Fetal death and congenital malformation in babies born to nuclear industry employees: report from the nuclear industry family study

doi:10.1016/S0140-6736(00)02812-9

The Lancet

Volume 356, Issue 9238, 14 October 2000, Pages 1293-1299

https://doi.org/10.1016/S0140-6736(00)02812-9 Get rights and content

Summary

Background

There is some concern about the genetic effects of exposure to low-level ionising radiation, but the evidence is sparse and conflicting. Most work has concentrated on cancer in offspring and little has been done on adverse reproductive outcome. We aimed to assess whether the offspring of men and women who are occupationally exposed to ionising radiation are at increased risk of fetal death and congenital malformation.

Methods

We analysed pregnancies reported by an occupational cohort of nuclear industry workers in the UK, employed at establishments operated by the Atomic Energy Authority, Atomic Weapons Establishment, and British Nuclear Fuels. Employment and radiation monitoring data supplied by employers was linked to each pregnancy.

Flndings

11 697 men and 1903 women reported one or more singleton pregnancy conceived after first employment within the nuclear industry, the men reporting a total of 23 676 singleton pregnancies and the women 3585. The risks of fetal death and congenital malformation were not related to whether the father had been monitored before conception or to the dose of radiation received. Among pregnancies reported by women, the risk of early (<13 weeks of gestation) miscarriage was higher if the mother had been monitored before conception (odds ratio [OR] 1·3, 95% CI 1·0–1·6), but there was no trend with dose. The risk of stillbirth was also higher if the mother had been monitored before conception (OR 2·2, 95% CI 1·0–4·6), but the finding was based on only 29 cases (13 exposed). The risk of any major malformation, or of specific groups of malformations, was not associated with matemal monitoring, or dose received, before conception.

Interpretation

We found no evidence of a link between exposure to low-level ionising radiation before conception and increased risk of adverse reproductive outcome in men working in the nuclear industry. Similarly for women there was no evidence of an association between monitoring before conception and malformation in offspring. The findings relating matermal preconceptual monitoring to increased risk of fetal death are equivocal and require further investigation.

Introduction

Whether there are measurable genetic effects of exposure to low-level ionising radiation is unclear.1, 2 Most epidemiological research has focused on the relation between paternal occupational exposure to ionising radiation before conception and cancer in their children.3, 4, 5, 6 Less attention has been paid to the possibility that radiation exposure might result in adverse reproductive outcomes, some of which are known to have genetic components.1, 2, 7 Radiation-induced damage to gametes or zygotes, or both, may lead to infertility or fetal death, or to an excess of surviving pregnancies with chromosomal defects or other malformations.

The nuclear industry family study was set up to investigate possible links between reproductive and child health, and occupational exposure to ionising radiation.⁸ We obtained data on reproductive history and health status of the offspring of male and female employees of major nuclear establishments throughout the UK. Results for childhood cancer have been reported previously.⁶ We report the findings for fetal death and congenital malformation here.

Section snippets

Methods

Detailed information about the study is reported elsewhere.⁸ In brief, we surveyed all the current employees of the Atomic Weapons Establishment, the Atomic Energy Authority, and British Nuclear Fuels between 1993 and 1996. For the last two authorities, past employees aged less than 75 years whose details were recorded on the pensions database were also included. Questionnaires were sent to 46 396 people in total. 3068 (7%) of all questionnaires (excluding reminders) were returned as

Fetal death

12% of the pregnancies reported by men and 15% of those reported by women ended in fetal death (table 1). Most were before 24 weeks of gestation, stillbirths (≥24 weeks'), accounting for only 8% of fetal deaths reported by men and 6% of those reported by women. Women reported relatively more fetal deaths in the first 12 weeks of pregnancy than men (8% vs 5% of all pregnancies, respectively), but the proportions at other gestations were similar.

Table 2 shows the findings relating to risk of

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ArticlesFetal death and congenital malformation in babies born to nuclear industry employees: report from the nuclear industry family study

Summary

Background

Methods

Flndings

Interpretation

Introduction

Section snippets

Methods

Fetal death

Lancet

Health effects of exposure to low levels of ionising radiation: (BEIR V)

Parental radiation exposure and children's health: are there effects on the second generation?

Occup Med

Results of case-control study of leukaemia and lymphoma among young people near Sellafield nuclear plant in West Cumbria

BMJ

Cancer in the offspring of radiation workers: a record linkage study

BMJ

Cancer in children of nuclear industry employees: a report on offspring under 25 years from the Nuclear Industry Family Study

BMJ

Conception to Birth

Nuclear industry family study: methods and description of a United Kingdom study linking occupational information held by employers to reproducton and child health

Occup Environ Med

Combined analysis of mortality in three United Kingdom nuclear industry workforces, 1946–1988

Radiat Res

Manual of the International Statistical Classification of Diseases and Related Health Problems 10th Revision

15 years of surveillance of congenital anomalies in Europe 1980–1994

Teratogenicity of high vitamin A intake

N Engl J Med

Articles
Fetal death and congenital malformation in babies born to nuclear industry employees: report from the nuclear industry family study