Investigation of a spontaneous abortion cluster: Lessons learned

Melissa A. McDiarmid, Patrick Breysse, Peter S.J. Lees, Barbara Curbow, Ken Kolodner

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


An investigation of a reported spontaneous abortion excess in an office environment was undertaken employing a multidisciplinary approach, including (1) an epidemiologic/ validation step; (2) an industrial hygiene survey, including electromagnetic field measurements and indoor air quality determinations; and (3) a risk perception/risk communication component. This approach was needed because there are numerous chemical and physical agents and psychosocial stressors that may potentially impact the reproductive status of female office workers. Although video display terminals (VDTs) are typically the focus of spontaneous abortion (SAB) investigations, one cannot ignore other stressors in the environment. Magnetic field exposures within a payroll area were determined using a hand‐held survey meter and data logging dosimeter. On average, the full shift time‐weighted average exposures of workers to extremely low frequency (ELF) magnetic fields in the payroll office area ranged from 1.0 to 5.6 mG. Influencing the investigation's protocol design were the Centers for Disease Control's (CDC's) recent Guidelines for Investigating Clusters of Health Events. Although these guidelines grew primarily out of cancer cluster investigations, we applied them in this instance and found them to be generalizable to reproductive hazards investigations. A spontaneous abortion excess was validated over a 2‐year period among 26 women with 32 reproductive events, with rates 1.5–2.5 times the expected, depending on comparison figures used. Lessons learned in the investigation, including the applicability of the CDC's Cluster Investigation Protocol and the enormous importance of risk perception and risk communication, are described. © 1994 Wiley‐Liss, Inc.

Original languageEnglish (US)
Pages (from-to)463-475
Number of pages13
JournalAmerican Journal of Industrial Medicine
Issue number4
StatePublished - Apr 1994


  • environmental exposures
  • extremely low frequency magnetic fields
  • reproductive health
  • risk communication
  • spontaneous abortion excess
  • video display terminals

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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