ratios (ORs) were calculated. The prevalences of major malformations were 2.3% among highly exposed women and 1.9% among weakly exposed women. ORs were 1.8 for solvent exposure before the third trimester, 1.2 for laboratory work in general and 5.3 for benzene exposure around the time of conception. No significant risk for laboratory work in general was seen, but there was an increased risk relative to exposures to solvents, especially benzene. These results are based on small numbers and should be interpreted cautiously.
Journal of Occupational and Environmental Medicine, Jan. 2005, Vol.47, No.1, p.11-19. Illus. 48 ref.

CIS 06-899 Karakaya A.E., Ozcagli E., Ertas N., Sardas S.
Assessment of abnormal DNA repair responses and genotoxic effects in lead exposed workers
Genotoxic effects of lead were studied in blood cell samples from 23 workers of battery manufacturing plants and 23 unexposed controls. Tests included chromosomal aberration (CA) assay and X-ray induced challenge (XRC) assay to assess DNA damage and interference with DNA repair processes after an in vitro exposure of X-ray. Cases were classified into categories according to their blood lead levels. The CA frequencies in the exposed and control groups were not significantly different by the conventional CA assay, however, the XRC assay demonstrated significantly elevated CAs. Non-significant but reduced DNA repair responses were also observed in lead exposed workers. The results suggest that lead exposure may cause reduction in DNA repair capacity.
American Journal of Industrial Medicine, Apr. 2005, Vol.47, No.4, p.358-363. Illus. 23 ref.

CIS 06-884 Guignon N., Sandret N., Vincent R.
Exposures to carcinogens, mutagens and reprotoxic substances
Exposition aux produits cancérogčnes, mutagčnes et reprotoxiques [in French]
Results of the SUMER 2003 survey of workers' exposure to occupational hazards, indicate that an estimated 2.3 million workers are exposed to carcinogens in France. Among the 83 chemicals or chemical families listed in the SUMER questionnaire, 28 are carcinogens, among which four are also classified as mutagens, and three are classified as reprotoxic. Most exposed workers are blue-collar male workers. Many women are exposed in the health and personal care sectors. During the last ten years, there has been a slight increase in exposures to carcinogens, but technical protective measures have become far more widespread. However, more than one third of the exposed workers still do not benefit from these measures.
Documents pour le médecin du travail, 3rd Quarter 2005, No.104, p.471-483.$File/TF144.pdf [in French]

CIS 06-652 Barruyer C.
Chemicals and fertility, a poorly understood link
Substances chimiques et fertilité, un lien trop méconnu [in French]
This article examines the antifertility effects of chemical substances commonly used in the construction industry. Substances with suspected spermicidal effects include some glycol ethers (banned in France since 1997), phthalates used as PVC plasticizers, styrene and some solvents. It is recommended that the exposure to these substances be limited, in particular through the use of personal protective equipment.
Prévention BTP, Dec. 2005, No.80, p.52-54. Illus.

CIS 06-625 Laffon B., Teixeira J.P., Silva S., Loureiro J., Torres J., Pásaro E., Méndez J., Mayan O.
Genotoxic effects in a population of nurses handling antineoplastic drugs, and relationship with genetic polymorphisms in DNA repair enzymes
Concern about the genotoxic risk associated with chronic handling of antineoplastic drugs has increased, and usual safety practices may not avoid exposure. The comet assay and micronuclei (MN) test were performed on 30 oncology nurses and 22 controls. Data obtained showed increased cytogenetic and DNA damage in the exposed group, although statistical significance was only reached in the comet assay. There is evidence that the present handling practices of antineoplastic drugs in some Portuguese hospitals may not prevent exposure. Present data suggest that genetic polymorphisms in the studied DNA repair enzymes may influence the individual susceptibility to DNA damage related to chronic handling of antineoplastic drugs.
American Journal of Industrial Medicine, Aug. 2005, Vol.48, No.2, p.128-136. Illus. 75 ref.

CIS 06-674 Idrovo A.J., Sanin L.H., Cole D., Chavarro J., Cáceres H., Narváez J., Restrepo M.
Time to first pregnancy among women working in agricultural production
This study explores risk factors potentially associated with reduced fertility among women working in cut flower production. A cross-sectional study of time to first pregnancy was undertaken in 47 Colombian floriculture companies. 2,085 women were interviewed regarding potential reproductive, lifestyle and work history predictors of time-to-pregnancy (TTP), measured in months. Fertility odds ratios (FORs) were estimated for various factors associated with longer TTPs. Reduced FORs were found for the several factors, including work in flower production, less than 24 months (FOR 0.86) or two years or more (FOR 0.73).
International Archives of Occupational and Environmental Health, July 2005, Vol.78, No.6, p.493-500. 45 ref.

CIS 06-376 Ichihara G.
Neuro-reproductive toxicities of 1-bromopropane and 2-bromopropane
2-Bromopropane (2-BP), used as an alternative to chlorofluorocarbons in a Korean electronics factory, caused reproductive and haematopoietic disorders in male and female workers. After identification of 2-BP toxicity, 1-bromopropane (1-BP) was introduced as an alternative. 1-BP was considered less mutagenic than 2-BP, but subsequent animal experiments revealed 1-BP to be a potent neurotoxic substance. It was also revealed that 1-BP has reproductive toxicity, but with target cells that are different from those of 2-BP. After the first animal study describing the neurotoxicity of 1-BP, human cases were reported showing decreased vibration perception, paraesthesia in the lower extremities, decreased sensation in the thighs, ventral and gluteal regions, stumbling and headache, as well as mucosal irritation. More work is necessary on the dose-response of bromopropanes in humans and on the mechanisms underlying the differences in toxic effects between the two bromopropanes.
International Archives of Occupational and Environmental Health, Mar. 2005, Vol.78, No.2, p.79-96. 94 ref.

CIS 06-371 Lai C.H., Liou S.H., Lin H.C., Shih T.S., Tsai P.J., Chen J.S., Yang T., Jaakkola J.J.K., Strickland P.T.
Exposure to traffic exhausts and oxidative DNA damage
To assess the association between exposure to traffic exhausts and indicators of oxidative DNA damage, a case-control study was undertaken involving 47 female highway toll station workers and 27 female office workers as a reference group. Exposure assessment was based on average and cumulative traffic density and a biomarker of exposure, urinary 1-hydroxypyrene-glucuronide (1-OHPG). Urinary 8-hydroxydeoxyguanosine (8-OHdG) was used as a biomarker of oxidative DNA damage. Plasma nitric oxide (NO) was measured as an indicator of oxidative stress related to traffic exhaust exposure. The mean concentration of urinary 8-OHdG was substantially higher among the exposed nonsmokers compared with the reference non-smokers. The mean concentration of NO among the exposed was also higher compared with the reference non-smokers. In linear regression adjusting for confounding, 8-OHdG was statistically significantly related to 1-OHPG. Results indicate that exposure to traffic exhausts increases oxidative DNA damage. Urinary 8-OHdG is a promising biomarker of traffic exhaust induced oxidative stress.
Occupational and Environmental Medicine, Apr. 2005, Vol.62, No.4, p.216-222. 31 ref.

CIS 06-367 Bilban M., Bilban Jakopin C., Ogrinc D.
Cytogenic tests performed on operating room personnel (the use of anaesthetic gases)
The cytogenic effects of chronic exposure to small doses of anaesthetic gases was studied in a group of workers handling these gases in operating theatres. Results were compared with those from radiologists exposed to ionizing radiation and from a group of Slovene citizens who were never exposed to genotoxic agents. Tests included structural chromosomal aberrations (SCA), sister chromatid exchanges (SCE) and the micronucleus assay (MN). The average frequency of SCAs in the study group was significantly higher than in the group of radiologists and Slovene citizens. The frequency of SCE and MN was also significant. These findings confirm those of previous studies, indicating that exposure to anaesthetic gases induces changes in human chromosomes.
International Archives of Occupational and Environmental Health, Feb. 2005, Vol.78, No.1, p.60-64. 23 ref.


CIS 10-0336 Vogel L.
Occupational health - Eight priority action areas for Community policy
Zdravje pri delu - Osem prednostnih področij za politiko Skupnosti [in Slovenian]
Arodveselība - Kopienas políticas astoņas proritārās darbības jomas [in Latvian]
Arbejdsmiljř - Otte proriterede indsatsomrĺder i EU [in Danish]
Zdravoslovni usloviya na trud - Osem prioritetni oblasti na deĭstvie za opredelyane na politikata na Evropeĭskata Obshtnost [in Bulgarian]
Iş sağliği - Topluluk politikasi için Sekiz öncelikli eylem alani [in Turkish]
Ochrana zdraví pří práci - Osm prioritních oblastí pro politiku Společenství [in Czech]
Salute sul lavoro - Otto aree prioritarie per la politica comunitaria [in Italian]
Spanish, Italian, Bulgarian, Czech, Danish, Lettish, Slovenian and Turkish translations of the document abstracted under CIS 04-529. The booklet reviews and discusses the main occupational health issues in the European Union, and proposes that they be given priority in EU actions in this area, from a trade union perspective. Contents: occupational health, a key area for reducing social inequalities in health; Community strategy for the period 2002-2006; prevention systems for a coherent strategy; important factors in work organization; chemical risks, a major cause of occupational health-related mortality; job insecurity; improving knowledge and prevention in reproductive health and maternity; recognition of occupational diseases.
European Trade Union Institute, Health and Safety Department, 5 Bd du Roi Albert II, B-1210 Bruxelles, Belgium, 2004. 32p. Illus. Price: EUR 10.00. Downloadable version (PDF format) free of charge.
Occupational_health.pdf [in English]
Santé_au_travail.pdf [in French]
Salud_laboral.pdf [in Spanish]
Zdravoslovni_usloviya_na_trud.pdf [in Bulgarian]
Ochrana_zdraví_při_práci.pdf [in Czech]
Arbejdsmiljř.pdf [in Danish]
Salute_sul_lavoro.pdf [in Italian]
Arodveselība.pdf [in Latvian]
Zdravje_pri_delu.pdf [in Slovenian]
Iş_sağliği.pdf [in Turkish]

CIS 06-1030
Bureau of Workers' Activities
Male and female reproductive health hazards in the workplace
Maẖāṭir al-ṣiḥḥa al-injābīa ladā al-ḏukūr wa al-ināṯ al-nāši'a (an makan al-(amal [in Arabic]
Arabic translation of the manual indexed under CIS 97-436. This training module contains information on how occupational hazards can affect the reproductive system of workers of either sex. Topics discussed include: the mechanism of reproductive damage (prior to conception, during pregnancy, after birth); sources of knowledge on reproductive hazards of chemical, physical or biological agents and of the work situation in general; protection against reproductive hazards; role of the health and safety representative; case study of negative male fertility outcome due to chemical exposure at work; glossary. In appendices: list of chemicals with reproductive toxicity; reproductive hazards to men and women; industries where there is evidence of adverse reproductive outcome in exposed women (without linkage to specific exposures); examples of agents toxic to the male reproductive system; carcinogenic chemical in electronics manufacturing; examples of substances observed to induce adverse reproductive outcomes following exposure during pregnancy.
Ministry of Health, Damascus, Syrian Arab Republic, 2004. x, 35p. Illus.

CIS 06-201 Magnusson L.L., Bonde J.P., Olsen J., Möller L., Bingefors K., Wennborg H.
Paternal laboratory work and congenital malformations
A study was carried out on male employees of biological and biomedical institutions in Swedish universities from 1970 to 1989. A control group comprised workers in non-biological departments of the same universities. Female partners were linked to the Swedish Medical Birth register. The total number of pregnancies available for study was 4170. The relationship between major malformations and exposure to laboratory work and to specific laboratory agents or techniques before the third trimester of pregnancy was analysed using logistic regression. There were a total of 81 births with at least one major malformation: 44 among those exposed to paternal laboratory work and 37 among the reference group. It was concluded that while the prevalence of congenital malformations was not increased in the offspring of male laboratory workers in general, paternal work with agents such as carcinogens could be of concern.
Journal of Occupational and Environmental Medicine, Aug. 2004, Vol.46, No.8, p.761-767. Illus. 43 ref.

CIS 06-178 Díaz-Valecillos M., Fernández J., Rojas A., Valecillos J., Cańizales J.
Chromosome alterations in workers exposed to ionizing radiation
Alteraciones cromosómicas en trabajadores expuestos a radiaciones ionizantes [in Spanish]
The objective of this study was to examine and characterize chromosome alterations and their relationship with radiation doses, length of occupational exposure and length of weekly exposure. It involved 18 Venezuelan petroleum industry workers exposed to ionizing radiation for at least one year and a control group of randomly selected non-exposed workers. For the exposed group, average age was 46.1 years, duration of employment was 17.5 years and weekly exposure was 4.3 hours. Chromosomal anomalies consisted of simple fragilities (66%) and combined fragilities with chromosome breaks, deletions and polyploidies (22%). Among controls, chromosome alterations consisted of simple fragilities in 55% of cases. Among radiologists, 88.8% of the chromosome alterations were found for doses below permissible levels. 88% of the radiologists showing anomalies had been exposed for over 10 years. The results indicate that, depending on the duration of employment and weekly exposures, chronic exposure to low doses of ionizing radiation may cause chromosome alterations.
Investigación Clínica, Sep. 2004, Vol.45, No.3, p.197-211. 39 ref.

CIS 05-360 Luderer U., Bushley A., Stover B.D., Bremner W.J., Faustman E.M., Takaro T.K., Checkoway H., Brodkin C.A.
Effects of occupational solvent exposure on reproductive hormone concentrations and fecundability in men
To assess fertility and reproductive endocrine function in solvent-exposed men, this study investigated time-to-pregnancy of in a cohort of painters and millwrights compared to a reference group of carpenters. Detailed data on occupational exposure, medical history and time-to-pregnancy were obtained by telephone interview. Plasma luteinizing hormone (LH), follicle stimulating hormone (FSH), and testosterone concentrations were determined by immunoassay. FSH concentrations increased significantly with increasing exposures to all solvents and to chlorinated solvents. There were no significant associations of solvent exposures with LH or testosterone levels. LH, FSH, and testosterone concentrations also did not differ by job title. Time-to-pregnancy was non-significantly longer in the painters and millwrights than the carpenters. There was no significant association between time-to-pregnancy and any of the exposures. The significant associations between FSH levels and solvent exposures suggest the potential for adverse effects of solvent exposures on reproductive function in men.
American Journal of Industrial Medicine, Dec. 2004, Vol.46, No.6, p.614-626. Illus. 49 ref.

CIS 05-162 Shiau C.Y., Wang J.D., Chen P.C.
Decreased fecundity among male lead workers
The objective of this study was to investigate time to pregnancy (TTP) in wives of male workers exposed to lead in order to determine the dose-response relation between blood lead and decreased fecundity. 163 currently-employed married male lead battery workers were classified into five categories of exposure based on questionnaire information and annual blood lead levels. Information pertaining to the TTP was collected using personal interviews of men and their spouses. Fecundity ratios (FRs) were calculated using regression techniques. After controlling for other factors associated with TTP, a dose-response relation was observed between blood lead level and TTP. The measured FRs were 0.90, 0.72, 0.52 and 0.40 for concurrent blood lead levels of <20, 20-29, 30-39, and >40µg/dl, respectively. These results corroborate the hypothesis that a raised blood lead level affects fecundity.
Occupational and Environmental Medicine, Nov. 2004, Vol.61, No.11, p.915-923. Illus. 42 ref.

CIS 04-415 Hanke W., Jurewicz J.
The risk of adverse reproductive and developmental disorders due to occupational pesticide exposure: An overview of current epidemiological evidence
This literature survey examines epidemiological studies on the association between parental occupation in agriculture and the incidence of infertility, congenital malformations, miscarriage, low birthweight, small-for-gestational-age birth, pre-term delivery and stillbirth. The findings suggest the need to increase awareness of workers who are occupationally exposed to pesticides about their potential negative influence on fertility and pregnancy outcome. Furthermore, in the light of existing although still limited evidence of adverse effects of pesticide exposure on fertility during the pre-conceptual period, the exposure to pesticides should be reduced at all times.
International Journal of Occupational Medicine and Environmental Health, 2nd quarter 2004, Vol.17, No.2, p.223-243. 80 ref.

CIS 04-406 Bilban M.
Mutagenic testing of workers exposed to toluene-diisocyanates during plastics production process
This study on the potential mutagenicity of toluene diisocyanates (TDI) involved 26 workers exposed to TDI during the production of plastics, together with 21 non-exposed controls. The concentration of TDI ranged between 0.007mg/3 and 0.016mg/3. Structural chromosome aberrations (SCA) were evaluated in 200 lymphocytes of peripheral blood, with an average occurrence of 2.6. Sister chromatid exchanges (SCE) were examined in 50 cells, the average occurrence being 8.127. Micronuclei (MN) were examined in 500 blocked cytokinesis cells, with an average occurrence of 12.07. The corresponding averages of the control group were 1.89 (SCA), 5.52 (SCE) and 4.38 (MN), respectively. The difference between the groups is of statistical significance, thus confirming the mutagenic activity of toluene diisocyanates or their metabolites.
American Journal of Industrial Medicine, May 2004, Vol.45, No.5, p.468-474. 25 ref.

CIS 04-399
World Health Organization (WHO)
Childhood pesticide poisoning - Information for advocacy and action
Pesticide poisoning is a serious health problem that disproportionately affects infants and children. Pesticides can be harmful when improperly used or stored, key risks being cancer, birth defects, damage to the nervous system and disruptions to the functioning of the endocrine system. The purpose of this booklet is to provide information on the effects of pesticide exposure on women and children and to propose appropriate preventive actions. Contents: texts of relevant international agreements; current knowledge concerning the risk of pesticide poisoning among children; what can be done to prevent pesticide poisoning among children at the local, regional, national and international levels; activities of international organizations.
United Nations Environment Programme, 11-13 chemin des Anémones, 1219 Châtelaine, Genčve, Switzerland, May 2004. 37p. Illus. 38 ref. [in English]

CIS 04-167 Tuimala J.
Inherited DNA repair capacity and individual responses to carcinogens
Although humans are exposed daily to genotoxic carcinogens, the body has efficient means to deal with absorbed harmful compounds. However, wide inter-individual differences have been shown to exist concerning the capacity to respond to chemical carcinogens. The aim of this thesis was to study the influence of polymorphisms in various DNA repair genes, the cytogenic damage (mutagen sensitivity, chromosomal aberrations and sister chromatide exchange) and the risk of cancer in the upper aerodigestive tract. The results show that polymorphism of DNA repair genes are able to influence the individual responses to genotoxic and carcinogenic exposures.
Finnish Institute of Occupational Health, FIOH-Bookstore, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland, 2004. 83p. Illus. Bibl.ref. Price: EUR 18.00. [in English]

CIS 03-1650 Solé Gómez M.D.
Reproductive health protection and promotion: Role of health care personnel of occupational safety and health services
Protección y promoción de la salud reproductiva: funciones del personal sanitario del servicio de prevención [in Spanish]
This information note describes the role of the medical staff of occupational safety and health services with respect to the prevention of hazards to reproductive health or to the development of the unborn child. Topics addressed: identification of the population subject to the risk of reproductive function changes; organic changes in pregnant women, new mothers and breast-feeding women; training and information of male and female personnel on the risks to reproductive health; advice tailored to the individual; specific prevention measures (three months prior to conception, during pregnancy, during breast feeding). Risk factors that need to be taken into account for the evaluation of hazards among breast-feeding women or new mothers, as well as critical periods and possible mechanisms of risks to reproductive health in case of paternal exposure to chemical agents, are presented in tabular form.
Instituto Nacional de Seguridad e Higiene en el Trabajo, Ediciones y Publicaciones, c/Torrelaguna 73, 28027 Madrid, Spain, 2004. 6p. Illus. 12 ref. [in Spanish]


CIS 06-105 Lebailly P., Devaux A., Pottier D., De Meo M., Andre V., Baldi I., Severin F, Bernaud J., Durand B., Henry-Amar M., Gauduchon P.
Urine mutagenicity and lymphocyte DNA damage in fruit growers occupationally exposed to the fungicide captan
The objective of this study was to determine haematological parameters, urine mutagenicity (on three Salmonella typhimurium strains), and DNA damage (using the comet assay) in mononuclear leucocytes of farmers before and after a one-day spraying period of pear and apple trees with the fungicide captan in usual conditions. A total of 19 farmers were exposed to captan during the 1998 and the 2000 spraying seasons. It was found that one-day spraying periods with captan and other pesticides does not significantly induce DNA damages in mononuclear leucocytes. In contrast, inefficient protective clothing could correlate with an increase in urine mutagenicity.
Occupational and Environmental Medicine, Dec. 2003, Vol.60, No.12, p.910-917. Illus. 39 ref.

CIS 06-179 Zakeri F., Assaei R., Varzegar R.
Chromosomal aberrations in workers occupationally exposed to chronic low-level ionizing radiation
To determine whether prolonged or repeated low-level exposure to ionizing radiation can induce chromosomal aberrations (CAs), a large-scale cytogenetic study of 450 radiation-exposed workers (industrial radiographers and personnel from nuclear research, medical X-ray diagnostic and nuclear medicine centres) was undertaken using the yield of CAs analysed in peripheral blood lymphocyte cultures. The results were compared with those of a control group consisting of healthy persons with no history of occupational exposure to radiation. The findings showed that the incidence of all types of CAs was significantly higher in all exposed groups than in the controls. The highest rate of aberrations was found among industrial radiographers and the lowest was obtained in the personnel of medical X-ray diagnostic centres. Although the mean frequency of CAs among male workers was slightly higher than among females, no obvious trend of increased aberrations as a function of either duration of employment or age was observed. The results suggest that education and retraining of staff concerning radiation safety guidelines and regulations and the use of up-to-date equipment are major considerations in reducing the workers' radiation exposure.
Central European Journal of Occupational and Environmental Medicine, 2003, Vol.9, No.1, p.33-38. 21 ref.

CIS 06-98 Mármol-Maneiro L., Fernández-D'Pool J., Sánchez B.J., Sirit Y.
Seminal profile of workers exposed to cholinesterase inhibiting insecticides
Perfil seminal en trabajadores expuestos a plaguicidas inhibidores de la colinesterasa [in Spanish]
The objective of this study was to examine the physical and chemical properties of the sperm of workers exposed to cholinesterase-inhibiting pesticides and to highlight a possible relationship with the total cholinesterase level in blood. The study involved 29 subjects aged between 20 and 54 years, exposed for four hours a day during a minimum period of one year, and a control group of 30 unexposed subjects. Results of spermatograms and measurements of blood cholinesterase levels showed significant differences between exposed subjects and controls in terms of sperm concentrations and quality. Results suggest that cholinesterase-inhibiting pesticides influence some sperm variables.
Investigación Clínica, June 2003, Vol.44, No.2, p.105-117. 50 ref.

CIS 04-551 Buzio L., De Palma G., Mozzoni P., Tondel M., Buzio C., Franchini I., Axelson O., Mutti A.
Glutathione S-transferases M1-1 and T1-1 as risk modifiers for renal cell cancer associated with occupational exposure to chemicals
This study investigates the possible interaction between occupational risk factors and genotype for glutathione S-transferases M1 and TI (GSTM 1 and GSTT 1) in renal cell cancer (RCC). One hundred patients with RCC and 200 outpatient controls were enrolled at Parma University Hospital. The polymorphisms of GSTM1 and GSTT1 were investigated by PCR; occupational history was collected by a structured questionnaire. Subjects with GSTM 1 present genotype showed higher risks for RCC, compared to GSTM 1 null subjects, if exposed to metals (OR 2.73) or pesticides (OR 3.46). The GSTT 1 present genotype also enhanced about twofold the risk of RCC among subjects exposed to solvents and pesticides, compared with those GSTT1 null. The results support the hypothesis that GSTM1 and GSTT1 polymorphisms can interact with several occupational exposures to significantly modify the risk of RCC among exposed subjects.
Occupational and Environmental Medicine, Oct. 2003, Vol.60, No.10, p.789-793. 30 ref.

CIS 04-576 Joffe M., Bisanti L., Apostoli P., Kiss P., Dale A., Roeleveld N., Lindbohm M.L., Sallmén M., Vanhoorne M., Bonde J.P.
Time to pregnancy and occupational lead exposure
Lead exposure is known to be harmful to the male reproductive system, including impairment of fertility. However, it is unclear whether currently existing low levels of exposure have this effect. This study retrospectively examines current workers in lead-using industries (battery manufacture, smelting, etc,), and in non-lead-using control industries in four European countries, with time to pregnancy as the outcome variable. Exposure assessment was mainly by blood lead values, which were available from the late 1970s, supplemented by imputed values where necessary. Three exposure models were studied: short term (recent) exposure, total duration of work in a lead using industry and cumulative exposure. A Cox proportional hazards model was used for the statistical analysis, with covariates for both partners. Results show that among the total of 1104 subjects that took part, 638 were occupationally-exposed to lead at the relevant time. Blood lead levels were mainly less than 50µg/dL. No consistent association of time to pregnancy with lead exposure was found in any of the exposure models. If any impairment of male reproductive function exists at the levels of occupational lead exposure now current, it does not appear to reduce biological fertility.
Occupational and Environmental Medicine, Oct. 2003, Vol.60, No.10, p.752-758. Illus. 35 ref.

CIS 04-165 Fahrig R., Görlitz B.D., Preiß A.
Bundesanstalt für Arbeitsschutz und Arbeitsmedizin
Genotoxic effects of 3,3'-dihydroxybenzidine including stability investigations
Prüfung der genotoxischen Wirkung von 3,3'-Dihydroxybenzidin einschließlich Untersuchungen zur Stabilität [in German]
In this study, the mutagenic activity of 3,3'-dihydroxybenzidine in various biological systems was examined. 3,3'-dihydroxybenzidine induced isolated mutations in bacteria as well as genetic mutations and chromosomal aberrations in cell cultures (V79). In a UDS test (non-programmed DNA synthesis) on rat hepatocytes, toxic effects were observed on the hepatocytes, but there was no increase in DNA synthesis. There was no evidence of 3,3'-dihydroxybenzidine toxicity in a micronucleus test on mice. The stability of 3,3'-dihydroxybenzidine in acetonitrile and in aqueous and organic solvent mixtures was also examined. In the latter case, degradation was observed in both buffered and unbuffered mixtures.
Wirtschaftsverlag NW, Postfach 10 11 10, 27511 Bremerhaven, Germany, 2003. 196p. Illus. 7 ref. Price: EUR 17.00.


CIS 06-824 Guidelines on reproductive health policy & programmes at the workplace
Guidance document on the prevention of reproductive hazards for both women and men in the workplace, whether due to chemical, physical or biological agents.
Department of Occupational Safety and Health, Ministry of Human Resources, Aras 2, 3 dan 4, Blok D3, Parcel D, Pusat Pentadbiran Kerajaan Persekutuan, 62502 Putrajaya, Malaysia, 2002. iv, 48p. 25 ref. [in English]

CIS 06-71 Reproductive health: Developing partnerships in the study of reproductive hazards in the workplace
This information note gives an overview of the types of studies conducted by NIOSH copncerning reproductive hazards in the workplaces. NIOSH develops partnerships to conduct three types of field studies (health hazard evaluations, industry-wide studies and technical assistance). Male reproductive health assessments include studies of the neuroendocrine function, spermatogenesis and fecundability, genetic damage to spermatozoa and sexual function. Female reproductive health assessments include studies of the neuroendocrine function, ovulation, menstrual cycle defects and luteal phase defects.
Publications Dissemination, National Institute for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway, Cincinnati, OH 45226-2002, USA, Apr. 2002. 1p. Illus. [in English]

CIS 03-1623 Cedergren M.I., Selbing A.J., Källén B.A.J.
Risk factors for cardiovascular malformation - A study based on prospectively collected data
This study included 277 women who had infants with a severe cardiac defect. Data on parental age, maternal reproductive history, disease in early pregnancy, reported maternal use of drugs and alcohol, smoking habits, parental occupation and maternal body mass index (BMI) were extracted from medical records. Maternal diabetes mellitus was associated with an increased risk for cardiovascular malformation (odds ratio (OR) 2.38), as was a high BMI (> 29, OR 1.46). A tendency towards an increased risk was found for involuntary childlessness, spontaneous abortion, thyroid drugs and nonsteroid anti-inflammatory drugs. Some known risk factors for cardiac defects (eg. maternal diabetes mellitus and the use of antiepileptics) could be identified in this study but other postulated risk factors could not be verified. It is possible, however, that there is an association with the use of nonsteroid anti-inflammatory drugs or drugs for thyroid disease. The relationship between a high BMI and cardiovascular malformation observed in this study may be explained by impaired maternal glucose tolerance.
Scandinavian Journal of Work, Environment and Health, Feb. 2002, Vol.28, No.1, p.12-17. 23 ref.

CIS 03-1774 Ghiassi-Nejad M., Varzegar R., Zakeri F., Rasouli-Nejad S.
Analysis of chromosomal aberrations, micronuclei and sister chromatid exchanges in lymphocytes of workers of a phosphate fertilizer factory
The frequencies of chromosomal aberrations, micronuclei and sister chromatid exchanges in peripheral blood lymphocytes were studied in 15 workers of an Iranian phosphate fertilizer factory exposed to chemicals and radioactive substances and in 15 unexposed controls. The exposed individuals showed higher frequencies of dicentrics as well as acentrics than the normal controls. The mean frequencies of chromosomal aberrations per 100 metaphases of workers and non-exposed controls were 5.06 and 1.52, respectively; those of micronucleated cells per 1000 binucleated lymphocytes of workers and controls were 47±8 and 12±5, respectively and the mean number of sister chromatid exchanges per 100 cells in workers and controls were 4.6±2.8 and 2.80±0.37, respectively. These results confirm the existence of clastogenic and genotoxic effects of chemical agents and radioactive materials.
Central European Journal of Occupational and Environmental Medicine, 2002, Vol.8, No.4, p.277-282. Illus. 17 ref.

CIS 03-1472 Freude G., Ullsperger P.
Infuence of stress on human fertility
Einfluss von Stress auf die Fertilität des Menschen [in German]
This article presents the findings of a literature review on the influence of stress on fertility, an aspect little considered so far in publications on stress. It is not disputed that stress is an important factor in influencing the onset of reproductive disorders, both in men and women. Among women, stress induces chronic anovulation, psychogenic amenorrhoea, false pregnancies, menstrual disorders, increased prolactin levels and miscarriages. Among men, stress induces lower sperm counts, lower sperm mobility, changes in sperm morphology, impotence, ejaculatory disorders, and lower levels of luteinizing hormone (LH) and testosterone.
Ergo-Med, May-June 2002, Vol.26, No.3, p.82-89. 38 ref.

CIS 03-740 Jung D., Böttiger A.
Mutagenicity and teratogenicity studies during the handling of cytostatic drugs
Studien zur Mutagenität und Teragenität beim Umgang mit Zytostatika [in German]
Three studies involving hospital pharmacists were carried out in order to establish mutagenic and teratogenic hazards during the handling of cytostatic drugs. Sister chromatid exchanges, breaks in DNA strands, alkyl guanidine transferase levels and mitosis levels were evaluated. Under working conditions that include the most recent technologies (work in laminar flow safety cabinets), no significant differences were observed between exposed and non-exposed groups.
Ergo-Med, Nov.-Dec. 2002, Vol.26, No.6, p.162-166. Illus. 3 ref.

CIS 03-821 Guidance on evaluation of reproductive toxicity data
This monograph provides guidance in the form of a structured approach for the interpretation of reproductive toxicity data. The approach is illustrated through the use of examples from several fertility and developmental toxicity studies. The possible role of maternal toxicity in the interpretation of the study findings is also taken into account. Contents: overview of the reproductive process; review of test guidelines; effects on embryo-foetal development; effects on fertility and reproduction; structured approach to evaluation of reproductive toxicity data. Appendices include: test guideline comparison; summary data sets for example substances.
European Centre for Ecotoxicology and Toxicology of Chemicals, Avenue E. Van Nieuwenhuyse 4, Bte. 6, 1160 Bruxelles, Belgium, Feb. 2002. 136p. Illus. 87 ref. Price : EUR 50.00.

CIS 03-195 Ibrahim K.S., Ahmed S.B.
Male endocrine dysfunction in lead smelter workers
Evidence of the effect of occupational exposure to lead on the male endocrine function is controversial. This study evaluated the primary (testicular) and secondary (hypothalamo-pituitary-testicular) effects of exposure to lead in 69 workers employed for an average of 16 years and in 40 non-exposed workers. The mean blood lead concentration was 42.92±4.89µg/dL in the exposed workers and 29.5± 5.3µg/dL in the control group. Concentrations of serum luteinizing hormone (LH) and follicle stimulating hormone (FSH) were both significantly higher in exposed workers but there was no significant difference in the level of testosterone in both groups. Exposed workers showed a statistically significant increase in the incidence of sexual problems (premature ejaculation, impotence, decreased libido). Periodic medical examination of workers and biological monitoring of blood lead are a necessity for the early detection of side effects or complications caused by exposure.
Central European Journal of Occupational and Environmental Medicine, 2002, Vol.8, No.1, p.31-38. 36 ref.

CIS 02-1991 Sheiner E.K., Sheiner E., Carel R., Potashnik G., Shoham-Vardi I.
Potential association between male infertility and occupational psychological stress
To investigate the influence of working conditions, occupational exposures to potential reproductive toxic agents and psychological stress on male fertility, male patients attending a fertility clinic were studied. 106 patients attended the clinic because of a male infertility problem (cases) while 66 attended because of a female infertility problem (controls). Male infertility was more associated with working in industry and construction as compared with other occupations (38.8% of cases, 23.0% of controls). Industry and construction workers were of lower educational level than the other workers, tended to smoke more (OR 2.53), worked more often in shifts (OR 3.12), reported physical exertion in work (OR 3.35) and were more exposed to noise and welding (OR 3.84 and 4.40 respectively). Male infertility was also found to be related to burnout indicators, the largest difference being obtained for cognitive weariness. Industry and construction jobs (OR 2.2) and cognitive weariness (OR 1.8) were found to be independent risk factors for male infertility problems.
Journal of Occupational and Environmental Medicine, Dec. 2002, Vol.44, No.12, p.1093-1099. 51 ref.

CIS 02-1672 Zhai R., Liu G., Ge X., Yang C., Huang C., Wu C., Christiani D.C.
Genetic polymorphisms of MnSOD, GSTM1, GSTT1 and OGG1 in coal workers' pneumoconiosis
This study investigated the association between genetic polymorphisms of various enzymes such as MnSOD, GSTM1, GSTT1, or OGG1 and susceptibility to coal workers' pneumoconiosis (CWP). The study population was composed of 259 retired coal miners who had similar dust exposure histories. Of these, there were 99 cases with ILO chest radiological criteria for CWP and 160 controls. Individual dust exposure variables were estimated from work histories, and smoking information was obtained from interviews. Polymerase chain reaction-based techniques evaluated the genotypes of all study subjects. Logistic regression analysis revealed no differences in genotype frequency of MnSOD, GSTM1, GSTT1, and OGG1 between miners with and without CWP. Cumulative dust exposures, but not genetic polymorphisms, were associated significantly with the presence of CWP. This study illustrates the complexity of factors that may contribute to the development of CWP.
Journal of Occupational and Environmental Medicine, Apr. 2002, Vol.44, No.4, p.372-377. 36 ref.

CIS 02-1798 Kitamura F., Araki S., Suzuki Y., Yokoyama K., Tanigawa Y., Iwasaki R.
Assessment of the mutations of p53 suppressor gene and Ha- and Ki-ras oncogenes in malignant mesothelioma in relation to asbestos exposure: A study of 12 American patients
To examine whether malignant mesothelioma due to asbestos have genetic alterations in the p53 suppressor gene and in Ha- and Ki-ras oncogenes, point mutations of these genes in paraffin-embedded operative open biopsied samples of the primary tumor of malignant mesothelioma of twelve patients were analysed. The genetic analysis was conducted by the polymerase chain reaction single-strand conformation polymorphism method in all patients and by sequencing analysis of DNA bases in the two patients with suspected gene mutation. The analysis of the p53 suppressor gene showed an amino acid converting mutation of exon 7 in one patient and a polymorphism of exon 6 in another patient. No genetic alteration was found in exons 1 and 2 of Ha- and Ki-ras oncogenes in any of the patients. The results suggest that the effects of asbestos exposure on the p53 suppressor gene and Ha- and Ki-ras oncogenes in malignant mesothelioma are negligible.
Industrial Health, Apr. 2002, Vol.40, No.2, p.175-181. Illus. 22 ref.

CIS 02-1788 Otsuka F.
Gene expression assay for hazard assessment of chemicals
Recent progress in the understanding of gene expression systems provides evidence that many industrial chemicals affect the transcriptional machineries directly or indirectly, and gene expression is now recognized as one of the main targets of many chemicals. In view of the increasing number of man-made chemicals, it is therefore necessary to establish a reliable gene expression assay with rapidity and high sensitivity. Among various gene expression assays, the so-called reporter assay is now accepted as a suitable tool to assess hazardous effects of chemicals on gene expression. This article focuses on the principle and applications of the reporter assay in research on endocrine disrupters.
Industrial Health, Apr. 2002, Vol.40, No.2, p.113-120. Illus. 49 ref.

CIS 02-1721 Kishi R., Kitahara T., Masuchi A., Kasai S.
Work-related reproductive, musculoskeletal and mental disorders among working women - History, current issues and future research directions
This literature review examines current issues and future research directions in occupational health of Japanese working women, with an emphasis on reproductive health, work-related musculoskeletal disorders (WMSDs) and mental disorders. In earlier studies on reproductive health, the main concern was pregnancy outcomes. Subsequently, interest focused on fecundity studies, such as time to pregnancy. Future research will examine outcomes not only during pregnancy but also disorders of hormonal balance and post-menopausal health conditions. WMSDs are reviewed mainly with respect to sex differences and their causative factors. Historically, mental health research about working women in Japan focused on job stress of nurses. In this survey, Japanese studies are compared with recent research in Europe and USA which examine the interaction between occupational stress and family roles.
Industrial Health, Apr. 2002, Vol.40, No.2, p.101-112. Illus. 63 ref.

CIS 02-1719 Guide to good practices for improving occupational safety and health in the area of risks to reproductive health and maternity
Guía de buenas prácticas para la mejora de la seguridad y la salud en el trabajo por razones de reproducción y maternidad [in Spanish]
This guide was developed as part of a European Union project for improving the protection of workers against risks to reproductive health and pregnancy (see CIS 02-1718) and is aimed at employers and employees, legal advisors, persons involved in collective bargaining and government services. It consists of three parts. The first part explains the basic biological aspects of human reproduction, the objectives of labour protection provisions, the responsibilities of employers, general hazards (mental and physical fatigue, work postures, stress, infection hazards) and specific hazards (physical, chemical and biological hazards, conditions of work). The second part presents the rights of workers during pregnancy, the different types of parental leave and the benefits offered by social security services. The final part explains the guaranteed rights (job protection against dismissal, other guarantees with respect to contractual relations, right to occupational safety and health protection). Appendices include: tables of substances with risk phrases R60, R61, R63 and R64; biological agents hazardous to female reproductive health; classification of substances having reproductive toxicity.
Ministerio de Trabajo y Asuntos Sociales, Dirección General de la Inspección de Trabajo y Seguridad Social, Spain, 2002. 126p. Illus. 27 ref.

CIS 02-1718 European project for the improvement of security and health in the workplace due to reproduction pregnancy reasons
Proyecto europeo para la mejora de la seguridad y la salud laboral por razones de reproducción y maternidad [in Spanish]
This booklet presents a general overview as well as the conclusions of a European project aimed at improving the protection of workers in the area of risks to reproductive health and pregnancy. Based on the results of a study of the systems adopted in various European Union countries, it singles out the best European practices applicable to Spain for the purpose of preparing guides on good practices aimed at employers, persons involved in collective bargaining and labour inspectors. Proposed improvements to European directives and the national provisions in this area are also included.
Ministerio de Trabajo y Asuntos Sociales, Dirección General de la Inspección de Trabajo y Seguridad Social, Spain, 2002. 32p.

CIS 02-1568 Reproduction and maternity
Reproducción y maternidad [in Spanish]
This leaflet published by the Spanish National Institute for Occupational Safety and Health describes the contents of four new occupational safety and health guides focused on risks to reproductive health, pregnancy and nursing mothers: guide to good practices for improving occupational safety and health with respect to reproduction and pregnancy (see 02-1719); guide to collective bargaining in the area of occupational risks to reproduction and pregnancy; guide for labour inspectors including check lists for risks to reproductive health and pregnancy; proposals for improving standards on the prevention of occupational risks to reproductive health and pregnancy.
Ministerio de Trabajo y Asuntos Sociales, Dirección General de la Inspección de Trabajo y Seguridad Social, Spain, 2002. 6p. Illus.

CIS 02-1240 Brender J., Suarez L., Hendricks K., Baetz R.A., Larsen R.
Parental occupation and neural tube defect-affected pregnancies among Mexican Americans
In this case-control study, it was examined whether parental occupational exposures were related to neural tube defect (NTD)-affected pregnancies among Mexican Americans living along the Texas-Mexico border. Case women were 184 Mexican-American women with NTD-affected pregnancies; control women were 225 study-area residents who delivered normal babies during the same period as the case women. The women were interviewed in person about maternal and paternal occupations and work exposures during the peri-conceptional period. Compared with control women, case women were more likely to have had occupational exposures to solvents and also were more likely to have worked in cleaning or health care occupations than control women. No compelling associations were found between paternal work exposures or occupations and NTDs in offspring in this population.
Journal of Occupational and Environmental Medicine, July 2002, Vol.44, No.7, p.650-656. 40 ref.

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