Non-occupational exposure to paint fumes during pregnancy and fetal growth in a general population☆,☆☆
Introduction
Organic solvents comprise a structurally diverse group of chemicals able to dissolve lipids and other high molecular weight compounds. They are volatile liquids at room temperature and their main routes of exposure are through inhalation and skin contact. They are widely used in both the work environment, e.g. the graphic industry and dry-cleaning, and the home environment in products such as paint and cleaning agents.
Epidemiological studies have indicated that women occupationally exposed to organic solvents during pregnancy may have a higher risk for spontaneous abortion, preterm birth and congenital malformations (McDonald et al., 1987; Kyyronen et al., 1989; Windham et al., 1991; Taskinen et al., 1994; McMartin et al., 1998; Khattak et al., 1999; Till et al., 2005; Chevrier et al., 2006; Garlantezec et al., 2009) than unexposed women, though the results are far from consistent (Taskinen et al., 1994; Khattak et al., 1999; Thulstrup and Bonde, 2006). Some studies have indicated that specific organic solvents such as per- and trichloroethylene (Windham et al., 1991) and toluene and xylene (Taskinen et al., 1994) might be more hazardous to the fetus than other organic solvents.
Ethanol is the most widely used organic solvent. Intake of ethanol during pregnancy is known to reduce fetal growth (Burd et al., 2007). A suggested mechanism of action is that ethanol impairs placental blood flow by constricting the blood vessels which induces hypoxia and fetal malnutrition (Burd et al., 2007). Epidemiological studies have suggested that also occupational exposure to organic solvents during pregnancy can decrease birth weight and gestational age (Lemasters et al., 1989; Lipscomb et al., 1991; Taskinen et al., 1994; Khattak et al., 1999; Wang et al., 2000; Chen et al., 2000; Ahmed and Jaakkola, 2007; Qin et al., 2008), which is supported by animal studies (Price et al., 1987; Ono et al., 1995).
To our knowledge, no study has investigated if exposure to organic solvents in the home environment during pregnancy affects the outcome of pregnancy in a general population. Organic solvents are used in different concentrations in all kinds of paint and many of these are liberated during painting and subsequently during drying and hardening. Many pregnant women are expected to be exposed to organic solvents from paint fumes during pregnancy due to “nesting behavior” and/or moving residence.
The aim of the present study was to investigate the association between exposure to paint fumes in the residence during pregnancy and birth weight, small for gestational age (SGA) and preterm births in a national prospective birth cohort.
Section snippets
Study population
The study was based on mother–child pairs enrolled in The Danish National Birth Cohort (DNBC) (Olsen et al., 2001), which consecutively recruited pregnant women from March 1996 to November 2002 from all over Denmark. All women who spoke Danish and intended to carry their pregnancy to term were invited to participate when they visited their general practitioner for the first pregnancy consultation. About half of all general practitioners in Denmark participated in the study, and around 60
Results
Of the 19,000 women included in this study, 8547 (45%) were exposed to paint fumes in their residence. Baseline characteristics of the women are shown in Table 1. Mean gestational age at the second interview was 32 weeks in this study population.
The mean birth weight for babies born of women exposed to paint fumes was 3584 g (SD 521 g) compared with 3592 g (SD 543 g) for babies of unexposed women. This small difference of −7.2 g was not significant in either the crude or the adjusted analysis (Table
Discussion
There were no statistically significant associations between exposure to paint fumes and birth weight and risk of preterm birth. We found a weak inverse relationship between exposure to paint fumes and the risk of SGA.
To our knowledge this is the first study on non-occupational exposure to paint fumes and fetal growth in a general population. We found no associations between exposure during pregnancy and birth weight and risk for preterm birth. This included no associations related to the
Acknowledgments
We thank senior researcher Johnny Hansen for his help with identifying the women potentially occupationally exposed to organic solvents.
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Funding: This study was supported by the Danish Agency for Science, Technology and Innovation. The Danish National Research Foundation has established the Danish Epidemiology Science Center that initiated and created the Danish National Birth Cohort. The cohort is furthermore a result of a major grant from this foundation. Additional support for the Danish National Birth Cohort is obtained from the Pharmacy Foundation, the Egmont Foundation, the March of Dimes Birth Defects Foundation, the Augustinus Foundation, and the Health Foundation.
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Ethical committee: The Danish ethical committee approved the study. The approval is attached (in Danish).