Drinking water contaminants and adverse pregnancy outcomes: a review.
Open accessAbstract
Concern for exposures to drinking water contaminants and their effects on adverse birth outcomes has prompted several studies evaluating chlorination disinfection by-products and chlorinated solvents. Some of these contaminants are found to be teratogenic in animal studies. This review evaluates 14 studies on chlorination disinfection by-products such as trihalomethanes (THMs) and five studies on chlorinated solvents such as trichloroethylene (TCE). The adverse birth outcomes discussed in this review include small for gestational age (SGA), low birth weight, preterm birth, birth defects, spontaneous abortions, and fetal deaths. Because of heterogeneities across the studies in the characterization of birth outcomes, the assessment and categorization of exposures, and the levels and mixtures of contaminants, a qualitative review was conducted. Generally, the chief bias in these studies was exposure misclassification that most likely underestimated the risk, as well as distorted exposure-response relationships. The general lack of confounding bias by risk factors resulted from these factors not being associated with drinking water exposures. The studies of THMs and adverse birth outcomes provide moderate evidence for associations with SGA, neural tube defects (NTDs), and spontaneous abortions. Because fewer studies have been conducted for the chlorinated solvents than for THMs, the evidence for associations is less clear. Nevertheless, the findings of excess NTDs, oral clefts, cardiac defects, and choanal atresia in studies that evaluated TCE-contaminated drinking water deserve follow-up.
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- Authors
- Bove, F., Shim, Y., & Zeitz, P.
- Affiliations
- Agency for Toxic Substances and Disease Registry (US)
- ORCID
- Bove, Frank
- Venue
- Environmental Health Perspectives
- Publisher
- American Chemical Society (ACS)
- Published
- 2002-02-01
- Volume
- 110
- Issue
- suppl 1
- Pages
- 61-74
- ISSN
- 0091-6765 (ISSN-L)
- 1552-9924
- PMC
- PMC1241148
- OpenAlex
- W2064281606
- Semantic Scholar
- 2561318194f15119864e4543bddb846bdf42d5eb
- Cited by
- 315
- References
- 32
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 8 · 2023: 14 · 2022: 7 · 2021: 12 · 2020: 8 · 2019: 10 · 2018: 16 · 2017: 5 · 2016: 14 · 2015: 14 · 2014: 8 · 2013: 19 · 2012: 15
- FWCI
- 12.03
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- public-domain
- creativecommons.org/licenses/by/4.0/ (vor, 5810 d)
- Locations
- Environmental Health Perspectives (publishedVersion, public-domain)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- 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 › Public Health and Environmental Issues
- Keywords
- drinking water contaminants, adverse pregnancy outcomes, chlorination by-products, trihalomethanes, chlorinated solvents, trichloroethylene, small for gestational age, low birth weight, preterm birth, congenital malformations, neural tube defects, miscarriage, fetal death, exposure misclassification, exposure-response relationship, teratogenicity
- MeSH terms
- Congenital Abnormalities, Abortion, Spontaneous, Adult, Chromosome Aberrations, Disease Models, Animal, Disinfectants, Female, Humans, Infant, Low Birth Weight, Infant, Newborn, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Solvents, Trichloroethylene, Water Pollutants, Water Supply, Trihalomethanes
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