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Original article

Vol. 154 No. 7 (2024)

Exposures to non-therapeutic chemicals before, during and after pregnancy: data from the Swiss Teratogen Information Service (STIS)

DOI
https://doi.org/10.57187/s.3751
Cite this as:
Swiss Med Wkly. 2024;154:3751
Published
16.07.2024

Summary

AIMS OF THE STUDY: Limited knowledge exists regarding exposures to non-therapeutic chemicals by women planning to conceive, or during pregnancy or breastfeeding. The Swiss Teratogen Information Service (STIS) provides information to healthcare professionals about medications and other exposures during pregnancy or breastfeeding. This study aimed to describe the queries on non-therapeutic chemicals addressed to the STIS over the past two decades.

METHODS: Using data from the STIS for the years 2000 to 2019, we conducted a descriptive analysis of all queries related to women’s exposures to non-therapeutic chemicals during pregnancy planning, pregnancy or breastfeeding.

RESULTS: Over two decades, the STIS database recorded 320 exposures to chemicals. Workplace settings accounted for over 60% of queries, followed by exposures at home (20%). In almost half (48%) of the queries, more than one chemical was mentioned, totalling 885 chemicals across these 320 queries. Commonly mentioned chemicals included isopropanol, acetone and lead. Solvents were the leading category of products (16%), followed by cleaning products (10%), paints (8%) and insecticides (5%). The follow-up data showed five diverse cases of congenital malformations, accounting for 4.0% (5 out of 125) of the sample, a figure in line with the background risk of malformations in the general population.

CONCLUSIONS: This study emphasises the importance of conducting research that comprehensively captures the highly heterogeneous exposures to non-therapeutic chemicals during pregnancy and suggests that attention should be given not only to professional settings, but also to domestic contexts.

References

  1. Vogel T, Lüde S, Baumgartner R, Rauber-Lüthy C, Simões-Wüst AP. Accidental or intentional exposure to potentially toxic medications, natural toxins and chemicals during pregnancy: analysis of data from Tox Info Suisse. Swiss Med Wkly. 2018 May;148:w14620. 10.4414/smw.2018.14620 DOI: https://doi.org/10.4414/smw.2018.14620
  2. Bably M, Arif AA, Post A. Prenatal use of cleaning and scented products and its association with childhood asthma, asthma symptoms, and mental health and developmental comorbidities. J Asthma. 2021 Jan;58(1):46–51. 10.1080/02770903.2019.1656229 DOI: https://doi.org/10.1080/02770903.2019.1656229
  3. Casas L, Zock JP, Carsin AE, Fernandez-Somoano A, Esplugues A, Santa-Marina L, et al. The use of household cleaning products during pregnancy and lower respiratory tract infections and wheezing during early life. Int J Public Health. 2013 Oct;58(5):757–64. 10.1007/s00038-012-0417-2 DOI: https://doi.org/10.1007/s00038-012-0417-2
  4. Henderson J, Sherriff A, Farrow A, Ayres JG. Household chemicals, persistent wheezing and lung function: effect modification by atopy? Eur Respir J. 2008 Mar;31(3):547–54. 10.1183/09031936.00086807 DOI: https://doi.org/10.1183/09031936.00086807
  5. Tjalvin G, Svanes Ø, Igland J, Bertelsen RJ, Benediktsdóttir B, Dharmage S, et al. Maternal preconception occupational exposure to cleaning products and disinfectants and offspring asthma. J Allergy Clin Immunol. 2022 Jan;149(1):422–431.e5. 10.1016/j.jaci.2021.08.025 DOI: https://doi.org/10.1016/j.jaci.2021.08.025
  6. Sherriff A, Farrow A, Golding J, Henderson J. Frequent use of chemical household products is associated with persistent wheezing in pre-school age children. Thorax. 2005 Jan;60(1):45–9. 10.1136/thx.2004.021154 DOI: https://doi.org/10.1136/thx.2004.021154
  7. Baumgartner R, Winterfeld U, Panchaud A, Simões-Wüst AP. Queries on medication use during pregnancy: characterisation of the Swiss Teratogen Information Service database. Swiss Med Wkly. 2022 May;152(2122):w30187. 10.4414/SMW.2022.w30187 DOI: https://doi.org/10.4414/SMW.2022.w30187
  8. Weber-Schoendorfer C, Kayser A, Tissen-Diabaté T, Winterfeld U, Eleftheriou G, Te Winkel B, et al. Fetotoxic risk of AT1 blockers exceeds that of angiotensin-converting enzyme inhibitors: an observational study. J Hypertens. 2020 Jan;38(1):133–41. 10.1097/HJH.0000000000002233 DOI: https://doi.org/10.1097/HJH.0000000000002233
  9. Pauliat E, Onken M, Weber-Schoendorfer C, Rousson V, Addor MC, Baud D, et al. Pregnancy outcome following first-trimester exposure to fingolimod: A collaborative ENTIS study. Mult Scler. 2021 Mar;27(3):475–8. 10.1177/1352458520929628 DOI: https://doi.org/10.1177/1352458520929628
  10. Winterfeld U, Weber-Schöndorfer C, Schaefer C, von Elm E, Buclin T. Ethical approval for multicenter cohort studies on drug exposure during pregnancy: A survey among members of the European Network of Teratology Information Services (ENTIS). Reprod Toxicol. 2018 Sep;80:68–72. 10.1016/j.reprotox.2018.06.002 DOI: https://doi.org/10.1016/j.reprotox.2018.06.002
  11. Swiss Teratogen Information Service S. Available from https://www.chuv.ch/en/stis/
  12. EUROCAT. Prevalence charts and tables | EU RD Platform. 2020. Available from https://eu-rd-platform.jrc.ec.europa.eu/eurocat/eurocat-data/prevalence_en
  13. Matas JL, Agana DF, Germanos GJ, Hansen MA, Modak S, Tanner JP, et al. Exploring classification of birth defects severity in national hospital discharge databases compared to an active surveillance program. Birth Defects Res. 2019 Nov;111(18):1343–55. 10.1002/bdr2.1539 DOI: https://doi.org/10.1002/bdr2.1539
  14. Ito S. Mother and Child: Medication Use in Pregnancy and Lactation. Clin Pharmacol Ther. 2016 Jul;100(1):8–11. 10.1002/cpt.383 DOI: https://doi.org/10.1002/cpt.383
  15. Dathe K, Schaefer C. The Use of Medication in Pregnancy. Dtsch Arztebl Int. 2019 Nov;116(46):783–90. DOI: https://doi.org/10.3238/arztebl.2019.0783
  16. Chen LJ, Chiou JY, Huang JY, Su PH, Chen JY. Birth defects in Taiwan: A 10-year nationwide population-based, cohort study. J Formos Med Assoc. 2020 Jan;119(1 Pt 3):553–9. 10.1016/j.jfma.2019.08.006 DOI: https://doi.org/10.1016/j.jfma.2019.08.006
  17. Svensson E, Ehrenstein V, Nørgaard M, Bakketeig LS, Rothman KJ, Sørensen HT, et al. Estimating the proportion of all observed birth defects occurring in pregnancies terminated by a second-trimester abortion. Epidemiology. 2014 Nov;25(6):866–71. 10.1097/EDE.0000000000000163 DOI: https://doi.org/10.1097/EDE.0000000000000163
  18. The Federal Council. SR 813.1 - Federal Act of 15 December 2000 on Protection against Dangerous Substances and Preparations (Chemicals Act, ChemA) 2023. Available from https://www.fedlex.admin.ch/eli/cc/2004/724/en
  19. The Federal Council. Chemicals Ordinance (ChemO). 2023. Available from https://www.anmeldestelle.admin.ch/chem/en/home/themen/recht-wegleitungen/chemikalienrecht/chemikalienverordnung.html
  20. The Federal Council. Chemical Risk Reduction Ordinance (ORRChem). 2017. Available from https://www.anmeldestelle.admin.ch/chem/en/home/themen/recht-wegleitungen/chemikalienrecht/chemikalien-risikoreduktionsverordnung.html
  21. Federal Administration. Federal Coordination Commission for Occupational Safety 2017. Available from https://www.ekas.ch/index-en.php?frameset = 1.
  22. SUVA. 2023. Available from https://www.suva.ch/en
  23. Federal Administration. 822.111.52 Verordnung des WBF über gefährliche und beschwerliche Arbeiten bei Schwangerschaft und Mutterschaft (Mutterschutzverordnung). 2015. Available from https://www.fedlex.admin.ch/eli/cc/2001/127/de
  24. SUVA. Grenzwerte am Arbeitsplatz. 2023. Available from https://www.suva.ch/de-ch/services/grenzwerte#gnw-location
  25. Federal Statistical Office. Housework and family work: Average time spent in hours per week [Haus- und Familienarbeit: Durchschnittlicher Zeitaufwand in Stunden pro Woche]. 2023. Available from https://www.bfs.admin.ch/bfs/de/home/statistiken/arbeit-erwerb/erwerbstaetigkeit-arbeitszeit/vereinbarkeit-unbezahlte-arbeit/haus-familienarbeit.assetdetail.17124520.html
  26. García AM, González-Galarzo MC, Ronda E, Ballester F, Estarlich M, Guxens M, et al. Prevalence of exposure to occupational risks during pregnancy in Spain. Int J Public Health. 2012 Oct;57(5):817–26. 10.1007/s00038-012-0384-7 DOI: https://doi.org/10.1007/s00038-012-0384-7
  27. Zachek CM, Schwartz JM, Glasser M, DeMicco E, Woodruff TJ. A screening questionnaire for occupational and hobby exposures during pregnancy. Occup Med (Lond). 2019 Oct;69(6):428–35. 10.1093/occmed/kqz094 DOI: https://doi.org/10.1093/occmed/kqz094
  28. Deierlein AL, Grayon AR, Zhu X, Sun Y, Liu X, Kohlasch K, et al. Personal Care and Household Cleaning Product Use among Pregnant Women and New Mothers during the COVID-19 Pandemic [Electronic Resource]. Int J Environ Res Public Health. 2022 May;19(9):5645. 10.3390/ijerph19095645 DOI: https://doi.org/10.3390/ijerph19095645

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