Chlorination disinfection by-products and risk of congenital anomalies in England and Wales.
Chlorination disinfection by-products and risk of congenital anomalies in England and Wales.
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DOI：
10.1289/ehp.10636
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发表时间：
2008-02
影响因子：
10.4
通讯作者：
Elliott P
中科院分区：
文献类型：
--
作者：
Nieuwenhuijsen MJ;Toledano MB;Bennett J;Best N;Hambly P;de Hoogh C;Wellesley D;Boyd PA;Abramsky L;Dattani N;Fawell J;Briggs D;Jarup L;Elliott P
据报道，各种先天性异常的风险增加与供水中的三卤甲烷（THM）暴露有关。我们进行了一项基于注册的研究，以确定THM浓度与英格兰和威尔士先天性异常风险之间的关系。我们从国家先天性异常系统、区域登记处和国家终止登记处获得先天性异常数据; THM数据从自来水公司获得。在怀孕前三个月的居住地建立了总THM（< 30、30至< 60、≥60 μg/L）、总溴化暴露（< 10、10至< 20、≥20 μg/L）和溴仿暴露（< 2、2至< 4、≥4 μg/L）的模型。我们纳入了2，605，226例活产、死产和终止妊娠病例，其中22，828例先天性异常病例。使用固定和随机效应模型对广泛定义的异常组（腭裂/唇腭裂、腹壁、主要心脏、神经管、泌尿和呼吸缺陷）、更严格的异常组（具有更好的确定性）以及孤立和多发异常进行分析。数据根据性别、母亲年龄和社会经济地位进行了调整。我们发现，对于广义或更严格的异常集，暴露类别之间没有统计学显著趋势。对于具有孤立缺陷的受限异常集，（p < 0.05）室间隔缺损的总THMs高暴露类别[比值比（OR）= 1.43; 95%置信区间（CI），1.00-2.04]和严重心血管缺陷和腹裂的溴仿高暴露类别中的过度风险（OR = 1.18; 95%CI，1.00-1.39; OR = 1.38; 95%CI，1.00-1.92）。在这项大型的全国性研究中，我们几乎没有发现饮用水中THM浓度与先天性异常风险之间关系的证据。
Increased risk of various congenital anomalies has been reported to be associated with trihalomethane (THM) exposure in the water supply. We conducted a registry-based study to determine the relationship between THM concentrations and the risk of congenital anomalies in England and Wales. We obtained congenital anomaly data from the National Congenital Anomalies System, regional registries, and the national terminations registry; THM data were obtained from water companies. Total THM (< 30, 30 to < 60, ≥60 μg/L), total brominated exposure (< 10, 10 to < 20, ≥20 μg/L), and bromoform exposure (< 2, 2 to < 4, ≥4 μg/L) were modeled at the place of residence for the first trimester of pregnancy. We included 2,605,226 live births, stillbirths, and terminations with 22,828 cases of congenital anomalies. Analyses using fixed- and random-effects models were performed for broadly defined groups of anomalies (cleft palate/lip, abdominal wall, major cardiac, neural tube, urinary and respiratory defects), a more restricted set of anomalies with better ascertainment, and for isolated and multiple anomalies. Data were adjusted for sex, maternal age, and socioeconomic status. We found no statistically significant trends across exposure categories for either the broadly defined or more restricted sets of anomalies. For the restricted set of anomalies with isolated defects, there were significant (p < 0.05) excess risks in the high-exposure categories of total THMs for ventricular septal defects [odds ratio (OR) = 1.43; 95% confidence interval (CI), 1.00–2.04] and of bromoform for major cardiovascular defects and gastroschisis (OR = 1.18; 95% CI, 1.00–1.39; and OR = 1.38; 95% CI, 1.00–1.92, respectively). In this large national study we found little evidence for a relationship between THM concentrations in drinking water and risk of congenital anomalies.
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影响因子：
5
作者：
BOVE, FJ;FULCOMER, MC;SAVRIN, JE
通讯作者：
SAVRIN, JE
影响因子：
5.4
作者：
Magnus, P;Jaakkola, JJK;Dybing, E
通讯作者：
Dybing, E
DOI：
10.1038/sj.jea.7500380
发表时间：
2005-03-01
期刊：
JOURNAL OF EXPOSURE ANALYSIS AND ENVIRONMENTAL EPIDEMIOLOGY
影响因子：
--
作者：
Whitaker, H;Best, N;Elliott, P
通讯作者：
Elliott, P
影响因子：
10.4
作者：
Toledano MB;Nieuwenhuijsen MJ;Best N;Whitaker H;Hambly P;de Hoogh C;Fawell J;Jarup L;Elliott P
通讯作者：
Elliott P
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N