对北卡罗来纳州勒琼海军陆战队基地受污染饮用水与早产、小于胎龄儿及出生体重的评估：一项横断面研究。
Evaluation of contaminated drinking water and preterm birth, small for gestational age, and birth weight at Marine Corps Base Camp Lejeune, North Carolina: a cross-sectional study.
作者信息
Ruckart Perri Zeitz, Bove Frank J, Maslia Morris
机构信息
Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, 4770 Buford Highway, MS F-58, Atlanta, GA 30341, USA.
出版信息
Environ Health. 2014 Nov 20;13:99. doi: 10.1186/1476-069X-13-99.
BACKGROUND
Births during 1968-1985 at Camp Lejeune were exposed to drinking water contaminated with trichloroethylene (TCE), tetrachloroethylene (PCE), and benzene.
METHODS
We conducted a cross-sectional study to evaluate associations between residential prenatal exposure to contaminated drinking water at Camp Lejeune during 1968-1985 and preterm birth, small for gestational age (SGA), term low birth weight (TLBW), and mean birth weight (MBW) deficit. Birth certificates identified mothers residing at Camp Lejeune at delivery. We analyzed exposure data for the entire pregnancy and individual trimesters. For each period examined, births were categorized as unexposed if mothers did not reside at Camp Lejeune or if their residence on base received uncontaminated drinking water. Ground water contaminant fate/transport and distribution system models provided monthly estimated contaminant levels at residences. For PCE and TCE, the exposed group was divided into four levels: < median value, ≥ median value, ≥75th percentile, and ≥90th percentile. For benzene, the exposed group was categorized as <1 part per billion (ppb) versus ≥1 ppb because of sparse data. Magnitude of effect estimates and exposure response relationships were used to assess associations. Confidence intervals (CIs) indicated precision of estimates.
RESULTS
For the highest TCE exposure category during the entire pregnancy, odds ratios (ORs) were 1.5 (95% CI: 1.2, 1.9) and 1.3 (95% CI: 0.8, 2.2) for SGA and TLBW, respectively, and reduced MBW β = -78.3 g (95% CI: -115.0, -41.7). The OR =1.3 (95% CI: 1.0, 1.6) for preterm birth and the highest PCE exposure category during the entire pregnancy. Monotonic exposure-response relationships were observed for benzene exposure during the entire pregnancy and TLBW (highest category OR =1.5, 85% CI: 0.9, 2.3). Although a monotonic association between benzene and adjusted MBW difference was also observed (highest category β = -36.2 g, 95% CI: -72.3, -0.1), the association disappeared when TCE was also added to the model. We found no evidence suggesting any other associations between outcomes and exposures.
CONCLUSION
Findings suggested associations between in utero exposures to TCE and SGA, TLBW and reduced MBW; benzene and TLBW; and PCE and preterm birth.
背景
1968年至1985年期间在勒琼营出生的婴儿接触到了被三氯乙烯（TCE）、四氯乙烯（PCE）和苯污染的饮用水。
方法
我们进行了一项横断面研究，以评估1968年至1985年期间在勒琼营居住时产前接触受污染饮用水与早产、小于胎龄儿（SGA）、足月低出生体重（TLBW）和平均出生体重（MBW）不足之间的关联。出生证明确定了分娩时居住在勒琼营的母亲。我们分析了整个孕期和各个孕季的接触数据。在每个检查期间，如果母亲不住在勒琼营或其在基地的住所使用未受污染的饮用水，则将出生分类为未接触。地下水污染物归宿/迁移和分配系统模型提供了住所每月估计的污染物水平。对于PCE和TCE，接触组分为四个水平：<中位数、≥中位数、≥第75百分位数和≥第90百分位数。对于苯，由于数据稀少，接触组分类为<十亿分之一（ppb）与≥1 ppb。效应估计的大小和接触反应关系用于评估关联。置信区间（CI）表明估计的精度。
结果
在整个孕期最高TCE接触类别中，SGA和TLBW的比值比（OR）分别为1.5（95%CI：1.2，1.9）和1.3（95%CI：0.8，2.2），MBW降低β=-78.3 g（95%CI：-115.0，-41.7）。整个孕期最高PCE接触类别中早产的OR=1.3（95%CI：1.0，1.6）。在整个孕期苯接触与TLBW之间观察到单调接触反应关系（最高类别OR=1.5，85%CI：0.9，2.3）。尽管在苯与调整后的MBW差异之间也观察到单调关联（最高类别β=-36.2 g，95%CI：-72.3，-0.1），但当模型中也加入TCE时，该关联消失。我们没有发现任何证据表明结局与接触之间存在其他关联。
结论
研究结果表明，子宫内接触TCE与SGA、TLBW和MBW降低之间存在关联；苯与TLBW之间存在关联；PCE与早产之间存在关联。
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