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Journal ArticleDOI

Association Between Trihalomethane Concentrations in Drinking Water and Adverse Pregnancy Outcome in Taiwan

TL;DR: The study results provide no evidence of an increased risk of TLBW, SGA, and preterm delivery at the relatively low concentrations of TTHMs in Taiwan's drinking water.
Abstract: Chlorination has been the major strategy for disinfection of drinking water in Taiwan. Recently there has been interest in the relationship between by-products of disinfection of drinking water and pregnancy outcomes including low birth weight and preterm delivery. We performed a study to examine the effects of exposure to total trihalomethanes (TTHMs) on the risk of term low birth weight (TLBW), small for gestational age (SGA), and preterm delivery in Taiwan. TTHMs data were available for 65 municipalities in Taiwan. The study population comprised 90,848 women residing in the 65 municipalities who had a first parity singleton birth between January 1, 2000 and December 31, 2002, and for which complete information on maternal age, education, gestational age, birth weight, and sex of the baby were available. Maternal TTHMs exposure was estimated from the TTHMs concentration for the municipality of residence at birth. The study results provide no evidence of an increased risk of TLBW, SGA, and preterm delivery at the relatively low concentrations of TTHMs in Taiwan's drinking water.
Citations
More filters
Journal ArticleDOI
TL;DR: This review presents a summary of the research concerning the production levels and sources of Cl-VOCs, their potential impacts on human health as well as state-of-the-art remediation technologies.

551 citations


Cites background from "Association Between Trihalomethane ..."

  • ...spontaneous abortion, low birth weight and birth defects) and CF exposure (Yang et al., 2007; Zeng et al., 2013)....

    [...]

  • ...…(Gander et al., 2002; Grostern and Edwards, 2006), phytoremediation (Wang et al., 2004; Aken, 2008), physical adsorption (Wei and Seo, 2010; Yang et al., 2007), thermal incineration (Lin et al., 2003; Tseng et al., 2003), advanced oxidation processes (AOPs) like photocatalytic oxidation…...

    [...]

  • ...Recent epidemiologic studies have also suggested the link between adverse reproductive outcomes (e.g. spontaneous abortion, low birth weight and birth defects) and CF exposure (Yang et al., 2007; Zeng et al., 2013)....

    [...]

Journal ArticleDOI
TL;DR: There was little or no evidence for associations between total trihalomethane concentration and adverse birth outcomes relating to fetal growth and prematurity, with the possible exception of SGA.
Abstract: Background:Exposure to total trihalomethanes in drinking water has been associated with several adverse birth outcomes relating to fetal growth and prematurity.Methods:We carried out a systematic review and meta-analysis of epidemiologic studies featuring original peer-reviewed data on the associati

159 citations


Cites methods from "Association Between Trihalomethane ..."

  • ...The meta-analysis included 2 population-based case-control studies,(16,17) 2 cross-sectional studies,(21,24) 1 cohort study,(13) 2 retrospective cohort studies,(12,22) 2 prospective pregnancy studies,(29,33) and 5 studies for which the design type was not explicitly named.(18,26,31,34,35) For the purposes of this review, the studies were defined as population case-control studies, retrospective pregnancy cohort studies, or prospective pregnancy cohort studies (Table 1)....

    [...]

Journal ArticleDOI
TL;DR: A comprehensive review of all known studies published from 1992 through August 2012 linking maternal exposure to environmental chemicals during pregnancy with preterm birth found no consistent evidence was found for positive associations between individual chemical exposures and pre term birth.
Abstract: Preterm birth is a significant public health concern, as it is associated with high risk of infant mortality, various morbidities in both the neonatal period and later in life, and a significant societal economic burden. As many cases are of unknown etiology, identification of the contribution of environmental contaminant exposures is a priority in the study of preterm birth. This is a comprehensive review of all known studies published from 1992 through August 2012 linking maternal exposure to environmental chemicals during pregnancy with preterm birth. Using PubMed searches, studies were identified that examined associations between preterm birth and exposure to five categories of environmental toxicants, including persistent organic pollutants, drinking-water contaminants, atmospheric pollutants, metals and metalloids, and other environmental contaminants. Individual studies were summarized and specific suggestions were made for future work in regard to exposure and outcome assessment methods as well as study design, with the recommendation of focusing on potential mediating toxicological mechanisms. In conclusion, no consistent evidence was found for positive associations between individual chemical exposures and preterm birth. By identifying limitations and addressing the gaps that may have impeded the ability to identify true associations thus far, this review can guide future epidemiologic studies of environmental exposures and preterm birth.

150 citations


Cites background from "Association Between Trihalomethane ..."

  • ...Of nine studies chosen for inclusion in that study, none found significant associations with preterm birth (Dodds et al., 1999; Gallagher et al., 1998; Hoffman et al., 2008; Kramer et al., 1992; Lewis et al., 2007; Savitz et al., 1995; Wright et al., 2003, 2004; Yang et al., 2007)....

    [...]

  • ...Of nine studies chosen for inclusion in that study, none found significant associations with preterm birth (Dodds et al., 1999; Gallagher et al., 1998; Hoffman et al., 2008; Kramer et al., 1992; Lewis et al., 2007; Savitz et al., 1995; Wright et al., 2003, 2004; Yang et al., 2007)....

    [...]

Journal ArticleDOI
TL;DR: There appears to be good epidemiological evidence for a relationship between exposure to DBPs, as measured by trihalomethanes (THMs), in drinking water and bladder cancer, but the evidence for other cancers including colorectal cancer is inconclusive and inconsistent.
Abstract: This paper summarizes the epidemiological evidence for adverse health effects associated with disinfection by-products (DBPs) in drinking water and describes the potential mechanism of action. There appears to be good epidemiological evidence for a relationship between exposure to DBPs, as measured by trihalomethanes (THMs), in drinking water and bladder cancer, but the evidence for other cancers including colorectal cancer is inconclusive and inconsistent. There appears to be some evidence for an association between exposure to DBPs, specifically THMs, and little for gestational age/intrauterine growth retardation and, to a lesser extent, pre-term delivery, but evidence for relationships with other outcomes such as low birth weight, stillbirth, congenital anomalies and semen quality is inconclusive and inconsistent. Major limitations in exposure assessment, small sample sizes and potential biases may account for the inconclusive and inconsistent results in epidemiological studies. Moreover, most studies have focused on total THMs as the exposure metric, whereas other DBPs appear to be more toxic than the THMs, albeit generally occurring at lower levels in the water. The mechanisms through which DBPs may cause adverse health effects including cancer and adverse reproductive effects have not been well investigated. Several mechanisms have been suggested, including genotoxicity, oxidative stress, disruption of folate metabolism, disruption of the synthesis and/or secretion of placental syncytiotrophoblast-derived chorionic gonadotropin and lowering of testosterone levels, but further work is required in this area.

147 citations


Cites background or result from "Association Between Trihalomethane ..."

  • ...Studies on pre-term delivery have generally shown no statistically significant associations with DBPs (Kramer et al. 1992; Bove et al. 1995; Savitz et al. 1995; Gallagher et al. 1998; Wright et al. 2003; Aggazzotti et al. 2004; Hinckley et al. 2005; Lewis et al. 2007; Yang et al. 2007), with the exception of the study by Yang et al....

    [...]

  • ...…associations (Bove et al. 1995; Gallagher et al. 1998; Källen & Robert 2000; Lewis et al. 2006) and others not (Kramer et al. 1992; Savitz et al. 1995; Kanitz et al. 1996; Dodds et al. 1999; Yang et al. 2000a, 2007; Jaakkola et al. 2001; Wright et al. 2003; Yang 2004; Toledano et al. 2005)....

    [...]

  • ...…(IUGR) showed some more consistent results, and a good proportion of them have found statistically significant associations (Kramer et al. 1992; Bove et al. 1995; Wright et al. 2003, 2004), while some did not (Dodds et al. 1999; Porter et al. 2005; Yang et al. 2007; Hoffman et al. 2008b) (table 3)....

    [...]

  • ...2003, 2004), while some did not (Dodds et al. 1999; Porter et al. 2005; Yang et al. 2007; Hoffman et al. 2008b) (table 3)....

    [...]

  • ...…1992; Bove et al. 1995; Savitz et al. 1995; Gallagher et al. 1998; Wright et al. 2003; Aggazzotti et al. 2004; Hinckley et al. 2005; Lewis et al. 2007; Yang et al. 2007), with the exception of the study by Yang et al. (2000a) and Yang (2004), who found a statistically significant increased risk....

    [...]

Journal ArticleDOI
TL;DR: The HIWATE project was a systematic analysis that combined the epidemiology on adverse pregnancy outcomes and other health effects with long-term exposure to low levels of drinking water disinfection byproducts in the European Union, and this study is the first to integrate quantitative in vitro toxicological data with analytical chemistry and human epidemiologic outcomes for drinking water DBPs.
Abstract: The HIWATE (Health Impacts of long-term exposure to disinfection byproducts in drinking WATEr) project was a systematic analysis that combined the epidemiology on adverse pregnancy outcomes and other health effects with long-term exposure to low levels of drinking water disinfection byproducts (DBPs) in the European Union. The present study focused on the relationship of the occurrence and concentration of DBPs with in vitro mammalian cell toxicity. Eleven drinking water samples were collected from five European countries. Each sampling location corresponded with an epidemiological study for the HIWATE program. Over 90 DBPs were identified; the range in the number of DBPs and their levels reflected the diverse collection sites, different disinfection processes, and the different characteristics of the source waters. For each sampling site, chronic mammalian cell cytotoxicity correlated highly with the numbers of DBPs identified and the levels of DBP chemical classes. Although there was a clear difference in the genotoxic responses among the drinking waters, these data did not correlate as well with the chemical analyses. Thus, the agents responsible for the genomic DNA damage observed in the HIWATE samples may be due to unresolved associations of combinations of identified DBPs, unknown emerging DBPs that were not identified, or other toxic water contaminants. This study represents the first to integrate quantitative in vitro toxicological data with analytical chemistry and human epidemiologic outcomes for drinking water DBPs.

147 citations

References
More filters
Journal ArticleDOI
TL;DR: This review presents a summary of the research concerning the production levels and sources of Cl-VOCs, their potential impacts on human health as well as state-of-the-art remediation technologies.

551 citations

Journal ArticleDOI
TL;DR: There was little or no evidence for associations between total trihalomethane concentration and adverse birth outcomes relating to fetal growth and prematurity, with the possible exception of SGA.
Abstract: Background:Exposure to total trihalomethanes in drinking water has been associated with several adverse birth outcomes relating to fetal growth and prematurity.Methods:We carried out a systematic review and meta-analysis of epidemiologic studies featuring original peer-reviewed data on the associati

159 citations

Journal ArticleDOI
TL;DR: A comprehensive review of all known studies published from 1992 through August 2012 linking maternal exposure to environmental chemicals during pregnancy with preterm birth found no consistent evidence was found for positive associations between individual chemical exposures and pre term birth.
Abstract: Preterm birth is a significant public health concern, as it is associated with high risk of infant mortality, various morbidities in both the neonatal period and later in life, and a significant societal economic burden. As many cases are of unknown etiology, identification of the contribution of environmental contaminant exposures is a priority in the study of preterm birth. This is a comprehensive review of all known studies published from 1992 through August 2012 linking maternal exposure to environmental chemicals during pregnancy with preterm birth. Using PubMed searches, studies were identified that examined associations between preterm birth and exposure to five categories of environmental toxicants, including persistent organic pollutants, drinking-water contaminants, atmospheric pollutants, metals and metalloids, and other environmental contaminants. Individual studies were summarized and specific suggestions were made for future work in regard to exposure and outcome assessment methods as well as study design, with the recommendation of focusing on potential mediating toxicological mechanisms. In conclusion, no consistent evidence was found for positive associations between individual chemical exposures and preterm birth. By identifying limitations and addressing the gaps that may have impeded the ability to identify true associations thus far, this review can guide future epidemiologic studies of environmental exposures and preterm birth.

150 citations

Journal ArticleDOI
TL;DR: The HIWATE project was a systematic analysis that combined the epidemiology on adverse pregnancy outcomes and other health effects with long-term exposure to low levels of drinking water disinfection byproducts in the European Union, and this study is the first to integrate quantitative in vitro toxicological data with analytical chemistry and human epidemiologic outcomes for drinking water DBPs.
Abstract: The HIWATE (Health Impacts of long-term exposure to disinfection byproducts in drinking WATEr) project was a systematic analysis that combined the epidemiology on adverse pregnancy outcomes and other health effects with long-term exposure to low levels of drinking water disinfection byproducts (DBPs) in the European Union. The present study focused on the relationship of the occurrence and concentration of DBPs with in vitro mammalian cell toxicity. Eleven drinking water samples were collected from five European countries. Each sampling location corresponded with an epidemiological study for the HIWATE program. Over 90 DBPs were identified; the range in the number of DBPs and their levels reflected the diverse collection sites, different disinfection processes, and the different characteristics of the source waters. For each sampling site, chronic mammalian cell cytotoxicity correlated highly with the numbers of DBPs identified and the levels of DBP chemical classes. Although there was a clear difference in the genotoxic responses among the drinking waters, these data did not correlate as well with the chemical analyses. Thus, the agents responsible for the genomic DNA damage observed in the HIWATE samples may be due to unresolved associations of combinations of identified DBPs, unknown emerging DBPs that were not identified, or other toxic water contaminants. This study represents the first to integrate quantitative in vitro toxicological data with analytical chemistry and human epidemiologic outcomes for drinking water DBPs.

147 citations

Journal ArticleDOI
TL;DR: Brominated disinfection byproducts may have higher health risks than their corresponding chlorinated DBPs and a potential role of an emerging alternate disinfectant, ferrate (FeVIO2− 4), in minimizing DBPs is briefly discussed.
Abstract: Disinfection byproducts (DBPs) in drinking water exhibit considerable adverse health effects; recent focus is on the brominated disinfection byproducts (Br-DBPs). The chlorination and chloramination of bromide ion containing water produce reactive bromo species, which subsequently react with natural organic matter (NOM) to yield Br-DBPs. The possible reactions involved in generating DBPs are presented. Identified Br-DBPs include bromomethanes, bromoacetic acid, bromoacetamides, bromoacetonitriles, and bromophenols. Mixed chloro- and bromo-species have also been identified. Pathways of the formation of Br-DBPs have been described. The concentration of Br- ion, pH, reaction time, and the presence of Cu(II) influence the yield of DBPs. The effects of water conditions on the production of Br-DBPs are presented. The epidemiological studies to understand the potential toxic effects of DBPs including Br-DBPs are summarized. Brominated DBPs may have higher health risks than their corresponding chlorinated DBPs. A potential role of an emerging alternate disinfectant, ferrate (FeV)O(2-)4), in minimizing DBPs is briefly discussed.

123 citations