Exposure to Drinking Water Disinfection By-Products and Pregnancy Loss
Abstract
Previous research has suggested that exposure to elevated levels of drinking water disinfection by-products (DBPs) may cause pregnancy loss. In 2000-2004, the authors conducted a study in three US locations of varying DBP levels and evaluated 2,409 women in early pregnancy to assess their tap water DBP concentrations, water use, other risk factors, and pregnancy outcome. Tap water concentrations were measured in the distribution system weekly or biweekly. The authors considered DBP concentration and ingested amount and, for trihalomethanes only, bathing/showering and integrated exposure that included ingestion. On the basis of 258 pregnancy losses, they did not find an increased risk of pregnancy loss in relation to trihalomethane, haloacetic acid, or total organic halide concentrations; ingested amounts; or total exposure. In contrast to a previous study, pregnancy loss was not associated with high personal trihalomethane exposure (> or =75 micro g/liter and > or =5 glasses of water/day) (odds ratio = 1.1, 95% confidence interval: 0.7, 1.7). Sporadic elevations in risk were found across DBPs, most notably for ingested total organic halide (odds ratio = 1.5, 95% confidence interval: 1.0, 2.2 for the highest exposure quintile). These results provide some assurance that drinking water DBPs in the range commonly encountered in the United States do not affect fetal survival.
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A subsequent North Carolina study with refined exposure characterization did not confirm the California spontaneous abortion results.
“A subsequent study conducted in North Carolina with a refined exposure characterization did not confirm these results [66].”
From Overview of Disinfection By-products and Associated Health Effects (2015) · cites this paper as [66]
The Results and Discussion report less support for the California association and describe refined exposure characterization. But the paper describes this as a study at three US locations, not a study conducted in North Carolina; its mention of the University of North Carolina concerns sample analysis, not a study site. (LLM, conf=0.88)
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- Authors
- Savitz, D. A., Singer, P. C., Herring, A. H., Hartmann, K. E., Weinberg, H. S., & Makarushka, C.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2006-09-12
- Volume
- 164
- Issue
- 11
- Pages
- 1043-1051
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W2098838722
- Semantic Scholar
- d69d10b9d7de3fb994cb89d97881e8adde48965e
- Cited by
- 177
- References
- 28
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 2 · 2023: 10 · 2022: 6 · 2021: 1 · 2020: 8 · 2019: 12 · 2018: 9 · 2017: 9 · 2016: 7 · 2015: 5 · 2014: 7 · 2013: 7 · 2012: 11
- FWCI
- 9.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Water Works Association Research Foundation
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Water Treatment and Disinfection
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Toxic Organic Pollutants Impact
- Keywords
- drinking water disinfection by-products, miscarriage, trihalomethanes, haloacetic acids, total organic halides, oral exposure, fetal survival, water distribution systems
- MeSH terms
- Abortion, Spontaneous, Adult, Data Interpretation, Statistical, Disinfectants, Environmental Exposure, Female, Humans, Hydrocarbons, Halogenated, Pregnancy, Pregnancy Outcome, Risk Factors, United States, Water Pollutants, Chemical, Water Supply, Water Purification, Trihalomethanes
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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