Exposure to Trihalomethanes through Different Water Uses and Birth Weight, Small for Gestational Age, and Preterm Delivery in Spain

• Published in: Environmental health perspectives Vol. 119; no. 12; pp. 1824 - 1830
• Main Authors: Villanueva, Cristina M., Gracia-Lavedán, Esther, Ibarluzea, Jesús, Marina, Loreto Santa, Ballester, Ferran, Llop, Sabrina, Tardón, Adonina, Fernández, Mariana F., Freire, Carmen, Goñi, Fernando, Basagaña, Xavier, Kogevinas, Manolis, Grimalt, Joan O., Sunyer, Jordi
• Format: Journal Article
• Language: English
• Published: Research Triangle Park, NC National Institute of Environmental Health Sciences 01.12.2011; US Department of Health and Human Services; National Institute of Environmental Health Sciences (NIEHS)
• Subjects: Adult; Aigua; Aspectes nutricionals; Biological and medical sciences; Birth weight; Chemical hazards; Children's Health; Cohort Studies; Cohort study; Creixement; Depuració; Diseases of mother, fetus and pregnancy; Disinfection; Disinfection by-products; Embaràs; Environment. Living conditions; Environmental Exposure - analysis; Environmental pollutants toxicology; Epidemiologia; Epidemiology; Epidemiology. Vaccinations; Female; Fetus; General aspects; Gestational age; Gynecology. Andrology. Obstetrics; Health aspects; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Small for Gestational Age; Infants (Premature); Infeccions respiratòries; Infectious diseases; Ingestion; Logistic Models; Low birth weight; Medical sciences; Models, Theoretical; Newborn; Physiological aspects; Potable water; Pregnancy; Pregnancy. Fetus. Placenta; Premature birth; Premature Birth - epidemiology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Small for gestational age; Spain - epidemiology; Swimming pools; Toxicology; Trihalomethanes; Trihalomethanes - analysis; Waste byproducts; Water; Water consumption; Water Pollutants, Chemical - analysis; Water pollution; Europe; Spain; Water; Pregnancy disorders; Trihalomethane; Epidemiology; Gestational age; Health and environment; premature birth; Cohort study; disinfection by-products; Public health; Human; Drinking water treatment; small for gestational age; Use; Low birth weight; Premature delivery; Disinfection; Exposure; Newborn diseases; Environ Health Perspect; Newborn; Prematurity; trihalomethanes; Birth weight; Water pollution; By product
• ISSN: 0091-6765; 1552-9924
• DOI: 10.1289/ehp.1002425

BACKGROUND: Evidence associating exposure to water disinfection by-products with reduced birth weight and altered duration of gestation remains inconclusive. OBJECTIVE: We assessed exposure to trihalomethanes (THMs) during pregnancy through different water uses and evaluated the association with birth weight, small for gestational age (SGA), low birth weight (LEW), and preterm delivery. METHODS; Mother-child cohorts set up in five Spanish areas during the years 2000—2008 contributed data on water ingestion, showering, bathing, and swimming in pools. We ascertained residential THM levels during pregnancy periods through ad hoc sampling campaigns (828 measurements) and regulatory data (264 measurements), which were modeled and combined with personal water use and uptake factors to estimate personal uptake. We denned outcomes following standard definitions and included 2,158 newborns in the analysis. RESULTS: Median residential THM ranged from 5.9 μg/L (Valencia) to 114.7 μg/L (Sabadell), and speciation differed across areas. We estimated that 89% of residential chloroform and 96% of brominated THM uptakes were from showering/bathing. The estimated change of birth weight for a 10% increase in residential uptake was -0.45 g (95% confidence interval: -1.36,0.45 g) for chloroform and 0.16 g (-1.38, 1.70 g) for brominated THMs. Overall, THMs were not associated with SGA, LBW, or preterm delivery. CONCLUSIONS: Despite the high THM levels in some areas and the extensive exposure assessment, results suggest that residential THM exposure during pregnancy driven by inhalation and dermal contact routes is not associated with birth weight, SGA, LBW, or preterm delivery in Spain.