Toledano, Mireille B.; Nieuwenhuijsen, Mark J.; Best, Nicky; Whitaker, Heather; Hambly, Peter; de Hoogh, Cornelis; Fawell, John; Jarup, Lars and Elliott, Paul
(2005).
| DOI (Digital Object Identifier) Link: | http://doi.org/10.1289/ehp.7111 |
|---|---|
| Google Scholar: | Look up in Google Scholar |
Abstract
We investigated the association between total trihalomethanes (TTHMs) and risk of stillbirth and low and very low birth weight in three water regions in England, 1992-1998; associations with individual trihalomethanes (THMs) were also examined. Modeled estimates of quarterly TTHM concentrations in water zones, categorized as low (< 30 mug/L), medium (30-59 mug/L), or high (greater than or equal to 60 mug/L), were linked to approximately 1 million routine birth and stillbirth records using maternal residence at time of birth. In one region, where there was a positive socioeconomic deprivation gradient across exposure categories, there was also a positive, significant association of TTHM with risk of stillbirth and low and very low birth weight. Overall summary estimates across the three regions using a random-effects model to allow for between-region heterogeneity in exposure effects showed small excess risks in areas with high TTHM concentrations for stillbirths [odds ratio (OR) = 1.11; 95% confidence interval (CI), 1.00-1.23), low birth weight (OR = 1.09; 95% CI, 0.93-1.27), and very low birth weight (OR = 1.05; 95% CI, 0.82-1.34). Among the individual THMs, chloroform showed a similar pattern of risk as TTHM, but no association was found with concentrations of bromodichloromethane or total brominated THMs. Our findings overall suggest a significant association of stillbirths with maternal residence in areas with high TTHM exposure. Further work is needed looking at cause-specific stillbirths and effects of other disinfection by-products and to help differentiate between alternative (noncausal) explanations and those that may derive from the water supply.
| Item Type: | Journal Article |
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| ISSN: | 0091-6765 |
| Keywords: | chemical; disinfection; infant low birth weight; pregnancy outcome; stillbirth; trihalomethanes; water pollution; water purification |
| Academic Unit/Department: | Faculty of Science, Technology, Engineering and Mathematics (STEM) > Mathematics and Statistics Faculty of Science, Technology, Engineering and Mathematics (STEM) |
| Item ID: | 18260 |
| Depositing User: | Colin Smith |
| Date Deposited: | 11 Sep 2009 15:43 |
| Last Modified: | 02 Aug 2016 13:31 |
| URI: | http://oro.open.ac.uk/id/eprint/18260 |
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