Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
Environ Health Perspect. 2011 Dec;119(12):1824-30. doi: 10.1289/ehp.1002425. Epub 2011 Aug 2.
Evidence associating exposure to water disinfection by-products with reduced birth weight and altered duration of gestation remains inconclusive.
We assessed exposure to trihalomethanes (THMs) during pregnancy through different water uses and evaluated the association with birth weight, small for gestational age (SGA), low birth weight (LBW), and preterm delivery.
Mother-child cohorts set up in five Spanish areas during the years 2000-2008 contributed data on water ingestion, showering, bathing, and swimming in pools. We ascertained residential THM levels during pregnancy periods through ad hoc sampling campaigns (828 measurements) and regulatory data (264 measurements), which were modeled and combined with personal water use and uptake factors to estimate personal uptake. We defined outcomes following standard definitions and included 2,158 newborns in the analysis.
Median residential THM ranged from 5.9 μg/L (Valencia) to 114.7 μg/L (Sabadell), and speciation differed across areas. We estimated that 89% of residential chloroform and 96% of brominated THM uptakes were from showering/bathing. The estimated change of birth weight for a 10% increase in residential uptake was -0.45 g (95% confidence interval: -1.36, 0.45 g) for chloroform and 0.16 g (-1.38, 1.70 g) for brominated THMs. Overall, THMs were not associated with SGA, LBW, or preterm delivery.
Despite the high THM levels in some areas and the extensive exposure assessment, results suggest that residential THM exposure during pregnancy driven by inhalation and dermal contact routes is not associated with birth weight, SGA, LBW, or preterm delivery in Spain.
将暴露于水消毒副产物与降低出生体重和改变妊娠持续时间联系起来的证据仍不确定。
我们通过不同的用水方式评估孕妇接触三卤甲烷（THMs）的情况，并评估其与出生体重、小于胎龄儿（SGA）、低出生体重（LBW）和早产的关系。
2000-2008 年期间，在西班牙五个地区建立了母婴队列，提供了关于饮水、淋浴、洗澡和在游泳池游泳的数据。我们通过专门的采样活动（828 次测量）和监管数据（264 次测量）确定了妊娠期间的住宅 THM 水平，并对其进行了建模，并与个人用水和吸收因子相结合，以估计个人吸收量。我们根据标准定义定义了结果，并在分析中纳入了 2158 名新生儿。
住宅 THM 的中位数范围为 5.9μg/L（巴伦西亚）至 114.7μg/L（萨瓦德尔），且不同地区的物质种类不同。我们估计，淋浴/洗澡导致住宅氯仿和 96%的溴代 THM 吸收量的 89%。对于住宅吸收量增加 10%，出生体重的估计变化为氯仿-0.45g（95%置信区间：-1.36，0.45g），溴代 THM 为 0.16g（-1.38，1.70g）。总体而言，THMs 与 SGA、LBW 或早产无关。
尽管一些地区的 THM 水平较高，暴露评估广泛，但结果表明，由吸入和皮肤接触途径导致的孕妇妊娠期间的住宅 THM 暴露与西班牙的出生体重、SGA、LBW 或早产无关。
