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首页> 外文期刊>Occupational and environmental medicine >Maternal exposure to water disinfection by-products during gestation and risk of hypospadias.
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Maternal exposure to water disinfection by-products during gestation and risk of hypospadias.

机译：孕期孕妇暴露于水消毒副产物中，并有尿道下裂的风险。

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BACKGROUND: The use of chlorine for water disinfection results in the formation of numerous contaminants called disinfection by-products (DBPs), which may be associated with birth defects, including urinary tract defects. METHODS: We used Arkansas birth records (1998-2002) to conduct a population-based case-control study investigating the relationship between hypospadias and two classes of DBPs, trihalomethanes (THM) and haloacetic acids (HAA). We utilised monitoring data, spline regression and geographical information systems (GIS) to link daily concentrations of these DBPs from 263 water utilities to 320 cases and 614 controls. We calculated ORs for hypospadias and exposure to DBPs between 6 and 16 weeks' gestation, and conducted subset analyses for exposure from ingestion, and metrics incorporating consumption, showering and bathing. RESULTS: We found no increase in risk when women in the highest tertiles of exposure were compared to those in the lowest for any DBP. When ingestion alone was used to assess exposure among a subset of 40 cases and 243 controls, the intermediate tertiles of exposure to total THM and the five most common HAA had ORs of 2.11 (95% CI 0.89 to 5.00) and 2.45 (95% CI 1.06 to 5.67), respectively, compared to women with no exposure. When exposure to total THM from consumption, showering and bathing exposures was evaluated, we found an OR of 1.96 (95% CI 0.65 to 6.42) for the highest tertile of exposure and weak evidence of a dose-response relationship. CONCLUSIONS: Our results provide little evidence for a positive relationship between DBP exposure during gestation and an increased risk of hypospadias but emphasise the necessity of including individual-level data when assessing exposure to DBPs.
机译：背景：使用氯进行水消毒会导致形成许多称为消毒副产物（DBP）的污染物，这些污染物可能与出生缺陷（包括尿路缺陷）有关。方法：我们使用阿肯色州的出生记录（1998-2002年）进行了一项基于人群的病例对照研究，调查了尿道下裂和两类DBP，三卤甲烷（THM）和卤代乙酸（HAA）之间的关系。我们利用监测数据，样条回归和地理信息系统（GIS）将这些DBP的每日浓度从263家供水公司链接到320个案例和614个控件。我们计算了尿道下裂和妊娠6至16周之间DBP的OR，并进行了子集分析以了解摄入的暴露，并结合了消耗，淋浴和沐浴的指标。结果：与任何DBP而言，暴露于最高三分位数的女性相比，接触最低三分位数的女性的风险没有增加。当仅通过摄入来评估40例病例和243例对照中的一部分的暴露时，总THM和五个最常见的HAA暴露的中间三分位数的OR分别为2.11（95％CI 0.89至5.00）和2.45（95％CI）与未接触女性相比，分别为1.06至5.67）。当评估了食用，淋浴和沐浴暴露对总THM的暴露时，我们发现最高暴露三分位数的OR为1.96（95％CI为0.65至6.42），并且与剂量反应关系的证据微弱。结论：我们的结果几乎没有证据表明妊娠期间DBP暴露与尿道下裂风险增加之间存在正相关关系，但强调评估DBP暴露时必须包括个人水平的数据。

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