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Smithells RW. 
“Environmental Teratogens Of Man”. 1976;32:27-33.
1 Alcohol 2 Anticonvulsants 3 Lysergide 4 Sex hormones 5 Warfarin 6 Folate deficiency 7 Operating-room environment 8 Blighted potatoes 9 Soft water 10 Conclusion The search for environmental factors responsible in whole or in part for congenital malformations must be almost as old as man himself. It had little or no scientific basis before Gregg's discovery of the teratogenic properties of the rubella virus (Gregg, 1941), and it received tremendous impetus from the thalidomide experience. Attention has been focused princi - pally on drugs, but the possibility of teratogenic factors in air, water and food has also attracted recent interest. There are many difficulties that lie in the way of proving beyond reasonable doubt that a particular environmental agent has teratogenic potential: (i) the more widely used a drug or food-stuff and the more common a malformation, the more often will they be associated by chance and the more difficult it is to establish a causal relation; (ii) a factor that predisposes to malformation is less easy to identify than one that invariably causes malformation; (iii) the "me-too' phenomenon (see section 3) is as capable of confirming a myth as a truth; (iv) retrospective studies have a major limitation in that the parents of malformed infants tend to give more frequent positive histories of almost anything ' then do the At Rents of healthy controls. Prospective studies with objective evidence of the factor under study are more tedious but more informative; (v) controls, in the sense of individuals differing from the study group ordy in respect of the factor studied, do not exist amongst human beings. In a recent review of teratogenic drugs in man, Wilson (1973) found only three for which there was convincing evidence of teratogenicity­thalidomide, steroid hormones (virilization) and folate antagonists. These three are not considered in the present paper, but a critical review is made of nine other possible environmental teratogens.
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