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Michalski AM, Luben TJ, Zaganjor I, Rhoads A, Romitti PA, Conway KM, Langlois PH, Feldkamp ML, Nembhard WN, Reefhuis J, Yazdy MM, Lin AE, Desrosiers TA, Hoyt AT, Browne ML. Maternal Exposure to Tap Water Disinfection By-Products and Risk of Selected Congenital Heart Defects. Birth Defects Res 2024; 116:e2391. [PMID: 39212068 DOI: 10.1002/bdr2.2391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 06/26/2024] [Accepted: 08/04/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND The use of chlorine to treat drinking water produces disinfection by-products (DBPs), which have been associated with congenital heart defects (CHDs) in some studies. METHODS Using National Birth Defects Prevention Study data, we linked geocoded residential addresses to public water supply measurement data for DBPs. Self-reported water consumption and filtration methods were used to estimate maternal ingestion of DBPs. We estimated adjusted odds ratios and 95% confidence intervals using logistic regression controlling for maternal age, education, body mass index (BMI), race/ethnicity, and study site to examine associations between CHDs and both household DBP level and estimated ingestion of DBPs. RESULTS Household DBP exposure was assessed for 2717 participants (1495 cases and 1222 controls). We observed a broad range of positive, null, and negative estimates across eight specific CHDs and two summary exposures (trihalomethanes and haloacetic acids) plus nine individual DBP species. Examining ingestion exposure among 2488 participants (1347 cases, 1141 controls) produced similarly inconsistent results. CONCLUSIONS Assessing both household DBP level and estimated ingestion of DBPs, we did not find strong evidence of an association between CHDs and DBPs. Despite a large study population, DBP measurements were available for less than half of participant addresses, limiting study power.
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Affiliation(s)
- Adrian M Michalski
- New York State Department of Health, Birth Defects Registry, Albany, New York, USA
| | - Thomas J Luben
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, Research Triangle Park, North Carolina, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ibrahim Zaganjor
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Anthony Rhoads
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA
| | - Paul A Romitti
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA
| | - Kristin M Conway
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA
| | - Peter H Langlois
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health - Austin Regional Campus, Austin, Texas, USA
| | - Marcia L Feldkamp
- Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Wendy N Nembhard
- Department of Epidemiology, Fay W. Boozman College of Public Health, and Arkansas Center for Birth Defects Research and Prevention, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jennita Reefhuis
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mahsa M Yazdy
- Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, Massachusetts, USA
| | - Angela E Lin
- Medical Genetics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Tania A Desrosiers
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Adrienne T Hoyt
- Department of Health and Human Performance, University of Houston, Houston, Texas, USA
| | - Marilyn L Browne
- New York State Department of Health, Birth Defects Registry, Albany, New York, USA
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, New York, USA
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Kancherla V, Rhoads A, Conway KM, Suhl J, Langlois PH, Hoyt AT, Shaw GM, Evans SP, Moore CA, Luben TJ, Michalski A, Feldkamp ML, Romitti PA. Maternal periconceptional exposure to drinking water disinfection by-products and neural tube defects in offspring. Birth Defects Res 2024; 116:e2370. [PMID: 38888449 PMCID: PMC11295258 DOI: 10.1002/bdr2.2370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/29/2024] [Accepted: 05/14/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Associations between maternal periconceptional exposure to disinfection by-products (DBPs) in drinking water and neural tube defects (NTDs) in offspring are inconclusive, limited in part by exposure misclassification. METHODS Maternal interview reports of drinking water sources and consumption from the National Birth Defects Prevention Study were linked with DBP concentrations in public water system monitoring data for case children with an NTD and control children delivered during 2000-2005. DBPs analyzed were total trihalomethanes, the five most common haloacetic acids combined, and individual species. Associations were estimated for all NTDs combined and selected subtypes (spina bifida, anencephaly) with maternal periconceptional exposure to DBPs in public water systems and with average daily periconceptional ingestion of DBPs accounting for individual-level consumption and filtration information. Mixed effects logistic regression models with maternal race/ethnicity and educational attainment at delivery as fixed effects and study site as a random intercept were applied. RESULTS Overall, 111 case and 649 control children were eligible for analyses. Adjusted odds ratios for maternal exposure to DBPs in public water systems ranged from 0.8-1.5 for all NTDs combined, 0.6-2.0 for spina bifida, and 0.7-1.9 for anencephaly; respective ranges for average daily maternal ingestion of DBPs were 0.7-1.1, 0.5-1.5, and 0.6-1.8. Several positive estimates (≥1.2) were observed, but all confidence intervals included the null. CONCLUSIONS Using community- and individual-level data from a large, US, population-based, case-control study, we observed statistically nonsignificant associations between maternal periconceptional exposure to total and individual DBP species in drinking water and NTDs and subtypes.
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Affiliation(s)
- V. Kancherla
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA
| | - A. Rhoads
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA
| | - K. M. Conway
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA
| | - J. Suhl
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA
| | - P. H. Langlois
- Department of Epidemiology, Human Genetics, and Environmental Science, University of Texas School of Public Health – Austin Campus, Austin, Texas, USA
| | - A. T. Hoyt
- Department of Health and Human Performance, University of Houston, Houston, Texas, USA
| | - G. M. Shaw
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - S. P. Evans
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - C. A. Moore
- Goldbelt Professional Services LLC, Chesapeake, Virginia, USA
| | - T. J. Luben
- Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | - A. Michalski
- New York State Department of Health, Bureau of Environmental and Occupational Epidemiology, Albany, New York, USA
| | - M. L. Feldkamp
- Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - P. A. Romitti
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA
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Unrine JM, McCoy N, Christian WJ, Gautam Y, Ormsbee L, Sanderson W, Draper R, Mooney M, Cromer M, Pennell K, Hoover AG. Spatial and seasonal variation in disinfection byproducts concentrations in a rural public drinking water system: A case study of Martin County, Kentucky, USA. PLOS WATER 2024; 3:e0000227. [PMID: 39175793 PMCID: PMC11340270 DOI: 10.1371/journal.pwat.0000227] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
To increase our understanding of the factors that influence formation of disinfection byproducts (DBPs) in rural drinking systems, we investigated the spatial and seasonal variation in trihalomethane (THM) and haloacetic acid (HAA) concentrations in relation to various chemical and physical variables in a rural public drinking water system in Martin County, Kentucky, USA. We collected drinking water samples from 97 individual homes over the course of one year and analyzed them for temperature, electrical conductivity, pH, free chlorine, total chlorine, THMs (chloroform, bromodichloromethane, dibromochloromethane, dichlorobromomethane, and bromoform) and HAAs (monochloroacetic acid, dichloroacetic acid, trichloroacetic acid, bromoacetic acid, and dibromoacetic acid). Spatial autocorrelation analysis showed only weak overall clustering for HAA concentrations and none for THMs. The relationship between modeled water age and TTHM or HAA5 concentrations varied seasonally. In contrast, there was strong variation for both HAA and THMs, with concentrations of HAA peaking in mid-summer and THMs peaking in early fall. Multiple regression analysis revealed that THM concentrations were strongly correlated with conductivity, while HAA concentrations were more strongly correlated with water temperature. Individual DBP species that only contained chlorine halogen groups were strongly correlated with temperature, while compounds containing bromine were more strongly correlated with conductivity. Further investigation revealed that increased drinking water conductivity associated with low discharge of the Tug Fork River, the source water, is highly correlated with increased concentrations of bromide. Discharge and conductivity of the Tug Fork River changed dramatically through the year contributing to a seasonal peak in bromide concentrations in the late summer and early fall and appeared to be a driver of brominated THM concentrations. Brominated DBPs tend to have higher toxicity than DBPs containing only chlorine, therefore this study provides important insight into the seasonal factors driving risk from exposure to DBPs in rural drinking water systems impacted by bromide.
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Affiliation(s)
- Jason M. Unrine
- Department of Plant and Soil Sciences, University of Kentucky, Lexington, Kentucky, United States of America
- Kentucky Water Research Institute, University of Kentucky, Lexington, Kentucky, United States of America
| | - Nina McCoy
- Martin County Concerned Citizens, Inc., Inez, Kentucky, United States of America
| | - W. Jay Christian
- Department of Epidemiology and Environmental Health, University of Kentucky, Lexington, Kentucky, United States of America
| | - Yogesh Gautam
- Department of Civil Engineering, University of Kentucky, Lexington, Kentucky, United States of America
| | - Lindell Ormsbee
- Department of Civil Engineering, University of Kentucky, Lexington, Kentucky, United States of America
| | - Wayne Sanderson
- Department of Biosystems and Agricultural Engineering, University of Kentucky, Lexington, Kentucky, United States of America
| | - Ricki Draper
- Livelihoods Knowledge Exchange Network, Lexington, Kentucky, United States of America
- Appalachian Citizens’ Law Center, Inc., Whitesburg, Kentucky, United States of America
| | - Madison Mooney
- Martin County Concerned Citizens, Inc., Inez, Kentucky, United States of America
- Livelihoods Knowledge Exchange Network, Lexington, Kentucky, United States of America
| | - Mary Cromer
- Appalachian Citizens’ Law Center, Inc., Whitesburg, Kentucky, United States of America
| | - Kelly Pennell
- Department of Civil Engineering, University of Kentucky, Lexington, Kentucky, United States of America
| | - Anna G. Hoover
- Department of Epidemiology and Environmental Health, University of Kentucky, Lexington, Kentucky, United States of America
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Maternal Exposure to Disinfection By-Products and Risk of Hypospadias in the National Birth Defects Prevention Study (2000-2005). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249564. [PMID: 33371304 PMCID: PMC7766973 DOI: 10.3390/ijerph17249564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/01/2020] [Accepted: 12/09/2020] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to estimate the association between 2nd and 3rd degree hypospadias and maternal exposure to disinfection by-products (DBPs) using data from a large case-control study in the United States. Concentration estimates for total trihalomethanes (TTHMs), the sum of the five most prevalent haloacetic acids (HAA5), and individual species of each were integrated with data on maternal behaviors related to water-use from the National Birth Defects Prevention Study (NBDPS) to create three different exposure metrics: (1) household DBP concentrations; (2) estimates of DBP ingestion; (3) predicted uptake (i.e., internal dose) of trihalomethanes (THMs) via ingestion, showering, and bathing. The distribution of DBP exposure was categorized as follows: (Q1/referent) < 50%; (Q2) ≥ 50% to < 75%; and (Q3) ≥ 75%. Logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Generally, null associations were observed with increasing TTHM or HAA5 exposure. An increased risk was observed among women with household bromodichloromethane levels in the second quantile (aOR: 1.8; 95% CI: 1.2, 2.7); however, this association did not persist after the inclusion of individual-level water-use data. Findings from the present study do not support the hypothesis that maternal DBP exposures are related to the occurrence of hypospadias.
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Parvez S, Ashby JL, Kimura SY, Richardson SD. Exposure Characterization of Haloacetic Acids in Humans for Exposure and Risk Assessment Applications: An Exploratory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E471. [PMID: 30736287 PMCID: PMC6388255 DOI: 10.3390/ijerph16030471] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 01/31/2019] [Accepted: 01/31/2019] [Indexed: 11/17/2022]
Abstract
Disinfected water is the major source of haloacetic acids (HAAs) in humans, but their inter- and intra-individual variability for exposure and risk assessment applications is under-researched. Thus, we measured HAAs in cross-sectional and longitudinal urine and water specimens from 17 individuals. Five regulated HAAs-mono, di, and trichloroacetic acid (MCAA, DCAA, and TCAA) and mono- and dibromoacetic acid (MBAA and DBAA)-and one unregulated HAA-bromochloroacetic acid (BCAA)-were measured. Urinary DCAA, MBAA, DBAA, and BCAA levels were always below the limits of detection (LOD). Measured levels and interindividual variability of urinary MCAA were higher than urinary TCAA. Longitudinal urinary specimens showed MCAA levels peaked in after-shower specimens, while TCAA levels remain unchanged. Correlation between urinary MCAA and TCAA was moderate but statistically significant. The prevalence of MCAA and TCAA in urine suggest they can be considered as biomarkers of HAA. Peak urinary MCAA in post-shower specimens suggest MCAA captures short-term exposure via dermal and/or inhalation, while urinary TCAA captures long-term exposure via ingestion. However, further research is warranted in a large pool of participants to test the reliability of MCAA as exposure biomarker.
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Affiliation(s)
- Shahid Parvez
- Department of Environmental Health Science, Indiana University Fairbanks School of Public Health, 1050 Wishard Boulevard, Indianapolis, IN 46202, USA.
| | - Jeffrey L Ashby
- Department of Environmental Health Science, Indiana University Fairbanks School of Public Health, 1050 Wishard Boulevard, Indianapolis, IN 46202, USA.
| | - Susana Y Kimura
- Department of Chemistry and Biochemistry, University of South Carolina, 631 Sumter St., Columbia, SC 29208, USA.
- Currently at the Department of Chemistry, University of Calgary, Calgary, Alberta, T2N 1N4 Canada.
| | - Susan D Richardson
- Department of Chemistry and Biochemistry, University of South Carolina, 631 Sumter St., Columbia, SC 29208, USA.
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