ArticleEnvironmental epidemiology (Philadelphia, Pa.)2020
Disinfection By-Product Exposures and the Risk of Musculoskeletal Birth Defects.
Article in Environmental epidemiology (Philadelphia, Pa.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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Who cites it
8 citing papers in PubMed.
- Risks of Birth Defects Following In Utero Exposures to Unregulated Brominated Haloacetic Acids.Birth defects research · 2025Article
- Application of Toxicologically Informed Relative Potency Factors to Examine Associations between Water Disinfection Byproducts and Birth Defects.Environmental science & technology · 2025Article
- Developmental Toxicity of Disinfection Byproducts in F344 Rats: Effects on Pregnancy Maintenance and Eye Development.Birth defects research · 2025Article
- Trihalomethanes and physicochemical quality of drinking water in Addis Ababa, Ethiopia.Heliyon · 2023Article
- Exposure and carcinogenic risk assessment of trihalomethanes (THMs) for water supply consumers in Addis Ababa, Ethiopia.Toxicology reports · 2023Article
- Estimating National Exposures and Potential Bladder Cancer Cases Associated with Chlorination DBPs in U.S. Drinking Water.Environmental health perspectives · 2022Article
- Exposure to Chloramine and Chloroform in Tap Water and Adverse Perinatal Outcomes in Shanghai.International journal of environmental research and public health · 2022Article
- Drinking Water Disinfection by-Products and Congenital Malformations: A Nationwide Register-Based Prospective Study.Environmental health perspectives · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundEpidemiological studies suggest that exposure to water disinfection by-products (DBPs) may increase the risk of certain birth defects. However, evidence for musculoskeletal defects (MSDs) is limited. Previous MSD studies have not examined DBPs beyond trihalomethanes (THMs) and have not separately examined limb or diaphragm defects which may have distinct developmental etiologies.
methodsWe calculated adjusted odds ratios (aORs) in a registry-based case-control study of birth defects in Massachusetts with complete quarterly 1999-2004 data on four THMs and five haloacetic acids (HAAs). We matched 10 controls each to 187 MSD cases based on week of conception. Weight-averaged town-level first-trimester DBP exposures were individually assigned based on residence at birth. We adjusted THM models for exposure to the sum of five HAAs (HAA5), and HAA models for the sum of four THMs (THM4).
resultsWe detected positive exposure-response associations for all grouped MSDs with THM4 quintiles (aOR range: 1.90-3.18) and chloroform quartiles (aOR range: 1.30-2.21), and for reduction of upper or lower limbs with chloroform quartiles (aOR range: 2.39-3.52). We detected elevated aORs for diaphragmatic hernia with DBP9 (sum of THM4 and HAA5), and chloroform and bromodichloromethane tertiles and an exposure-response relationship for THM4 tertiles (aOR range: 1.67-1.80).
conclusionsThis is the first epidemiological study to examine HAAs in relation to MSDs. Given the indirect nature of our exposure assessment data and small case numbers, the exposure-response relationships that we detected for THM4 and chloroform warrant further investigation.
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Registered trials
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