EXPOSURE TO ORGANIC SOLVENTS IN PREGNANCY

Organic solvents are carbon-based solvents that are capable of dissolving or dispersing one or more other substances. Organic solvents can belong to many different chemical classes, including aliphatic hydrocarbons, aromatic hydrocarbons, alcohols, amines, esters, ethers, ketones, and halogenated hydrocarbons. Common uses for organic solvents are in dry cleaning (tetrachloroethylene), paint thinners (toluene, white spirit), nail polish removers and glue solvents (acetone, methyl acetate, ethyl acetate), stain removers (hexane, petrol ether), detergents (glycol ethers) and perfumes (ethanol). Organic solvents are also widely used in chemical, pharmaceutical, oil, and gas industries, including in chemical synthesis and purification processes. Exposure usually occurs via inhalation or the dermal route.

There are limited data describing pregnancy outcomes following exposure to solvents in general; data relating to specific classes of solvent are also scarce. Studies have raised concerns about the possible reproductive effects of organic solvent exposure, largely as a consequence of occupational exposure. Adverse pregnancy outcomes reported include miscarriage, congenital malformation, low infant birth weight, and altered childhood neurodevelopment; however, data are conflicting. Additionally, the data are likely heavily confounded by multiple exposures and sociodemographic factors and limited through exposures being assumed by job title or place of residence. Therefore, given the confounding and methodological limitations, studies indicating increased risks do not provide conclusive proof of a causal association between maternal organic solvent exposure and adverse fetal or developmental outcomes.

Pregnant women should be advised to avoid exposure to organic solvents as a precautionary measure. Where exposure cannot be avoided, personal protective equipment (PPE) should be employed as per the manufacturer’s instructions and exposure should ideally be well below occupational exposure limits. Maternal toxicity should be treated as for the non-pregnant patient and, where clinically indicated, treatment should not be withheld on account of pregnancy.

The need for additional fetal monitoring should be determined on a case-by-case basis, taking into account factors such as whether exposure was acute or chronic, whether PPE was employed and the stage of pregnancy. Where high level exposure and/or symptoms of maternal toxicity have occurred, please contact UKTIS for a case-specific assessment of the risk of fetal harm. Other risk factors may also be present in individual cases which may independently increase the risk of adverse pregnancy outcome. Clinicians are reminded of the importance of consideration of such factors.