American Journal of Epidemiology Advance Access originally published online on September 6, 2006
American Journal of Epidemiology 2006 164(11):1043-1051; doi:10.1093/aje/kwj300
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ORIGINAL CONTRIBUTIONS |
Exposure to Drinking Water Disinfection By-Products and Pregnancy Loss
1 Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, NC
2 Current affiliation: Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, NY
3 Department of Environmental Sciences and Engineering, University of North Carolina School of Public Health, Chapel Hill, NC
4 Department of Biostatistics, University of North Carolina School of Public Health, Chapel Hill, NC
5 Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC
Correspondence to Dr. David A. Savitz, Department of Community and Preventive Medicine, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1057, New York, NY 10029-6574 (e-mail: david.savitz{at}mssm.edu).
Previous research has suggested that exposure to elevated levels of drinking water disinfection by-products (DBPs) may cause pregnancy loss. In 2000–2004, the authors conducted a study in three US locations of varying DBP levels and evaluated 2,409 women in early pregnancy to assess their tap water DBP concentrations, water use, other risk factors, and pregnancy outcome. Tap water concentrations were measured in the distribution system weekly or biweekly. The authors considered DBP concentration and ingested amount and, for trihalomethanes only, bathing/showering and integrated exposure that included ingestion. On the basis of 258 pregnancy losses, they did not find an increased risk of pregnancy loss in relation to trihalomethane, haloacetic acid, or total organic halide concentrations; ingested amounts; or total exposure. In contrast to a previous study, pregnancy loss was not associated with high personal trihalomethane exposure (
75 µg/liter and 5 glasses of water/day) (odds ratio = 1.1, 95% confidence interval: 0.7, 1.7). Sporadic elevations in risk were found across DBPs, most notably for ingested total organic halide (odds ratio = 1.5, 95% confidence interval: 1.0, 2.2 for the highest exposure quintile). These results provide some assurance that drinking water DBPs in the range commonly encountered in the United States do not affect fetal survival.
abortion, spontaneous; pregnancy; water pollutants
Abbreviations: DBP, disinfection by-product; HAA, haloacetic acid; THM, trihalomethane; TOX, total organic halide
Editor's note:An invited commentary on this article appears on page 1052.
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Related articles in Am. J. Epidemiol.:
- Invited Commentary: Disinfection By-Products and Pregnancy Loss—Lessons
- Penelope P. Howards and Irva Hertz-Picciotto
Am. J. Epidemiol. 2006 164: 1052-1055.[Extract] [FREE Full Text]
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