Drinking water disinfection byproducts and risk of orofacial clefts in the National Birth Defects Prevention Study

Weyer, Peter J.; Rhoads, Anthony; Suhl, Jonathan; Luben, Thomas J.; Conway, Kristin M; Langlois, Peter H.; Shen, Dereck; Liang, Dong; Puzhankara, Soman; Anderka, Marlene; Bell, Erin M.; Feldkamp, Marcia L.; Hoyt, Adrienne T.; Mosley, Bridget S.; Reefhuis, Jennita; Romitti, Paul A.

doi:10.1002/bdr2.1348

Cited by 9 publications

(16 citation statements)

References 31 publications

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“…The collection of DBP data by the NBDPS has been described previously [ 25 ], and we summarize the process briefly here. During the interview, women reported their residential history throughout pregnancy and the three months before conception.…”

Section: Methodsmentioning

confidence: 99%

“…In instances where service area maps were not available, 2010 census place shape maps were used to approximate service boundaries. In cities with multiple PWSs that did not clearly define service boundaries, the system serving the largest population was linked with the residence [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

“…To account for temporal and spatial fluctuation within a single water system, PWSs may take samples from different sites on the same day and multiple times during a calendar year. Thus, for each residence, we (1) calculated the mean DBP concentration for all samples collected on a single day among PWSs that took samples at multiple locations, and (2) estimated inverse time-weighted means if samples were taken on different days during each woman’s periconceptional period, with greater weights applied to measurements taken closer to each woman’s estimated date of conception [ 25 ]. If a woman had more than one place of residence during the periconceptional period, time-weighted means were calculated based on the number of days she reported living at each residence.…”

Section: Methodsmentioning

confidence: 99%

“…Methods developed by the Center for Health Effects of Environmental Contamination (CHEEC) at the University of Iowa were utilized to implement this classification of DBP exposure [ 25 ]. If a woman reported no changes in water consumption or source during pregnancy, we multiplied the number of 8 oz.…”

Section: Methodsmentioning

confidence: 99%

“…weights applied to measurements taken closer to each woman's estimated date of conception [25]. If a woman had more than one place of residence during the periconceptional period, time-weighted means were calculated based on the number of days she reported living at each residence.…”

Section: Dbp Concentrations In Household Tap Watermentioning

confidence: 99%

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Maternal Exposure to Disinfection By-Products and Risk of Hypospadias in the National Birth Defects Prevention Study (2000–2005)

Ibrahim

Luben

Desrosiers

et al. 2020

IJERPH

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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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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Dbp Concentrations In Household Tap Watermentioning

confidence: 99%

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Maternal Exposure to Disinfection By-Products and Risk of Hypospadias in the National Birth Defects Prevention Study (2000–2005)

Ibrahim

Luben

Desrosiers

et al. 2020

IJERPH

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Maternal periconceptional exposure to drinking water disinfection by‐products and neural tube defects in offspring

Kancherla,

Rhoads,

Conway

et al. 2024

Birth Defects Research

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BackgroundAssociations 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.MethodsMaternal 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.ResultsOverall, 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.ConclusionsUsing 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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Maternal Exposure to Tap Water Disinfection By‐Products and Risk of Selected Congenital Heart Defects

Michalski,

Luben,

Zaganjor

et al. 2024

Birth Defects Research

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BackgroundThe use of chlorine to treat drinking water produces disinfection by‐products (DBPs), which have been associated with congenital heart defects (CHDs) in some studies.MethodsUsing 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.ResultsHousehold 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.ConclusionsAssessing 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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Drinking water disinfection byproducts and risk of orofacial clefts in the National Birth Defects Prevention Study

Cited by 9 publications

References 31 publications

Maternal Exposure to Disinfection By-Products and Risk of Hypospadias in the National Birth Defects Prevention Study (2000–2005)

Maternal Exposure to Disinfection By-Products and Risk of Hypospadias in the National Birth Defects Prevention Study (2000–2005)

Maternal periconceptional exposure to drinking water disinfection by‐products and neural tube defects in offspring

Maternal Exposure to Tap Water Disinfection By‐Products and Risk of Selected Congenital Heart Defects

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