Background-Many cytotoxic drugs have been reported to be carcinogens, mutagens or teratogens. This study examined the association of maternal occupational exposure to handling toxic drugs and pregnancy intention status with risk of birth defects among a cohort of female veterinarians. Methods-Data on health and exposure during each pregnancy were obtained by self-administered mailed questionnaire from 321 female participants (633 pregnancies) in a follow up survey of the Health Risks of Australian Veterinarian (HRAV) project. Eligible participants were graduates ofAustralian veterinary schools during the 45-year period 1960-2000; 77% of respondents graduated after 1980. The Generalised Estimation Model by Poisson Regression with robust error variance was used to calculate crude and adjusted relative risk (IRR) in a multiple regression procedure to compare those exposed to cytotoxic drugs with thosee unexposed in a homogenous group of women worked in clinical veterinary practice. Results-Female veterinarians handling toxic drugs during their pregnancy had a two-fold increased risk of birth defects in their offspring (IRR=2.03, 95%CI (1.03-4.08). There was also a significant increased risk of birth defects in offspring of those women who didn't have planned pregnancy and those women who took 4 to 12 months or more than to become pregnant. The results were consistent in subgroup analysis of more recent graduates (after 1980) and in those working specifically in small animal practice. Conclusion-The results of this study, combined with existing data on animals and humans and with results found from previous surveys on other health care workers, suggest that the adverse effect of handling toxic drugs may include an increased risk of birth defects.
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