Assemble about 1000 cases of selected non-genetic malformations detected in newborns in the first week of life and 2000 control pregnancies. Assess the occupational risks by independently reviewing the work exposures of the mothers and where possible identify the likeley substances involved. Combine some of the results of this study in Bratislava, Budapest and Lublin with the earlier case-control study in western european countries to confirm or refute risk factors for congenital malformations. Publicise the results with a view to initiating preventive strategies in the workplaces of the EC and in eastern Europe.
There has been a slow increase in the understanding of risk factors arising in the workplace which may increase the rates of congenital malformations in the babies of working women. However for the vast majority of malformations (excluding those of genetic or known cause) there are large variations in rates between different centres. Some of the reasons for this are likely to reside in the general environment, in particular in the working environment of women and men.
Building on the experience of a large co-operative study in four countries of the EU an extension of the methodology is proposed to cover three countries of the CCE. This will allow the maximization of the experience already gained, the transfer of the experience between further participants, and the inclusion of study areas in which exposure to potential hazardous substances in the workplace is much less controlled than in western Europe. There is an element of urgency to study risk factors where exposures are higher in CCE countries than in many developed countries before they are reduced by increasing control over the working environment. It is easier to measure effects of high exposures on congenital malformation, than of very low exposures.
Therefore a co-operative case-control study between the experienced co-ordinators of the OMECON study and centres in Hungary, Slovakia and Poland which have the appropriate experience and interest, is proposed. This will produce a combined data base of great power to identify significant risk factors in the workplace for congenital malformations as a preliminary to their control in all countries of the EU, CCE and possibility the NIS. The proposal builds on existing teams and experience, maximizing previous investment in research funds in this important area.
The objectives are to conduct a case-control study to collect workplace and other data in mothers of children with a select list of congenital malformations, and two controls. Independently assess any occupational exposures including level and timing, using local Industrial Hygienists, and coordinated by hygienists involved in the previous OMECON study. Analyse the new data to estimate relative risks, adjusting for known confounding variables, of occupational exposures and groups of related congenital malformations. Initial analysis of combined data from the proposed study and the completed OMECON study for exposures and malformations of interest.
Funding SchemeCSC - Cost-sharing contracts
833 01 Bratislava
20 090 Lublin