Chlorination by-products in tap water and semen quality in England and Wales

Iszatt, Nina; Nieuwenhuijsen, Mark; Bennett, James L.; Best, Nicky; Povey, Andrew C.; Pacey, Allan; Moore, H. D. M.; Cherry, Nicola; Toledano, Mireille B.

doi:10.1136/oemed-2012-101339

Cited by 23 publications

(7 citation statements)

References 32 publications

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“…A separate study in China found a trend toward lower sperm concentrations with higher serum trihalomethane levels (Zeng et al ., ). Three studies, however, found no significant effect of trihalomethane exposure on sperm counts (Fenster et al ., ; Luben et al ., ; Iszatt et al ., ).…”

Section: Ambient and Other Occupational Exposuresmentioning

confidence: 97%

Chronic exposures and male fertility: the impacts of environment, diet, and drug use on spermatogenesis

2016

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SUMMARYSeveral recent studies have suggested that sperm concentrations and semen quality have been decreasing over the past several decades in many areas of the world. The etiology of these decreases is currently unknown. Acute events can have significant impacts on spermatogenesis and are often readily identified during the male fertility evaluation. The majority of male factor infertility, however, is idiopathic. Chronic, low-dose exposures to chemicals and nutrients are more difficult to identify, but are extremely prevalent. These exposures have been shown to have dramatic effects on both individual and community health and interest in the cumulative and synergistic impacts of such agents on spermatogenesis has been increasing. While our understanding of these potential hazards is evolving, it is clear that they may significantly influence male reproductive potential. This review explores the literature related to effects of chronic exposures from drug use, dietary intake, and the environment on spermatogenesis in humans and animals.

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Section: Ambient and Other Occupational Exposuresmentioning

confidence: 97%

Chronic exposures and male fertility: the impacts of environment, diet, and drug use on spermatogenesis

2016

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“…Studies have suggested a negative impact of DBP exposure on normal sperm morphology [58] and on sperm concentration [59], but not on motility percentage, after adjusting for confounders [60]. A large case-control study conducted in the UK reported no evidence of poor semen quality in association with total trihalomethanes (THMs), chloroform, or brominated THMs in public drinking water [61]. In China, a cross-sectional study that measured urine TCAA in approximately 2,000 men visiting a reproduction center showed a negative correlation between markers of sperm quality and urine TCAA levels, but no dose-response association was observed [62].…”

Section: Fertilitymentioning

confidence: 99%

Overview of Disinfection By-products and Associated Health Effects

Villanueva

Cordier²,

Font-Ribera

et al. 2015

Curr Envir Health Rpt

235

124

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The presence of chemical compounds formed as disinfection by-products (DBPs) is widespread in developed countries, and virtually whole populations are exposed to these chemicals through ingestion, inhalation, or dermal absorption from drinking water and swimming pools. Epidemiological evidence has shown a consistent association between long-term exposure to trihalomethanes and the risk of bladder cancer, although the causal nature of the association is not conclusive. Evidence concerning other cancer sites is insufficient or mixed. Numerous studies have evaluated reproductive implications, including sperm quality, time to pregnancy, menstrual cycle, and pregnancy outcomes such as fetal loss, fetal growth, preterm delivery, and congenital malformation. The body of evidence suggests only minor effects from high exposure during pregnancy on fetal growth indices such as small for gestational age (SGA) at birth. Populations highly exposed to swimming pools such as pool workers and professional swimmers show a higher prevalence of respiratory symptoms and asthma, respectively, although the direction of the association, and thus causality, is not clear among professional swimmers. The risk of asthma, wheezing, eczema, and other respiratory outcomes among children attending swimming pools has been the object of extensive research. Early studies suggested a positive association, while subsequent larger studies found no correlations or showed a protective association. Future research should develop methods to evaluate the effects of the DBP mixture and the interaction with personal characteristics (e.g., genetics, lifestyle), clarify the association between swimming pools and respiratory health, evaluate the occurrence of DBPs in lowand middle-income countries, and evaluate outcomes suggested by animal studies that have not been considered in epidemiological investigations.

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“…Of the epidemiologic studies that examined female reproduction, outcomes assessed included altered menstruation (Windham et al, ), female fertility (Dahl et al, ), and pregnancy loss/stillbirth/spontaneous abortion (Waller et al, ; Savitz et al, ; King et al, ; Dodds et al, ; Wennborg et al, ; Savitz et al, ; Toledano et al, ; Iszatt et al, ). All studies of male reproduction examined sperm concentration, count, motility, and/or quality (Chang et al, ; Iszatt et al, ; Yang et al, ; Zeng et al, ; Zeng, Chen, et al, ). Although some positive statistical associations for male or female reproductive outcomes were detected in some (but not all) epidemiologic studies of chloroform exposure, the literature on these endpoints is relatively sparse compared with that for developmental outcomes.…”

Section: Resultsmentioning

confidence: 99%

Impact of chloroform exposures on reproductive and developmental outcomes: A systematic review of the scientific literature

Williams

Bates

Pace

et al. 2018

Birth Defects Research

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Aims:We assessed the animal and epidemiological data to determine if chloroform exposure causes developmental and/or reproductive toxicity. Results and Discussion: Initial scoping identified developmental toxicity as the primary area of concern. At levels producing maternal toxicity in rats and mice, chloroform caused decrements in fetal weights and associated delays in ossification. In a single mouse inhalation study, exposure to a high concentration of chloroform was associated with small fetuses and increased cleft palate. However, oral exposure of mice to chloroform at a dose 4 times higher was negative for cleft palate; multiple inhalation studies in rats were also negative. Epidemiologic data on low birth weight and small for gestational age were generally equivocal, preventing conclusions from being drawn for humans. The animal data also show evidence of very early (peri-implantation) total litter losses at very high exposure levels. This effect is likely maternally mediated rather than a direct effect on the offspring. Finally, the epidemiologic data indicate a possible association of higher chloroform exposure with lower risk of preterm birth (<37 weeks gestation). Conclusions: The available animal data suggest that exposures lower than those causing maternal toxicity should be without developmental effects in the offspring. Also, most studies in humans rely on group-level geographic exposure data, providing only weak epidemiologic evidence for an association with development outcomes and fail to establish a causal role for chloroform in the induction of adverse developmental outcomes at environmentally relevant concentrations. K E Y W O R D Sbirth defects, chloroform, developmental toxicity, epidemiology, teratogenicity

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Chlorination by-products in tap water and semen quality in England and Wales

Cited by 23 publications

References 32 publications

Chronic exposures and male fertility: the impacts of environment, diet, and drug use on spermatogenesis

Chronic exposures and male fertility: the impacts of environment, diet, and drug use on spermatogenesis

Overview of Disinfection By-products and Associated Health Effects

Impact of chloroform exposures on reproductive and developmental outcomes: A systematic review of the scientific literature

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