Kogevinas Manolis, Bustamante Mariona, Gracia-Lavedán Esther, Ballester Ferran, Cordier Sylvaine, Costet Nathalie, Espinosa Ana, Grazuleviciene Regina, Danileviciute Asta, Ibarluzea Jesus, Karadanelli Maria, Krasner Stuart, Patelarou Evridiki, Stephanou Euripides, Tardón Adonina, Toledano Mireille B, Wright John, Villanueva Cristina M, Nieuwenhuijsen Mark
From the aBarcelona Institute for Global Health (ISGlobal), Barcelona, Spain; bUniversitat Pompeu Fabra (UPF), Barcelona, Spain; cCIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; dMunicipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain; eCenter for Genomic Regulation (CRG), Barcelona, Spain; fFISABIO-UJI-University of Valencia Unit of Research, Valencia, Spain; gCIBERESP, Madrid, Spain; hINSERM (National Institute of Health and Medical Research) U1085-IRSET, Rennes, France; iUniversity of Rennes I, Rennes, France; jDepartment of Environmental Sciences, Vytauto Didziojo Universitetas, Kaunas, Lithuania; kBiodonostia Health Institute, San Sebastián, Spain; lPublic Health Department of Gipuzkoa, San Sebastian, Spain; mDepartment of Marine Sciences, University of the Aegean, Mytilene, Greece; nMetropolitan Water District of Southern California, La Verne, CA; oFlorence Nightingale Faculty of Nursing and Midwifery, King's College London, London, United Kingdom; pEnvironmental Chemical Processes Laboratory (ECPL), Department of Chemistry, University of Crete, Heraklion, Greece; qIUOPA, Universidad de Oviedo, Asturias, Spain; rMRC-PHE Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, London United Kingdom; and sBradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom.
Epidemiology. 2016 Nov;27(6):903-11. doi: 10.1097/EDE.0000000000000544.
We examined the association between exposure during pregnancy to trihalomethanes, the most common water disinfection by-products, and birth outcomes in a European cohort study (Health Impacts of Long-Term Exposure to Disinfection By-Products in Drinking Water). We took into account exposure through different water uses, measures of water toxicity, and genetic susceptibility.
We enrolled 14,005 mothers (2002-2010) and their children from France, Greece, Lithuania, Spain, and the UK. Information on lifestyle- and water-related activities was recorded. We ascertained residential concentrations of trihalomethanes through regulatory records and ad hoc sampling campaigns and estimated route-specific trihalomethane uptake by trimester and for whole pregnancy. We examined single nucleotide polymorphisms and copy number variants in disinfection by-product metabolizing genes in nested case-control studies.
Average levels of trihalomethanes ranged from around 10 μg/L to above the regulatory limits in the EU of 100 μg/L between centers. There was no association between birth weight and total trihalomethane exposure during pregnancy (β = 2.2 g in birth weight per 10 μg/L of trihalomethane, 95% confidence interval = 3.3, 7.6). Birth weight was not associated with exposure through different routes or with specific trihalomethane species. Exposure to trihalomethanes was not associated with low birth weight (odds ratio [OR] per 10 μg/L = 1.02, 95% confidence interval = 0.95, 1.10), small-for-gestational age (OR = 0.99, 0.94, 1.03) and preterm births (OR = 0.98, 0.9, 1.05). We found no gene-environment interactions for mother or child polymorphisms in relation to preterm birth or small-for-gestational age.
In this large European study, we found no association between birth outcomes and trihalomethane exposures during pregnancy in the total population or in potentially genetically susceptible subgroups. (See video abstract at http://links.lww.com/EDE/B104.).
在一项欧洲队列研究（长期暴露于饮用水消毒副产物对健康的影响）中，我们研究了孕期暴露于最常见的水消毒副产物三卤甲烷与出生结局之间的关联。我们考虑了通过不同用水方式的暴露、水毒性指标以及遗传易感性。
我们纳入了来自法国、希腊、立陶宛、西班牙和英国的14,005名母亲（2002年至2010年）及其子女。记录了与生活方式和水相关活动的信息。我们通过监管记录和专项采样活动确定了三卤甲烷的居住浓度，并按孕期和整个孕期估算了特定途径的三卤甲烷摄入量。我们在巢式病例对照研究中检测了消毒副产物代谢基因中的单核苷酸多态性和拷贝数变异。
各中心的三卤甲烷平均水平在约10μg/L至高于欧盟规定的100μg/L限值之间。出生体重与孕期三卤甲烷总暴露之间无关联（每10μg/L三卤甲烷导致出生体重增加2.2g，95%置信区间为-3.3, 7.6）。出生体重与通过不同途径的暴露或特定三卤甲烷种类无关。三卤甲烷暴露与低出生体重（每10μg/L比值比[OR]=1.02，95%置信区间=0.95, 1.10）、小于胎龄儿（OR = 0.99, 0.94, 1.03）和早产（OR = 0.98, 0.9, 1.05）均无关联。我们未发现母亲或儿童多态性与早产或小于胎龄儿之间存在基因-环境相互作用。
在这项大型欧洲研究中，我们发现总体人群或潜在遗传易感亚组中，出生结局与孕期三卤甲烷暴露之间无关联。（见视频摘要：http://links.lww.com/EDE/B104.）
