From the George Warren Brown School of Social Work and Institute of Public Health (Dr Rivera-Núñez), Washington University, St Louis, Missouri; and National Center for Environmental Assessment (Drs Rivera-Núñez and Wright), Office of Research and Development, US Environmental Protection Agency, Cincinnati, Ohio.
J Occup Environ Med. 2013 Oct;55(10):1125-34. doi: 10.1097/JOM.0b013e3182a4ffe4.
We examined the relationship between adverse reproductive outcomes and exposure to several disinfection by-products including haloacetic acids (HAAs), trihalomethanes (THMs), and the brominated THMs sum (THMBr).
Second- and third-trimester exposure scores were estimated from quarterly town-level average THM and HAA concentration data and were examined relative to mean birth weight (BWT), small for gestational age (SGA), and preterm delivery (PTD).
We found an increased risk of PTD for second-trimester chloroform, bromodichloromethane, and all HAA exposure metrics (adjusted odds ratio range: 1.04 to 1.15), but detected no associations for SGA and third-trimester exposures. Mean BWT deficits were observed across all HAA (26 to 33 g) and THMBr (11 to 23 g) exposure categories.
We detected consistent associations for adjusted mean BWT and THMBr exposures; these data reinforce the need to consider different disinfection by-product exposure metrics in epidemiological studies.
我们研究了几种消毒副产物（包括卤乙酸（HAAs）、三卤甲烷（THMs）和溴化三卤甲烷总和（THMBr））暴露与不良生殖结局之间的关系。
根据季度城镇平均 THM 和 HAA 浓度数据，估算了第二和第三个三个月的暴露评分，并将其与平均出生体重（BWT）、小于胎龄儿（SGA）和早产（PTD）进行了比较。
我们发现第二季度三氯甲烷、溴二氯甲烷和所有 HAA 暴露指标的 PTD 风险增加（调整后的比值比范围：1.04 至 1.15），但未发现 SGA 和第三个三个月暴露的相关性。在所有 HAA（26 至 33 克）和 THMBr（11 至 23 克）暴露类别中均观察到平均 BWT 缺陷。
我们检测到调整后的平均 BWT 和 THMBr 暴露的一致性关联；这些数据强化了在流行病学研究中需要考虑不同消毒副产物暴露指标的必要性。
