Pesticide exposures and fetal death: a review of the epidemiologic literature

Despite considerable concern regarding the effects on reproductive outcome of exposures to pesticides, convincing evidence for the developmental toxicity of occupational and environmental pesticide exposure in humans is lacking. In this comprehensive review of the English language epidemiologic literature, we summarize studies that have examined potential associations between fetal deaths (both spontaneous abortions and stillbirths) and specific pesticides, as well as maternal and paternal employment in occupations with potential for exposure. While many of the epidemiologic studies to date suffer from methodologic problems, the data are suggestive of increased risks of fetal deaths associated with pesticides in general and maternal employment in the agricultural industry. There is a clear need for epidemiologic research that focuses on specific pesticide products or chemical families, with improved exposure assessment. The potential role of solvents in developmental toxicity associated with pesticide use by both males and females should also be considered.