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1.
Toxicol Sci ; 62(1): 124-39, 2001 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-11399800

RESUMO

Methoxyethanol (ethylene glycol monomethyl ether, EGME), ethoxyethanol (ethylene glycol monoethyl ether, EGEE), and ethoxyethyl acetate (ethylene glycol monoethyl ether acetate, EGEEA) are all developmental toxicants in laboratory animals. Due to the imprecise nature of the exposure data in epidemiology studies of these chemicals, we relied on human and animal pharmacokinetic data, as well as animal toxicity data, to derive 3 occupational exposure limits (OELs). Physiologically based pharmacokinetic (PBPK) models for EGME, EGEE, and EGEEA in pregnant rats and humans have been developed (M. L. Gargas et al., 2000, Toxicol. Appl. Pharmacol. 165, 53-62; M. L. Gargas et al., 2000, Toxicol. Appl. Pharmacol. 165, 63-73). These models were used to calculate estimated human-equivalent no adverse effect levels (NAELs), based upon internal concentrations in rats exposed to no observed effect levels (NOELs) for developmental toxicity. Estimated NAEL values of 25 ppm for EGEEA and EGEE and 12 ppm for EGME were derived using average values for physiological, thermodynamic, and metabolic parameters in the PBPK model. The uncertainties in the point estimates for the NOELs and NAELs were estimated from the distribution of internal dose estimates obtained by varying key parameter values over expected ranges and probability distributions. Key parameters were identified through sensitivity analysis. Distributions of the values of these parameters were sampled using Monte Carlo techniques and appropriate dose metrics calculated for 1600 parameter sets. The 95th percentile values were used to calculate interindividual pharmacokinetic uncertainty factors (UFs) to account for variability among humans (UF(h,pk)). These values of 1.8 for EGEEA/EGEE and 1.7 for EGME are less than the default value of 3 for this area of uncertainty. The estimated human equivalent NAELs were divided by UF(h,pk) and the default UFs for pharmacodynamic variability among animals and among humans to calculate the proposed OELs. This methodology indicates that OELs (8-h time-weighted average) that should protect workers from the most sensitive adverse effects of these chemicals are 2 ppm EGEEA and EGEE (11 mg/m(3) EGEEA, 7 mg/m(3) EGEE) and 0.9 ppm (3 mg/m(3)) EGME. These recommendations assume that dermal exposure will be minimal or nonexistent.


Assuntos
Etilenoglicóis/farmacocinética , Exposição por Inalação , Modelos Biológicos , Método de Monte Carlo , Exposição Ocupacional , Níveis Máximos Permitidos , Administração por Inalação , Animais , Área Sob a Curva , Relação Dose-Resposta a Droga , Etilenoglicóis/administração & dosagem , Humanos , Nível de Efeito Adverso não Observado , Especificidade da Espécie
2.
Am J Ind Med ; 33(3): 293-6, 1998 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-9481428

RESUMO

A retrospective cohort mortality study was conducted at a chemical plant producing acetic acid and acetic anhydride, two chemicals essential in the synthesis of cellulose triacetate fiber. Previously, we reported excess mortality from biliary tract and prostate cancers among workers in cellulose triacetate fiber manufacturing plants. In the present investigation, an excess of prostate cancer (SMR = 330.4; 95% confidence interval = 121.3-719.1) was observed among former chemical plant workers, some of whom had been exposed to both acetic acid and acetic anhydride. These apparent increases in mortality are difficult to interpret biologically, particularly in light of recent suggestions concerning the role of endocrine factors. Additional work is planned to more fully characterize potential occupational exposures that might explain the etiology of prostate cancer.


Assuntos
Indústria Química , Neoplasias da Próstata/mortalidade , Ácido Acético/síntese química , Anidridos Acéticos/síntese química , Fatores Etários , Neoplasias Brônquicas/mortalidade , Celulose/análogos & derivados , Celulose/síntese química , Estudos de Coortes , Intervalos de Confiança , Feminino , Seguimentos , Cardiopatias/mortalidade , Humanos , Pneumopatias/mortalidade , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Neoplasias/mortalidade , Exposição Ocupacional , Neoplasias da Próstata/etiologia , Grupos Raciais , Estudos Retrospectivos , Fatores Sexuais , Texas/epidemiologia , Neoplasias da Traqueia/mortalidade
3.
Occup Environ Med ; 51(11): 761-7, 1994 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-7849854

RESUMO

OBJECTIVES: The purpose of the study was to investigate potential reproductive effects of sodium borates on occupationally exposed male employees at a large mining and production facility in the Mojave Desert of California. METHODS: The standardised birth ratio (SBR) was used to assess fertility of the male employees. Live births were the measured end point, and the rate of female to male offspring was also assessed. Data were collected through a questionnaire after a series of on site introductory and explanatory meetings with the employees. Initial non-responders were followed up by telephone. Medical insurance records were assessed for those who declined to participate. RESULTS: The questionnaire was a good method of ascertainment for live births. There was no evidence of selection bias in the results. There was a highly significant excess of offspring fathered by the male employees. There was no evidence of a relation between exposure and this excess of offspring, nor were there any temporal differences during the period of observation (> 30 years). Also, there was an excess of the percentage of female offspring fathered by these male employees. This excess of female offspring was not significant. There was no evidence of an exposure relation to sodium borates with this excess of female offspring nor were there any temporal differences. CONCLUSION: Under the conditions studied, there were no adverse reproductive effects of high borate doses as reported from oral ingestion studies in animals.


Assuntos
Boratos/efeitos adversos , Fertilidade/efeitos dos fármacos , Mineração , Exposição Ocupacional , Exposição Paterna , Razão de Masculinidade , Adulto , Coeficiente de Natalidade , Humanos , Masculino , Pessoa de Meia-Idade
4.
Occup Environ Med ; 51(6): 386-96, 1994 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-8044230

RESUMO

Mortality data have been updated for a further 12 years for a cohort of workers in the reinforced plastics and composites industry with exposures to styrene monomer and other chemicals. The cohort consisted of 15,826 male and female employees who were exposed to styrene for at least six months between 1948 and 1977 at 30 participating manufacturing plants in the United States. A total of 1628 deaths were reported during the extended observation period, 1948-89. Mortality from several causes showed significant increases--namely, all causes, all cancers, oesophageal cancer, lung cancer, cancer of the cervix uteri, cancer of other female genital organs, hypertensive heart disease, certain non-malignant respiratory diseases, motor vehicle accidents, and homicides. When, however, mortality data were examined in terms of duration of employment, durations of styrene exposure, and cumulative styrene exposure no upward trend was detected in any of these causes of death. Most of the increases in mortality were among workers who were employed for only six months to a year or who had very low cumulative exposure (< 10 ppm-years). Therefore, the increased mortality was not likely to be related to exposure to styrene. Several explanations for the increased mortality are offered, including low socioeconomic class, smoking, and lifestyle factors characteristic of short term workers. There was no increased mortality from lymphatic and haematopoietic cancers overall or from any specific haematological malignancies. In particular, no increase in mortality from non-Hodgkin's lymphoma, Hodgkin's disease, multiple myeloma, or leukaemia was found. Furthermore, detailed exposure-response analyses did not show any relation between exposure to styrene and any of these haematological malignancies. The lack of an exposure-response relation further supports the conclusion that workers in the reinforced plastics industry in this study did not experience any increased risk of lymphatic and haematopoietic cancers as a result of their exposure to styrene.


Assuntos
Doenças Profissionais/mortalidade , Exposição Ocupacional/efeitos adversos , Estirenos/efeitos adversos , Causas de Morte , Estudos de Coortes , Feminino , Seguimentos , Humanos , Indústrias , Masculino , Plásticos , Fatores de Risco , Fatores de Tempo
5.
Int Arch Occup Environ Health ; 64(4): 235-41, 1992.
Artigo em Inglês | MEDLINE | ID: mdl-1468791

RESUMO

We conducted an epidemiologic study of skin cancer incidence rates for four counties in Montana. The two counties considered to be exposed to arsenic were Deer Lodge, containing the former Anaconda copper smelter, and Silver Bow, containing an open pit copper mine. Residents in these counties had potential exposure to arsenic and other heavy metals. Gallatin and Park counties served as controls. All histologically proven skin cancer cases during the period January 1980 through June 1986 were collected from pathology services and dermatologists in these four counties. In addition, all skin cancer cases from four dermatologists practicing in urban referral areas outside the counties were reviewed. Results were analyzed by individual as well as by two different definitions of anatomically distinct lesions: the National Cancer Institute (NCI) definition and the study definition. There were 1616 individuals with skin cancer in the four counties during the period under consideration, yielding 2252 (NCI definition) and 2451 (study definition) cases. The clinical features of the skin cancers in the exposed counties were not similar to those described for arsenic-related skin cancer. The age-adjusted annual skin cancer rates were higher for the two control counties as compared to either the county with the former smelter, Deer Lodge, or the county with the mine, Silver Bow. Our results cannot be explained by differences in ascertainment, latitude, or altitude. They can be partially explained by differences in both outdoor employment and medical practice. The overall skin cancer incidence rates for the exposed counties were well within the range of skin cancer rates observed for other locations in the United States.


Assuntos
Arsênio/efeitos adversos , Cobre , Metalurgia , Doenças Profissionais/induzido quimicamente , Exposição Ocupacional/efeitos adversos , Neoplasias Cutâneas/induzido quimicamente , Idoso , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Montana/epidemiologia , Doenças Profissionais/epidemiologia , Doenças Profissionais/patologia , Fatores de Risco , Pele/patologia , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia
6.
Am J Ind Med ; 20(3): 317-34, 1991.
Artigo em Inglês | MEDLINE | ID: mdl-1928109

RESUMO

The cohort consisted of 10,173 men who had worked for at least one year in jobs involving exposure to vinyl chloride prior to 1 January 1973. These men were employed at 37 plants in the U.S., belonging to 17 companies. Observation of the mortality experience of the cohort was updated from 31 December 1972 to 31 December 1982 (the study now covering 1942-1982). A total of 1,536 cohort members were identified as having died. The observed mortality, by cause, was compared with the expected based on U.S. mortality rates, standardized for age, race, and calendar time. Analyses by length of exposure, latency, age at first exposure, calendar year of first exposure, and type of products were performed. The study confirmed that the vinyl chloride workers experience a significant mortality excesses in angiosarcoma (15 deaths), cancer of the liver and biliary tract (SMR = 641), and cancer of the brain and other central nervous system (SMR = 180). In addition, the study also found a significant mortality excess in emphysema/chronic obstructive pulmonary disease (COPD) (SMR = 179). On the other hand, the study did not find any excess in either respiratory cancer or lymphatic and hematopoietic cancer. This study also found an increase in biliary tract cancers, independent from liver cancer.


Assuntos
Doenças Profissionais/mortalidade , Cloreto de Vinil/efeitos adversos , Adulto , Causas de Morte , Estudos de Coortes , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/induzido quimicamente , Neoplasias/mortalidade , Doenças Profissionais/induzido quimicamente , Estados Unidos/epidemiologia
7.
Br J Ind Med ; 46(8): 521-8, 1989 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-2775672

RESUMO

Through ecological analyses and case-control studies, the possible relation of gastric cancer and leukaemia to dibromochloropropane (DBCP) contamination of drinking water in Fresno County, California, has been examined. The ecological analyses examined the correlation between gastric cancer and leukaemia (including the lymphatic varieties), mortality rates, and DBCP concentrations in drinking water by census tract in Fresno County, 1960-83. No correlation was found between gastric cancer or leukaemia and DBCP. The gastric cancer case-control study consisted of 263 deaths from gastric cancer in the county, 1975 to mid-1984, and 1044 controls, using information on residential history and occupation of both cases and controls. Analyses were based on residence at death, as well as one and ten years before death. The case-control study did not find any relation between gastric cancer and DBCP in drinking water. Hispanics in the county were found to experience a relative risk of gastric cancer of 2.77, compared with non-Hispanics. A similar case-control study consisting of 259 cases of leukaemia and 1161 controls found no relation between all leukaemia or lymphatic leukaemia and DBCP in drinking water. Farm workers, however, do appear to have an increased risk of leukaemia.


Assuntos
Antinematódeos/efeitos adversos , Inseticidas/efeitos adversos , Leucemia/mortalidade , Propano/análogos & derivados , Neoplasias Gástricas/mortalidade , Poluentes Químicos da Água/efeitos adversos , Poluentes da Água/efeitos adversos , Doenças dos Trabalhadores Agrícolas/etnologia , Doenças dos Trabalhadores Agrícolas/mortalidade , California , Humanos , Leucemia/etnologia , Propano/efeitos adversos , Fatores de Risco , Neoplasias Gástricas/etnologia , Abastecimento de Água
8.
Int Arch Occup Environ Health ; 61(6): 403-7, 1989.
Artigo em Inglês | MEDLINE | ID: mdl-2744871

RESUMO

This report describes an epidemiologic investigation of the relationship between dibromochloropropane (DBCP), contamination in drinking water and birth outcomes between 1978 and 1982 in Fresno County, California, USA. Census tracts in the county were categorized according to DBCP level in drinking water. A direct comparison between exposure categories was done by the use of the Mantel-Haenszel chi-square procedure to compute relative ratios or risks for low birth weight and birth defect, adjusting for age, race, percent Hispanic, and parity. No correlation between these birth outcomes and DBCP contamination was found. In addition, we did not find any difference in sex ratio in relation to DBCP contamination.


Assuntos
Inseticidas/efeitos adversos , Propano/análogos & derivados , Reprodução/efeitos dos fármacos , Poluentes Químicos da Água/efeitos adversos , Poluentes da Água/efeitos adversos , Abastecimento de Água , Adolescente , Adulto , Peso ao Nascer , California , Anormalidades Congênitas/epidemiologia , Feminino , Hispânico ou Latino , Humanos , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Complicações do Trabalho de Parto/epidemiologia , Complicações do Trabalho de Parto/etnologia , Paridade , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/etnologia , Propano/efeitos adversos , Risco , Razão de Masculinidade
9.
Am J Public Health ; 78(1): 47-51, 1988 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-3337305

RESUMO

This paper discusses methodology in developing exposure data for the water supply contaminant dibromochloropropane (DBCP) in Fresno County, California. There are 532 drinking water systems (49 large and 483 small) within Fresno County plus 14,000 private wells. We determined the number of wells per system, the output per well, and the population served by each system. The task of deriving water quality estimates for each census tract was complicated by the fact that a single census tract can be served by more than one system; each system usually has more than one well; and a single well can have several episodes of testing for various contaminants. We calculated a series of weighted averages for concentrations of DBCP, arsenic, and nitrates for each census tract, using water production figures for each well as the weighting factor. Water quality data were derived from a total of 14,861 laboratory reports, although the majority did not report on all contaminants. Mean DBCP levels ranged from 0.0041 ppb to 5.7543 ppb among the census tracts. We found no correlation between DBCP levels per census tract compared to either arsenic or nitrates. We believe that we made as complete an exposure assessment as practically feasible.


Assuntos
Métodos Epidemiológicos , Inseticidas/análise , Propano/análogos & derivados , Abastecimento de Água/análise , Arsênio/análise , California , Humanos , Nitratos/análise , Propano/análise , Abastecimento de Água/normas
10.
Am J Public Health ; 78(1): 43-6, 1988 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-3337304

RESUMO

This report describes an epidemiologic investigation of the relationship between DBCP (dibromochloropropane) contamination in drinking water and birth rates between 1978 and 1982 in Fresno County, California. Census tracts in the county were categorized according to DBCP level in their drinking water. Standardized birth ratios and relative birth ratios (adjusted for age, race, per cent Hispanic, and parity) were calculated for these census tracts. No relation between birth ratios and DBCP contamination in drinking water was found.


Assuntos
Coeficiente de Natalidade , Inseticidas/efeitos adversos , Propano/análogos & derivados , Poluição Química da Água , Abastecimento de Água/análise , Adulto , California , Etnicidade , Feminino , Humanos , Recém-Nascido , Inseticidas/análise , Propano/efeitos adversos , Propano/análise
11.
J Occup Med ; 29(2): 142-7, 1987 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-3819895

RESUMO

In recent years, incidents involving health-related complaints due to poor indoor air quality have increased dramatically. These problems have generally occurred in new or remodeled buildings. Following relocation to a new building, some employees began to experience health complaints, including upper respiratory tract irritation, headaches, fatigue, and eye irritation. A questionnaire was designed which elicited information about specific work locations, symptom experience, and timing of such symptoms. Although no causative agent(s) could be isolated, the data collected indicate that over the 5-week time period of investigation the rate and persistence of new symptoms decreased. The health complaints experienced appeared to be neither persistent nor pervasive enough to constitute an ongoing health and safety hazard at the facility. Reasons were proposed why some new and/or remodeled buildings have this type of problem while others do not.


Assuntos
Arquitetura de Instituições de Saúde , Medicina do Trabalho , Ventilação , Adulto , Feminino , Humanos , Masculino , Doenças Profissionais/etiologia
13.
J Occup Med ; 28(11): 1145-50, 1986 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-3097279

RESUMO

A follow-up report was done of workers exposed to 1,2-dibromo-3-chloropropane (DBCP) 7 years after termination of exposure. A 1977 study of male pesticide workers exposed to DBCP in a California agricultural chemical plant identified many who were azoospermic or oligospermic. Sperm concentration and serum follicle-stimulating hormone (FSH) levels in 44 of these workers were reassessed 5 to 8 years after exposure was terminated in 1977. Two of the eight originally azoospermic workers produced sperm during the follow-up, although only one had normal sperm counts. No increase in sperm production could be detected in men who had low sperm counts in 1977, and elevated serum FSH levels did not drop in oligospermic or azoospermic men. These results suggest that permanent destruction of germinal epithelium occurs in most DBCP-sterile persons.


Assuntos
Doenças Profissionais/induzido quimicamente , Oligospermia/induzido quimicamente , Propano/análogos & derivados , Hormônio Foliculoestimulante/sangue , Seguimentos , Humanos , Masculino , Propano/toxicidade , Contagem de Espermatozoides , Fatores de Tempo
14.
Occup Med ; 1(3): 375-9, 1986.
Artigo em Inglês | MEDLINE | ID: mdl-3299782

RESUMO

Studies of adverse reproductive effects on male workers have only become prominent in the last 10 years and have used a variety of approaches to evaluate male reproductive function. This article focuses on studies that utilize semen analysis.


Assuntos
Doenças Profissionais/induzido quimicamente , Reprodução/efeitos dos fármacos , Sêmen/análise , Anormalidades Induzidas por Medicamentos/etiologia , Aborto Espontâneo/induzido quimicamente , Dibrometo de Etileno/efeitos adversos , Feminino , Humanos , Inseticidas/efeitos adversos , Masculino , Gravidez , Propano/efeitos adversos , Propano/análogos & derivados , Espermatogênese/efeitos dos fármacos
15.
Br J Ind Med ; 42(7): 435-48, 1985 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-2410010

RESUMO

A historical prospective mortality study was conducted on a cohort of 34 156 male members of a heavy construction equipment operators union with potential exposure to diesel exhaust emissions. This cohort comprised all individuals who were members of the International Union of Operating Engineers, Locals 3 and 3A, for at least one year between 1 January 1964 and 31 December 1978. The mortality experience of the entire cohort and several subcohorts was compared with that of United States white men, adjusted for age and calendar time. The comparison statistic was the commonly used standardised mortality ratio (SMR). Historical environmental measurements did not exist, but partial work histories were available for some cohort members through the union dispatch computer tapes. An attempt was made to relate mortality experience to the union members' dispatch histories. Overall mortality for the entire cohort and several subgroups was significantly lower than expected. When cause specific mortality was examined, however, the study provided suggestive evidence for the existence of several potential health problems in this cohort. Mortality from liver cancer for the entire cohort was significantly high. Although mortality from lung cancer for the entire cohort was similar to expected, a positive trend by latency was observed for lung cancer. A significant excess of mortality from lung cancer was found among the retirees and the group for whom no dispatch histories were available. Other dispatch groups showed no evidence of lung cancer excess. In addition, the total cohort experienced significant mortality excess from emphysema and accidental deaths.


Assuntos
Poluentes Ocupacionais do Ar/efeitos adversos , Indústrias , Doenças Profissionais/mortalidade , Emissões de Veículos/efeitos adversos , Acidentes de Trabalho , Adulto , Idoso , Humanos , Sindicatos , Masculino , Pessoa de Meia-Idade , Mortalidade , Neoplasias/mortalidade , Ocupações , Aposentadoria , Fatores de Tempo , Estados Unidos
17.
Am J Ind Med ; 7(4): 295-306, 1985.
Artigo em Inglês | MEDLINE | ID: mdl-3887908

RESUMO

A noninvasive and inexpensive epidemiologic program for evaluating the possible effects of occupational exposures on fertility is proposed. This surveillance program utilizes reproductive information obtainable from a short questionnaire (1-2 pages in length) or directly from existing medical, employment, or insurance records, and results can be generated readily on a routine basis. This program examines the reproductive experience of the exposed workers in terms of live births compared with that of the US general population with the proper statistical adjustments. It calculates the standardized birth ratios (SBR), adjusting for maternal age, parity, calendar time, and race. Such an analysis will detect whether there is a significant decrease in fertility among a group of employees, and is, therefore, a useful surveillance tool. The proposed method should be viewed as a mechanism to provide an early signal for any potential hazard and to direct priority for other more in-depth epidemiologic or physiologic studies. The procedure is illustrated with data from individuals exposed to EDB, DBCP, and waste-water treatment plant processes. The method can be modified to compare the reproductive performance of an exposed group to that of an internal control group. With an internal control group, additional confounding factors can be taken into consideration. The relative merits of this approach compared to another method of fertility evaluation, semen analysis, are discussed.


Assuntos
Medicina do Trabalho , Vigilância da População , Reprodução , Adulto , Fatores Etários , Coeficiente de Natalidade , Coleta de Dados , Exposição Ambiental , Dibrometo de Etileno/efeitos adversos , Família , Feminino , Fertilidade , Humanos , Masculino , Paridade , Gravidez , Propano/efeitos adversos , Propano/análogos & derivados , Grupos Raciais , Esterilização Reprodutiva , Inquéritos e Questionários , Eliminação de Resíduos Líquidos
18.
Fertil Steril ; 42(1): 82-6, 1984 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-6724014

RESUMO

This article presents data from 861 men who have participated in 14 separate occupational studies on testicular function. This population represents the largest series taken from occupational studies. The mean and median sperm counts were 107.1 and 83.0 million/ml of semen, respectively. The percentage of men with sperm counts less than 20 million/ml of semen was 8.7%. No significant differences were noted for age or race. A major issue in occupational studies requiring semen samples is how to successfully recruit the target population to participate. The number of semen samples requested can influence willingness to participate. Data from 137 men, each with three separate sperm counts, indicate that a single sample will suffice for an occupational study.


Assuntos
Agricultura , Indústria Química , Contagem de Espermatozoides , Adulto , Doenças dos Trabalhadores Agrícolas/induzido quimicamente , Exposição Ambiental , Humanos , Infertilidade Masculina/induzido quimicamente , Masculino , Doenças Profissionais/induzido quimicamente , Valores de Referência
19.
Am J Public Health ; 74(5): 499-501, 1984 May.
Artigo em Inglês | MEDLINE | ID: mdl-6711728

RESUMO

We investigated pregnancy outcomes in 101 wives of workers employed in a waste water treatment plant (WWTP), and verified fetal losses by hospital records. Paternal work histories were compiled and each of the 210 pregnancies was assigned a paternal exposure category. The relative risk of fetal loss was increased when paternal exposure to the WWTP occurred around the time of conception.


Assuntos
Aborto Espontâneo/etiologia , Pai , Esgotos , Eliminação de Resíduos Líquidos , Aborto Espontâneo/epidemiologia , Adolescente , Adulto , California , Exposição Ambiental , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Gravidez
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