The Effect of Trihalomethane and Haloacetic Acid Exposure on Fetal Growth in a Maryland County

• Published in: American journal of epidemiology Vol. 162; no. 4; pp. 334 - 344
• Main Authors: Porter, Chad K., Putnam, Shannon D., Hunting, Katherine L., Riddle, Mark R.
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 15.08.2005; Oxford Publishing Limited (England)
• Subjects: Adolescent; Adult; Analysis. Health state; Biological and medical sciences; CDBPs; Chlorine; chlorine disinfection by-products; confidence interval; Confidence Intervals; disinfectants; Epidemiology; Female; fetal growth retardation; Fetal Growth Retardation - chemically induced; Fetuses; five haloacetic acids; General aspects; HAA5; Human exposure; Humans; Hydrocarbons, Brominated - adverse effects; Hydrocarbons, Brominated - analysis; Hydrocarbons, Chlorinated - adverse effects; Hydrocarbons, Chlorinated - analysis; Infant, Newborn; intrauterine growth retardation; IUGR; Male; Maryland - epidemiology; Maternal Age; Medical sciences; odds ratio; Pregnancy; Prenatal Care; Prenatal development; Public health. Hygiene; Public health. Hygiene-occupational medicine; total trihalomethane; trihalomethanes; TTHM; Water Pollutants, Chemical - adverse effects; Water Pollutants, Chemical - analysis; Water Purification; Water supply; Water treatment; United States; North America; Maryland; America; USA, Maryland; Chlorine; Water supply; Trihalomethane; Exposure; Acetic acid derivative; Epidemiology; Growth retardation; Fetal development; disinfectants; Acids; Danger; Fetus; trihalomethanes; Water pollution; fetal growth retardation; Disinfecting agent; Public health; Geographical variation
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwi211

As water flows from treatment plants to the tap, chlorine, used to disinfect surface water meant for residential use, reacts with residual organic and inorganic matter, creating chlorine disinfection by-products. In recent years, these by-products have been scrutinized as a potential reproductive and developmental hazard. This study examined whether exposure to the four total trihalomethanes or the five haloacetic acids (two major subgroups of chlorine disinfection by-products) was related to an increased risk of intrauterine growth retardation in four regions of a Maryland county from 1998 to 2002. Maternal exposure to each by-product was evaluated for each trimester as well as over the entire pregnancy. The authors were not able to demonstrate any consistent, statistically significant effect on intrauterine growth retardation associated with any of the chlorine disinfection by-products, nor did they find any indication of a dose-response relation. However, they did find some potential for a slightly elevated risk of intrauterine growth retardation during the second and third trimesters for both total trihalomethanes and five haloacetic acids when comparing increasing quintiles of exposure to constituents of total trihalomethanes and five haloacetic acids.