title: Exposure to drinking water disinfection by-products and pregnancy loss.
abstract: 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 (> or =75 micro g/liter and > or =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.
authors.affiliation: Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, NC, USA. david.savitz@mssm.edu
authors.forename: David A
authors.initials: DA
authors.lastname: Savitz
authors.forename: Philip C
authors.initials: PC
authors.lastname: Singer
authors.forename: Amy H
authors.initials: AH
authors.lastname: Herring
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Hartmann
authors.forename: Howard S
authors.initials: HS
authors.lastname: Weinberg
authors.forename: Christina
authors.initials: C
authors.lastname: Makarushka
mesh_terms: D000022:Abortion, Spontaneous / Q000139:chemically induced* / Q000453:epidemiology*; D000328:Adult; D003627:Data Interpretation, Statistical; D004202:Disinfectants / Q000009:adverse effects*; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D006846:Hydrocarbons, Halogenated / Q000009:adverse effects* / Q000032:analysis; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012307:Risk Factors; D022882:Trihalomethanes / Q000009:adverse effects* / Q000032:analysis; D014481:United States / Q000453:epidemiology; D014874:Water Pollutants, Chemical / Q000009:adverse effects* / Q000032:analysis; D018508:Water Purification / Q000379:methods*; D014881:Water Supply
chemical_list: D004202:Disinfectants; D006846:Hydrocarbons, Halogenated; D022882:Trihalomethanes; D014874:Water Pollutants, Chemical