Case Reports

A 23 year old female laboratory technician was employed as an atomic spectrophotometer operator. She was normally fit and well, did not smoke, drink alcohol or use caffeine, although she was taking prenatal vitamins daily including 4000 IU of vitamin A (UK adult recommended daily amount 2500 IU). Working without personal protective equipment, she was exposed daily to NMP and small quantities of methanol and/or acetone. Ultrasound examination revealed a healthy fetus at 14 weeks gestation. After raising concerns with an occupational medicine consultant about an NMP material safety data sheet listing reports of fetotoxicity and teratogenicity in rats, she was given a respirator and protective clothing including latex gloves, a lab coat and goggles. The latex gloves dissolved and extensive dermal exposure to the hands occurred at 16 weeks gestation, when she cleaned up a spillage of NMP. Over the following four days she experienced malaise, headache, nausea and vomiting. Staining of the hands was still apparent two weeks later. After a week of sick leave, she returned to work and daily exposures to NMP continued for 42 hours per week until week 20 of gestation. No measurement of air NMP concentrations was made during the period of her exposure. A follow up ultrasound at 25 weeks of gestation revealed intrauterine growth retardation as evidenced by humerus and femur lengths and abdominal circumference corresponding to 21 weeks gestation. This was confirmed by a further ultrasound scan at week 28 and fetal demise occurred at week 31 of gestation (Solomon et al., 1996). Although vitamin A, to which the patient was also exposed daily, is a known teratogen, it affects fetal development as opposed to survival or growth (Briggs et al., 1994).

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