{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:55:51Z","timestamp":1789757751419,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2007,1,19]],"date-time":"2007-01-19T00:00:00Z","timestamp":1169164800000},"content-version":"vor","delay-in-days":4950,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Industrial Med"],"published-print":{"date-parts":[[1993,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Health care workers may be occupationally exposed to known and suspected teratogens including viruses, anesthetic gases, sterilants, mercury, and x\u2010radiation. To assess the risk of congenital defects among offspring of health care workers, we analyzed parental occupational histories for 4,915 case babies with congenital defects, registered during the years 1968\u20131980 by the Metropolitan Atlanta Congenital Defects Program (MACDP) registry, and for 3,027 control babies born without defects during the same period. Offspring of mothers employed in a nursing occupation during the periconceptional period had a modest excess risk of having at least one congenital defect (relative risk [RR] = 1.42; 95% confidence interval [CI] 1.06\u20131.88); the offspring were at statistically significant increased risk of having anencephaly or spina bifida (RR = 2.00; 95% CI 1.01\u20134.30), coarctation of the aorta (RR = 2.06; 95% CI 1.10\u20133.82), genital system defects (RR = 1.61; 95% CI 1.03\u20132.53), and urinary system defects (RR = 3.43; 95% CI 1.41\u20138.34). These associations were not confounded by maternal age, education, or alcohol consumption. Offspring of mothers employed in administrative or clerical jobs in the health care industry also had a modest excess risk of defects (RR = 1.35; 95% CI 0.96\u20131.90), including a statistically significant excess risk of limb defects. We also found associations between neural tube defects and potential exposure to anesthetic gases and to x\u2010radiation, but each association was based on only three case babies of potentially exposed parents. We found no associations between defects and paternal health care employment, except for a few individual defects, and these were based on small numbers of exposed subjects. Only one of five previous studies reviewed found an increased risk of congenital defects among offspring of nurses, but three of the four negative studies had substantially smaller sample sizes than the present study. Detection bias may be a possible explanation for the apparent excess risk of certain defects among offspring of nurses. \u00a9 1993 Wiley\u2010Liss, Inc.<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#note1\"\/><jats:fn><jats:p>This article is a US Government work and, as such, is in the public domain in the United States of America.<\/jats:p><\/jats:fn>\n<\/jats:p>","DOI":"10.1002\/ajim.4700240103","type":"journal-article","created":{"date-parts":[[2007,4,20]],"date-time":"2007-04-20T10:34:19Z","timestamp":1177065259000},"page":"11-23","source":"Crossref","is-referenced-by-count":50,"title":["Case\u2010control study of congenital defects and parental employment in health care"],"prefix":"10.1002","volume":"24","author":[{"given":"Thomas D.","family":"Matte","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Mulinare","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. David","family":"Erickson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,1,19]]},"reference":[{"key":"e_1_2_1_2_1","unstructured":"The Association of Schools of Public Health(1988): A proposed national strategy for the prevention of disorders of reproduction. \u2018\u2018Proposed National Strategies for the Prevention of Leading Work\u2010Related Diseases and Injuries Part 2.\u2019\u2019 Atlanta: National Institute for Occupational Safety and Health p1\u201329."},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197903153001120"},{"key":"e_1_2_1_4_1","first-page":"265","article-title":"Occupational and outcome of pregnancy: A population\u2010based study in Norway","volume":"160","author":"Bjerkedal T","year":"1984","journal-title":"Prog Clin Biol Res"},{"issue":"2","key":"e_1_2_1_5_1","first-page":"1s","article-title":"Premature mortality in the United States: Public health issues in the use of years of potential life lost","volume":"35","author":"Centers for Disease Control","year":"1986","journal-title":"MMWR"},{"key":"e_1_2_1_6_1","unstructured":"Clement C CarlsonRJ PeckJC(1986): \u201cThe Future of Work and Health.\u201d Dover Massachusetts: Auburn House Publishing."},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.1980.0345"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/10.3.247"},{"key":"e_1_2_1_9_1","unstructured":"El BatawiMA Formenko V Hemminki K Sorsa M Vergieva T(1987): Effects of occupational health hazards on reproductive functions. Report prepared by a World Health Organization meeting Geneva August 4\u20138 1986. Geneva: World Health Organization."},{"key":"e_1_2_1_10_1","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1001\/jama.1984.03350070021017","article-title":"Vietnam veterans' risk for fathering babies with birth defects","volume":"252","author":"Erickson JD","year":"1984","journal-title":"JAMA"},{"key":"e_1_2_1_11_1","doi-asserted-by":"crossref","unstructured":"EricksonJD Mulinare J McClainPW FitchTG JamesLM McClearnAB AdamsMJ(1984b): Vietnam veterans' risk for fathering babies with birth defects. Atlanta: Centers for Disease Control.","DOI":"10.1001\/jama.1984.03350070021017"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-197907000-00008"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/68.3.703"},{"key":"e_1_2_1_14_1","first-page":"490","article-title":"Health effects associated with exposure to anaesthetic gases in Ontario hospital personnel","volume":"47","author":"Guirguis SS","year":"1990","journal-title":"Br J Ind Med"},{"key":"e_1_2_1_15_1","first-page":"467","volume-title":"Birth Defects and Drugs in Pregnancy","author":"Heinonen OP","year":"1977"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.4700040122"},{"key":"e_1_2_1_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.39.2.141"},{"key":"e_1_2_1_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00378188"},{"key":"e_1_2_1_19_1","first-page":"16","article-title":"Epidemiology of birth defects","volume":"5","author":"Janerich DT","year":"1983","journal-title":"Am J Epidemiol"},{"key":"e_1_2_1_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/tera.1420410608"},{"key":"e_1_2_1_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.4700040123"},{"key":"e_1_2_1_22_1","unstructured":"LynbergMC KhouryMJ(1990):Contribution of birth defects to infant mortality among racial\/ethnic minority groups United States 1983. CDC Surveillance Summaries MMWR 39 (No. SS3):1\u201312."},{"key":"e_1_2_1_23_1","unstructured":"Makuc D Lalich N(1983):Employment characteristics of mothers during pregnancy. Health: United States 1983. DHHS publication no. (PHS) 84\u20131232. Washington D.C.: National Center for Health Statistics."},{"key":"e_1_2_1_24_1","first-page":"581","article-title":"Congenital defects and work in pregnancy","volume":"45","author":"McDonald AD","year":"1988","journal-title":"Br J Ind Med"},{"key":"e_1_2_1_25_1","unstructured":"McDowallME(1985): Occupational reproductive epidemiology: The use of routinely collected statistics in England and Wales 1980\u201382. London: Her Majesty's Stationery Office."},{"key":"e_1_2_1_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.4700200403"},{"key":"e_1_2_1_27_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-102-5-658"},{"key":"e_1_2_1_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(77)91666-X"},{"key":"e_1_2_1_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.1978.22.3.202"},{"key":"e_1_2_1_30_1","first-page":"152","article-title":"Maternal occupation and industry and the pregnancy outcome of U.S. married women, 1980","volume":"99","author":"Schilling S","year":"1984","journal-title":"Public Health Rep"},{"key":"e_1_2_1_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(82)80338-7"},{"key":"e_1_2_1_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.6166.779"},{"key":"e_1_2_1_33_1","volume-title":"1980 Census of the Population, Classified Index of Industries and Occupational","author":"U.S. Bureau of the Census","year":"1980"}],"container-title":["American Journal of Industrial Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fajim.4700240103","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajim.4700240103","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T15:06:00Z","timestamp":1698246360000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajim.4700240103"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1993,7]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1993,7]]}},"alternative-id":["10.1002\/ajim.4700240103"],"URL":"https:\/\/doi.org\/10.1002\/ajim.4700240103","archive":["Portico"],"relation":{},"ISSN":["0271-3586","1097-0274"],"issn-type":[{"value":"0271-3586","type":"print"},{"value":"1097-0274","type":"electronic"}],"subject":[],"published":{"date-parts":[[1993,7]]}}}