title: Twin frequency and industrial pollution in different regions of Hesse, Germany.
abstract: OBJECTIVE
  To investigate whether twinning occurs more frequently in residents in the vicinity of a toxic waste incinerator (TWI).
  
  
  METHODS
  Within a longitudinal environmental study that addressed child health second grade school children and their parents were recruited. The proportion of twinning in the TWI region was compared with two comparison areas. In a second confirmatory investigation, birth records for the years 1994-97 from the Hessian Perinatal Survey (HEPS) were accessed to determine whether the incidence of twinning was higher in regions around the TWI compared to adjacent reference areas.
  
  
  RESULTS
  In the environmental study, 61.5% of the children and 95% of their mothers participated. In mothers, twinning was 5.3% in the TWI region compared to 1.6% and 2.3% in the comparison regions. The proportion of mothers with fertility assessment/treatment was 5.7%, 8.3%, and 0% respectively. The prevalence of twinning was not significantly higher (4.5%) in mothers with treatment compared to mothers without (3.7%). From the HEPS, data of 20 603 births was analysed. The incidence of twins was significantly higher in areas which surround the TWI and other industries (1.4-1.6 per 100 births) compared to births in reference areas (0.8 per 100).
  
  
  CONCLUSIONS
  Twinning rates may be associated with exposure to industrial pollution. Future environmental health studies that consider multiple births as an outcome are warranted. These should also investigate whether the incidence of monozygotic or dizygotic twinning may be associated with industrial pollution.
authors.affiliation: Epidemiological Working Group of the Ministry of Environment and Health and the Institute for Medical Biometry and Epidemiology, University Hospital Hamburg-Eppendorf, Germany. osius@uke.uni-hamburg.de
authors.forename: N
authors.initials: N
authors.lastname: Obi-Osius
authors.forename: B
authors.initials: B
authors.lastname: Misselwitz
authors.forename: W
authors.initials: W
authors.lastname: Karmaus
authors.forename: J
authors.initials: J
authors.lastname: Witten
mesh_terms: D001723:Birth Rate; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D005260:Female; D005298:Fertility; D005858:Germany / Q000453:epidemiology; D006256:Hazardous Waste / Q000009:adverse effects* / Q000032:analysis; D006801:Humans; D015994:Incidence; D017745:Incineration; D008137:Longitudinal Studies; D011247:Pregnancy; D038522:Twinning, Monozygotic; D014427:Twins / Q000706:statistics & numerical data*
chemical_list: D006256:Hazardous Waste