Residence near power lines and mortality from neurodegenerative diseases: longitudinal study of the Swiss population

The relation between residential magnetic field exposure frompower lines and mortality from neurodegenerative conditionswas analyzed among 4.7 million persons of the Swiss NationalCohort (linking mortality and census data), covering the period2000–2005. Cox proportional hazard models were used toanalyze the relation of living in the proximity of 220–380kV power lines and the risk of death from neurodegenerativediseases, with adjustment for a range of potential confounders.Overall, the adjusted hazard ratio for Alzheimer's disease inpersons living within 50 m of a 220–380 kV power linewas 1.24 (95% confidence interval (CI): 0.80, 1.92) comparedwith persons who lived at a distance of 600 m or more. Therewas a dose-response relation with respect to years of residencein the immediate vicinity of power lines and Alzheimer's disease:Persons living at least 5 years within 50 m had an adjustedhazard ratio of 1.51 (95% CI: 0.91, 2.51), increasing to 1.78(95% CI: 1.07, 2.96) with at least 10 years and to 2.00 (95%CI: 1.21, 3.33) with at least 15 years. The pattern was similarfor senile dementia. There was little evidence for an increasedrisk of amyotrophic lateral sclerosis, Parkinson's disease,or multiple sclerosis. dementia; neurodegenerative diseases; radiation, nonionizing     

Risk of selected birth defects by maternal residence close to power lines during pregnancy

Methods: Two controls matched for sex, year of birth, and municipality were selected randomly for children with the following defects: central nervous system (CNS) defects, cardiac defects, respiratory system defects, oesophageal defects, and clubfoot. The distances between maternal addresses, during pregnancy, and power lines were obtained from maps mainly of scale 1:5000. The magnetic fields in the residences were estimated based on distance, current, voltage, and configuration.

Results: The highest increased risks were seen for hydrocephalus (OR 1.73, 95% CI 0.26 to 11.64) and for cardiac defects (OR 1.54, 95% CI 0.89 to 2.68).

Conclusion: This study does not support the hypothesis that residential exposure to electromagnetic fields from power lines causes any of the investigated outcomes.

     

Multivitamin supplementation and risk of birth defects.

It is widely accepted that supplementation with folic acid, a B vitamin, reduces the risk of neural tube defects (NTDs). This case-control study tested the hypothesis that multivitamins reduce risks of selected birth defects other than NTDs. Infants with and without birth defects and aborted fetuses with birth defects were ascertained in the greater metropolitan areas of Boston, Philadelphia, and Toronto during 1993-1996. Mothers were interviewed within 6 months after delivery about a variety of factors, including details on vitamin use. Eight case groups were included: cleft lip with or without cleft palate, cleft palate only, conotruncal defects, ventricular septal defects, urinary tract defects, limb reduction defects, congenital hydrocephaly, and pyloric stenosis (n's ranged from 31 to 186). Controls were 521 infants without birth defects (nonmalformed controls) and 442 infants with defects other than those of the cases (malformed controls). Daily multivitamin supplementation was evaluated according to gestational timing categories, including periconceptional use (28 days before through 28 days after the last menstrual period). Odds ratios (ORs) below 1.0 were observed for all case groups except cardiac defects, regardless of control type. For periconceptional use, ORs with 95% confidence intervals that excluded 1.0 were estimated for limb reduction defects using both nonmalformed controls (OR = 0.3) and malformed controls (OR = 0.2) and for urinary tract defects using both nonmalformed controls (OR = 0.6) and malformed controls (OR = 0.5). Statistically significant ORs for use that began after the periconceptional period were observed for cleft palate only and urinary tract defects. These data support the hypothesis that periconceptional vitamin supplementation may extend benefits beyond a reduction in NTD risk. However, other than folic acid's protecting against NTDs, it is not clear what nutrient or combination of nutrients might affect risk of other specific defects.     

Maternal occupational exposure and risk of specific birth defects

BACKGROUND: Gregg identified the teratogenic effect of maternal rubella infection in 1941 and since then there has been a focus on risk factors for birth defects. In nearly 70% of all birth defects, there is still no known risk factor and close to 30% of all pregnancies end in a foetal loss or spontaneous abortion, often because of a defect in the foetus. A large percentage of the workforce consists of women of reproductive age. METHODS: A search in MEDLINE for original literature and examination of the association between exposure during pregnancy and the risk of birth defects. RESULTS: Five specific birth defects were identified: neural tube defects, cleft lip and cleft palate, congenital heart defects, urinary tract defects and limb defects. The next step was to include studies with information on occupational exposure during pregnancy. CONCLUSION: There seems to be growing concern as to whether organic solvents, including glycol ethers, pesticides and heavy metals may play a teratogenic role. There is no convincing evidence linking occupational exposure during pregnancy and birth defects.     

出生缺陷影响因素的meta分析

目的:探讨出生缺陷发生的影响因素,为开展防治工作提供依据。方法:利用meta分析方法研究国内12篇关于出生缺陷发生影响因素的文献。累计病例3771例,对照31549例。结果:单因素分析中各因素及其合并比值比(OR)分别为:家族遗传史(5.11)、生育畸形史(2.94)、近亲结婚(7.69)、胎数(4.67)、产次(1.77)、胎龄(0.71)、家庭附近有污染(2.22)、孕期暴露于有害物质(4.37)、孕期感冒(2.18)、孕期发热(10.25)、孕期服药(2.98)、孕期接触宠物(3.12)、父亲吸烟(2.32)与饮酒(1.90)、常吃新鲜蔬菜(0.59)与水果(0.67);多因素分析中各因素及其合并比值比(OR)分别为:家族遗传史(2.61)、生育畸形史(2.87)、孕期服药(5.11)、孕期暴露于有害物质(4.76)和父亲吸烟(1.53)。结论:家族遗传史、生育畸形史、近亲结婚、母亲年龄、胎数、产次、家庭附近有污染、孕期暴露于有害物质、孕期感冒、孕期发热、孕期服药、孕期接触宠物、父亲吸烟与饮酒是出生缺陷发生的危险因素,胎龄、常吃新鲜蔬菜与水果是出生缺陷发生的保护因素。     

出生缺陷危险因素的系统评价

目的 系统评价出生缺陷的危险因素,为制定最佳预防控制决策,实行有效的干预措施、提供科学依据.方法 搜集国内外近10～20年间关于出生危险因素的研究文献,根据文献纳入和排除标准先对其初步筛选,再通过文献质量评估对符合要求的数据进行定性和定量分析.对不同纳入结果进行敏感性分析;应用漏斗图、线性回归分析和失安全数综合评估研究文献的发表性偏倚.结果 Meta分析结果表明:孕3个月内孕妇感冒或发热OR=7.64,95% CI:5.61～10.40;妊娠前后接触化学制剂OR=4.14,95% CI:2.88～5.95;孕期服药史OR=3.94,95% CI:2.25～6.88;辅助生殖技术OR=1.38,95% CI:1.28～1.48.累积Meta分析结果表明:所有时间点的Meta分析结果均具有显著性差异;敏感性分析结果与原结论相近;线性回归法表明在a=0.05检验水准上漏斗图对称有统计学意义,失安全数大于5k+10,发表行偏倚得到了较好地控制.定性分析结果表明纳入文献的现有研究中关于中国人群与出生缺陷相关联的遗传、环境危险因素为:①先天疾患家族史;②既往出生缺陷史;③近亲结婚;④母亲及父亲方面的多种因素.结论 按照Wynder标准:在中国人群中孕3个月内孕妇感冒或发热、妊娠前后接触化学制剂、孕期服药史与出生缺陷均呈中度相关,研究结果较真实地反映了我国近20年来出生缺陷环境危险因素的流行病学主要研究结果.在所有人群中辅助生殖技术与出生缺陷存在弱相关.纳入的关于遗传、环境因素的现有研究中未见或少见微波辐射、高温、孕母营养和体重、受孕季节、环境激素、家庭经济情况、孕期情绪以及父亲年龄等因素与出生缺陷发生风险的文献.     

Maternal dietary glycaemic intake during pregnancy and the risk of birth defects

High sugar intake has been linked to fetal anomalies in the presence and absence of insulin resistance. Using dietary data collected in the Boston University Slone Epidemiology Birth Defects Study, we examined whether high dietary glycaemic index (dGI) or load (dGL) increased the risk of birth defects. Non-diabetic mothers of 1921 cases and 704 controls were interviewed within 6 months of delivery (1988-98) about pregnancy events and exposures, including a 99-item food frequency questionnaire. Case groups included amniotic bands, craniosynostosis, gastroschisis, hypospadias, small intestinal defects, anorectal defects, limb reductions, omphalocele, cleft lip and/or palate, renal agenesis, and tracheoesophageal fistula. Cubic splines were used to determine cut-point values for high dGI and dGL in relation to the risk of each birth defect. The cut-points were used in logistic regression models to calculate odds ratios (OR) and 95% confidence intervals [CI]. Control mothers in the lowest quartile of glycaemic intake were more likely to be non-Hispanic White, ≥ 30 years of age, have higher family income, have a normal body mass index and reside in Boston. Findings were null for most case groups. The anorectal defect case group was found to have elevated risks for dGL [adjusted OR: 2.4; 95% CI: 1.1, 4.9], while estimates for dGI were elevated for the amniotic band case group [adjusted OR: 3.0; 95% CI: 1.1, 8.1]. Because this is the first paper (to our knowledge) to explore dGI and dGL in relation to a spectrum of birth defects, additional studies are needed.     

Maternal diabetes: The risk for specific birth defects

We studied the risk for specific birth defects among infants of mothers with gestational and chronic diabetes using data collected by the Spanish Collaborative Study of Congenital Malformations (ECEMC). For the years 1976 to 1985, we identified 10,087 infants with malformations and 9,994 control infants; 155 of the case infants and 89 of the controls were born to diabetic mothers. The crude odds ratio for any minor or major defect and insulin-treated diabetes was 5.5 (95% CI =1.2, 24.8), and for major malformations it was 8.7 (95% CI =1.8, 34.7). The risk for defects involving the central nervous system (CNS), skeletal system and cardiovascular system were significantly increased. Infants of non-insulin-treated diabetic mothers were 2.9 times more likely to have a major congenital birth defect (95% CI =1.2, 7.2): The crude odds ratio for any major or minor defect and mothers with gestational diabetes requiring insulin was 1.9 (95% CI = 1.1, 3.4). Similar risk was observed for major defects (OR =1.9, 95% CI =1.0, 3.7). These results suggest that infants of insulin-treated diabetic mothers have an increased risk of developing malformations of the CNS, cardiovascular system and skeletal system. We also found an increased risk for specific defect categories among infants of mothers with gestational diabetes treated with insulin.Corresponding author.     

Maternal smoking and the risk of congenital birth defects: a cohort study

BACKGROUND: The literature linking gestational smoking to congenital defects has been very inconsistent. The purpose of this study was to reinvestigate the relation between gestational smoking and congenital malformations. METHODS: This study was a retrospective cohort (N = 18,016) of live births in the TriHealth Hospital system from 1 January 1998 to 31 December 1999. The cohort included 1,943 mothers who were smokers. Congenital defects were grouped into 22 different categories. Multifactorial logistic regression was used to find any association between exposure and the possible outcomes. RESULTS: Mothers who smoked were significantly younger and had babies of lower birth weight and shorter gestational age (P < .05). Of the 22 categories of congenital defects, only cardiovascular system abnormalities showed a significant difference (P < .01) between the two groups. The remaining 21 categories of congenital defects showed no statistical difference. CONCLUSION: Women who smoke during pregnancy have infants that are significantly smaller and of shorter gestational age compared with mothers who do not smoke. Based on these data and findings from most of the available literature, however, gestational smoking is unlikely to cause a large increase in congenital birth defects.     

出生缺陷危险因素及诊断研究进展

出生缺陷正在成为婴儿死亡的主要原因,是目前全世界关注的一个重大公共卫生问题.出生缺陷可由遗传因素如染色体畸变、基因突变引起,也可由环境致畸因素或两者共同作用所致.我国出生缺陷发生率呈上升趋势.这些缺陷类型如果通过早期诊断、早期干预,其中至少70%可以避免.出生缺陷干预是一个系统工程,需要全社会参与.产前超声筛查和母体血清生化指标检测是胎儿出生缺陷干预的有效手段,是出生缺陷干预二级预防中的重要组成部分.     

Exploratory spatial data analysis for the identification of risk factors to birth defects

Background

Nearly 10% of the population of Turkey lives in the Southeast Anatolian Project (SEAP) region. The population growth rate and the rate of unintended pregnancies are high and family planning services are insufficient in this region. Lifetime induced abortion rate is also high in this region. Public health problems of the SEAP region were investigated in the "SEAP Public Health Project" in 2001 and 2002. As it is one of the most important health problems of the women living in this region; induced abortion was also investigated in this project.

Methods

An optimumsample size representing the rural and urban area of the region (n = 1150) was chosen by the State Institute of Statistics by a sampling method proportional to size. 1126 of the area's 1150 houses have been visited and data about induced abortions have been obtained by applying a questionnaire to 1491 ever married women who live in the region.

Results

It has been found that 9.0% of these women who had at least one pregnancy in their life had at least one induced abortion. The lifetime induced abortion per 100 pregnancies was found to be 2.45. The primary reason given for induced abortions was "wanting no more children" (64.6%). Lifetime induced abortions were 5.3 times greater with women using a family planning method than women not using family planning methods. Lifetime induced abortions were 4.1 times greater with unemployed women than working women. Most of the women have used private doctors in order to have an induced abortion. Although 32.29% have not yet begun to use a contraceptive method after their last induced abortion, 43.75% of the women have since started to use an effective contraceptive method. 23.96% of them have begun to use an ineffective contraceptive method.

Conclusions

Induced abortion is still an important problem at the SEAP region. The results of the study remind us that unemployed women and women who have more than four children is our target group in the campaign against induced abortions. Most of the women use private doctors in order to have an induced abortion. Thus, priority must be given to educate private gynecologists with respect to induced abortion. After induced abortions, a qualified family planning consultant can be given to women and they can be secured to use a suitable contraceptive method.     

Residence,delivery and referral patterns of infants and fetuses with birth defects delivered in Hawaii, 1986-1999

Information on residence, delivery and referral patterns is useful to a birth defects program for allocation of resources, predicting where deliveries may have occurred, and estimating the impact of altering geographic inclusion criteria. The purpose of this study was to describe the residence, delivery and referral patterns for infants and fetuses with birth defects delivered in Hawaii. Data were obtained from the Hawaii Birth Defects Program and included birth defects cases delivered between 1986 and 1999 with known delivery residence and place of delivery. Of 12,873 total cases, 171 (1%) were delivered to out-of-state residents. Of the remaining 12,702 cases delivered to residents in the four Counties of Hawaii, 9905 (78%) were to City and County of Honolulu residents and 2797 (22%) were to residents of Hawaii, Kauai and Maui Counties. Of the cases delivered to City and County of Honolulu residents, 9903 were delivered in that County. Of the cases delivered to residents of the other three Counties, 591 (21%) were referred to the City and County of Honolulu for delivery, and 1602 (57%) were referred to the City and County of Honolulu for any reason. Honolulu delivery referral rates and total referral rates for cases delivered to Hawaii, Kauai and Maui County residents were higher with prenatal diagnosis of a birth defect (59 and 87%, respectively) and elective termination (70 and 85%, respectively), and varied among 53 different types of birth defect (0-83% and 23-100%, respectively).     

山东省围产儿出生缺陷危险因素的病例对照研究

【目的】探讨山东省围产儿出生缺陷的危险因素．为提高出生人口素质提供参考依据。【方法】采用以医院为基础的1：1配比的病例对照研究方法．以统一的调查表及调查方式对341例出生缺陷儿和对照的父母进行了调查．应用SAS软件对所有调查因素进行单因素及多因素非条件Logistic回归分析。【结果】出生缺陷的主要危险因素是：多次自然流产（OR=12．72）、有既往分娩畸胎儿史（OR=10．12）、妊娠异常反应史（OR=20．10）、母亲孕期饲养宠物（OR=25．14）、感冒并发烧〉38℃（OR=20．90）、服用镇静药（OR=7．16）、解热镇痛药（OR=26．13）、激素类药（OR=11．31）、接触有机溶剂（OR=13．01）、母亲孕期有不良精神刺激（OR=12．08）、父亲接触噪声（OR=6．74）、父亲接触有机溶剂（OR=6．27）。【结论】母亲孕期饲养宠物、感冒并发烧〉38℃、服用镇静药、解热镇痛药、激素类药、接触有机溶剂、母亲孕期有不良精神刺激、多次自然流产．母亲职业为工人、农民．有既往分娩畸胎儿史、妊娠异常反应史。父亲接触噪声、接触有机溶剂等是围产儿出生缺陷的危险因素。     

围产儿出生缺陷危险因素的Logistic配对研究

目的　探讨广西围产儿出生缺陷发生的各种危险因素 ,并规划出生缺陷的干预措施。方法　用条件Logistic回归模型对广西 2 0 0 0年 2 76对围产儿 (配对病例对照 )的父母所暴露的环境危险因素进行分析。结果　有统计学意义的危险因素是 :母亲孕期接触农药 (OR =5 76 4 ) ,孕期营养不良 (OR =4 5 95 ) ,父亲接触化学制剂 (OR =2 5 0 5 ) ,孕期接触化学制剂 (OR =2 331) ,产次 >2 (OR =1 934) ,孕期体力劳动过重 (OR =1 4 80 ) ,孕期不良情绪(OR =1 4 6 0 )等与出生缺陷的发生有关。结论　在广西进行出生缺陷干预可从职业因素、营养因素及心理因素等方面入手。     

Residential proximity to high-voltage power lines and risk of childhood hematological malignancies

BACKGROUND: Epidemiologic studies of electromagnetic fields and childhood cancers have focused on home exposure. The authors investigated whether residence in districts near high-voltage power lines is associated with childhood hematological malignancies, using small area analysis. METHODS: Among 50,000 children in a city in Japan, 14 cases aged younger than 15 years were diagnosed with these malignancies in the period from 1992 through 2001. A total of 294 districts constituting this city were classified according to their proximity to high-voltage power lines (either 66 kV or 220 kV). Mantel-Haenszel rate ratio is used to calculate incidence rate ratio and its 95% confidence interval (CI). RESULTS: Compared to districts of which no area fell within 300 m of high-voltage power lines, districts in which at least 50% of the area fell within 300 m of high-voltage power lines demonstrated an increased risk (incidence rate ratio: 2.2; 95% CI: 0.5-9.0). The association was strengthened for homes in which patients had resided for the longest interval of their lives (incidence rate ratio: 3.4; 95% CI: 0.9-13.2). Point-in-time measurements showed no increase in magnetic field levels for patient homes in districts near the lines. CONCLUSION: An increased, albeit nonsignificant, risk of childhood hematological malignancies associated with residential proximity to high-voltage power lines warrants further investigations.     

Elevated birth defects in racial or ethnic minority children of women living near hazardous waste sites

This case-control study evaluated the relationship between birth defects in racial or ethnic minority children born during 1983-1988 and the potential exposure of their mothers to contaminants at hazardous waste sites in California. Four categories of race or ethnicity were used: black/African American, Hispanic/Latino, American Indian/Alaska Native, and Asian/Pacific Islander. Case subjects were 13,938 minority infants with major structural birth defects (identified by the California Birth Defects Monitoring Program) whose mothers resided in selected counties at the time of delivery. The control group was composed of 14,463 minority infants without birth defects who were randomly selected from the same birth cohort as the case subjects. The potential for exposure was determined by whether the mother resided at the time of delivery in the same census tract as a hazardous waste site that was on the U.S. Environmental Protection Agency's National Priorities List (NPL). Racial/ethnic minority infants whose mothers had been potentially exposed to hazardous waste were at slightly increased risk for birth defects (odds ratio [OR] = 1.12, 95% confidence interval [CI] = 0.98-1.27) than were racial/ethnic minority infants whose mothers had not been potentially exposed. The greatest association was between potential exposure and neural tube defects (OR = 1.54, 95% CI = 0.93-2.55), particularly anencephaly (OR = 1.85, 95% CI = 0.91-3.75). The strongest association between birth defects and potential exposure was among American Indians/Alaska Natives (OR = 1.19, 95% CI = 0.62-2.27). Despite the limitations of this study, the consistency of these findings with previous studies suggests an association between environmental risk factors and birth defects. This is particularly relevant to minority populations. We recommend further investigation of birth defects among minority communities, particularly among American Indians/Alaska Natives. Special attention should also be paid to those defects and contaminants that consistently are associated with exposure to hazardous waste.