Background: Epidemiological evidence of an association between disinfectionby-products (DBPs) exposure via drinking water and reproductive outcomes is still inconclusive.Objective: The aim of this study was to investigate the association between trihalomethanes (THMs), chlorite and chlorate exposure and congenital anomalies.Methods: A case-control study was carried out in Emilia-Romagna Region (Italy). Data on 1917 different congenital anomalies (neural tube, cardiac, diaphragm and abdominal wall,oesophagus, cleft lip and palate, respiratory, urinary tract and chromosomal anomalies) observed in the period 2002–2005 were extracted from the Regional Malformation Registry. Four controls (newborns without anomalies) were randomly selected form the Regional Birth Register and frequency matched to cases according to pregnancy period. The network supplying water during the first trimester of pregnancy was identified on the basis of mother’s address: DBPs data, technical and structural information were linked to each subject.Results: Overall, THMs exposure was very low (mean:3.8 +/- 3.6 mg/l), and no risk excess was observed. Chlorite and chlorate values were fairly high (mean:427+/-184 mg/l and 283+/-79 mg/l, respectively). Women exposed to chlorite level >700 mg/l were at higher risk of newborns with renal defects (OR: 3.30; 95%IC:1.35–8.09),abdominal wall defects(OR:6.88;95%IC:1.67–28.33) and cleftpalate (OR: 4.1; 95%IC:0.98–16.8); women exposed to chlorate level >200 mg/l were at higher risk of newborns with obstructive urinary defects (OR:2.88;95%IC:1.09–7.63), cleftpalate (OR:9.60;95%IC:1.04–88.9) and spina bifida (OR:4.94;95%IC:1.10–22).Conclusions: This was the first study showing an excess risk of different congenital anomalies related to chlorite and chlorate exposure via drinking water: further research is needed to confirm the observed relationships in large datasets, specifically for chlorate, an unregulated DBP.

Trihalomethanes, chlorite, chlorate in drinking water and risk of congenital anomalies: A population-based case-control study in Northern Italy / Righi, Elena; Petra, Bechtold; Danila, Tortorici; Paolo, Lauriola; Elisa, Calzolari; Gianni, Astolfi; Mark J., Nieuwenhuijsen; Fantuzzi, Guglielmina; Aggazzotti, Gabriella. - In: ENVIRONMENTAL RESEARCH. - ISSN 0013-9351. - STAMPA. - 116:(2012), pp. 66-73. [10.1016/j.envres.2012.04.014]

Trihalomethanes, chlorite, chlorate in drinking water and risk of congenital anomalies: A population-based case-control study in Northern Italy

RIGHI, Elena;FANTUZZI, Guglielmina;AGGAZZOTTI, Gabriella
2012

Abstract

Background: Epidemiological evidence of an association between disinfectionby-products (DBPs) exposure via drinking water and reproductive outcomes is still inconclusive.Objective: The aim of this study was to investigate the association between trihalomethanes (THMs), chlorite and chlorate exposure and congenital anomalies.Methods: A case-control study was carried out in Emilia-Romagna Region (Italy). Data on 1917 different congenital anomalies (neural tube, cardiac, diaphragm and abdominal wall,oesophagus, cleft lip and palate, respiratory, urinary tract and chromosomal anomalies) observed in the period 2002–2005 were extracted from the Regional Malformation Registry. Four controls (newborns without anomalies) were randomly selected form the Regional Birth Register and frequency matched to cases according to pregnancy period. The network supplying water during the first trimester of pregnancy was identified on the basis of mother’s address: DBPs data, technical and structural information were linked to each subject.Results: Overall, THMs exposure was very low (mean:3.8 +/- 3.6 mg/l), and no risk excess was observed. Chlorite and chlorate values were fairly high (mean:427+/-184 mg/l and 283+/-79 mg/l, respectively). Women exposed to chlorite level >700 mg/l were at higher risk of newborns with renal defects (OR: 3.30; 95%IC:1.35–8.09),abdominal wall defects(OR:6.88;95%IC:1.67–28.33) and cleftpalate (OR: 4.1; 95%IC:0.98–16.8); women exposed to chlorate level >200 mg/l were at higher risk of newborns with obstructive urinary defects (OR:2.88;95%IC:1.09–7.63), cleftpalate (OR:9.60;95%IC:1.04–88.9) and spina bifida (OR:4.94;95%IC:1.10–22).Conclusions: This was the first study showing an excess risk of different congenital anomalies related to chlorite and chlorate exposure via drinking water: further research is needed to confirm the observed relationships in large datasets, specifically for chlorate, an unregulated DBP.
2012
116
66
73
Trihalomethanes, chlorite, chlorate in drinking water and risk of congenital anomalies: A population-based case-control study in Northern Italy / Righi, Elena; Petra, Bechtold; Danila, Tortorici; Paolo, Lauriola; Elisa, Calzolari; Gianni, Astolfi; Mark J., Nieuwenhuijsen; Fantuzzi, Guglielmina; Aggazzotti, Gabriella. - In: ENVIRONMENTAL RESEARCH. - ISSN 0013-9351. - STAMPA. - 116:(2012), pp. 66-73. [10.1016/j.envres.2012.04.014]
Righi, Elena; Petra, Bechtold; Danila, Tortorici; Paolo, Lauriola; Elisa, Calzolari; Gianni, Astolfi; Mark J., Nieuwenhuijsen; Fantuzzi, Guglielmina; ...espandi
File in questo prodotto:
File Dimensione Formato  
righi 2012 Environ Res OK.pdf

Accesso riservato

Descrizione: articolo
Tipologia: Versione pubblicata dall'editore
Dimensione 190.58 kB
Formato Adobe PDF
190.58 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/728461
Citazioni
  • ???jsp.display-item.citation.pmc??? 17
  • Scopus 77
  • ???jsp.display-item.citation.isi??? 60
social impact