American Journal of Epidemiology Vol. 141, No. 6: 531-538
Copyright © 1995 by The Johns Hopkins University School of Hygiene and Public Health
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Nitrous Oxide and Spontaneous Abortion in Female Dental Assistants
1Epidemiology Branch, National Institute of Environmental Health Sciences Research Triangle Park, NC
2 Westat, Inc., Durham NC
3Statistics and Biomathematics Branch, National Institute of Environmental Health Sciences Research Triangle Park, NC
4Department of Epidemiology, University of North Carolina School of Public Health Chapel Hill, NC
Reprint requests to Dr. Andrew S. Rowland, Epidemiology Branch A3–05, NIEHS, P. O. Box 12233, Research Triangle Park, NC 27709
The relation between anesthetic gas exposure and spontaneous abortion remains unresolved. We examined the effect of nitrous oxide on spontaneous abortion among female dental assistants. Questionnaires were sent to 7,000 dental assistants aged 18–39 years who were registered in California in 1987; 4,856 (69%) responded. Analysis was based on 1,465 respondents whose most recent pregnancy was conceived while working full time. Women were asked how many hours a week they worked with nitrous oxide during this pregnancy and whether the excess gas was scavenged (vented). Relative risk of spontaneous abortion (through week 20) was calculated using a person-week model. This allowed women with current pregnancies (13%) or induced abortions (10%) to be included for appropriate time periods of risk. A total of 101 pregnancies (7%) ended as spontaneous abortions. An elevation in risk of spontaneous abortion was seen among women who worked with nitrous oxide for 3 or more hours per week in offices not using scavenging equipment (relative risk = 2.6, 95% confidence interval 1.3–5.0, adjusted for age, smoking, and number of amalgams prepared per week), but not among those using nitrous oxide in offices with scavenging equipment. This relation changed little when analyses were restricted to confirmed pregnancies or examined for several types of potential bias. Scavenging equipment appears to be important in protecting the reproductive health of women working with nitrous oxide. Am J Epidemiol 1995;141:531–8.
abortion, spontaneous; air pollutants, occupational; cohort studies; dental staff; nitrous oxide; occupational diseases
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