Center for Health Effects of Environmental Contamination, Office of the Vice President for Research and Economic Development, University of Iowa, Iowa City, Iowa.
Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa.
Birth Defects Res. 2018 Jul 17;110(12):1027-1042. doi: 10.1002/bdr2.1348.
Maternal exposure to drinking water disinfection byproducts (DBP)s may contribute to orofacial cleft (OFC) development, but studies are sparse and beset with limitations.
Population-based, maternal interview reports of drinking water filtration and consumption for 680 OFC cases (535 isolated) and 1826 controls were linked with DBP concentration data using maternal residential addresses and public water system monitoring data. Maternal individual-level exposures to trihalomethanes (THM)s and haloacetic acids (HAA)s (µg/L of water consumed) were estimated from reported consumption at home, work, and school. Compared to no exposure, associations with multisource maternal exposure <1/2 or ≥1/2 the Maximum Contaminant Levels (MCL)s for total THMs (TTHM)s and HAAs (HAA5) or Maximum Contaminant Level Goals (MCLG)s for individual THMs and HAAs (if non-zero) were estimated for all OFCs and isolated OFCs, cleft palate (CP), and cleft lip ± cleft palate (CL/P) using logistic regression analyses.
Compared to controls, associations were near or below unity for maternal TTHM, HAA5, and individual THM exposures with all OFCs and isolated OFCs, CP, and CL/P. Associations also were near or below unity for individual HAAs with statistically significant, inverse associations observed with each OFC outcome group except CL/P.
This study examined associations for maternal reports of drinking water filtration and consumption and maternal DBP exposure from drinking water with OFCs in offspring. Associations observed were near or below unity and mostly nonsignificant. Continued, improved research using maternal individual-level exposure data will be useful in better characterizing these associations.
母体暴露于饮用水消毒副产物（DBP）可能导致口腔颌面裂（OFC）的发生，但此类研究较为匮乏且存在局限性。
本研究基于人群，通过对 680 例口腔颌面裂病例（535 例孤立性）和 1826 例对照的母体访谈报告进行分析，将饮用水过滤和消费情况与母体居住地及公共供水系统监测数据相关联，以获取母体个体的三卤甲烷（THM）和卤乙酸（HAA）暴露浓度（单位：水中消耗的微克/升）。根据在家、工作和学校的报告饮用水摄入量，估计母体多源暴露于 THM 总和（TTHM）和 HAA 总和（HAA5）<1/2 或≥1/2 最大污染物水平（MCL），以及单独的 THM 和 HAA 的最大污染物水平目标（MCLG）（如果非零）的情况。使用逻辑回归分析，评估所有口腔颌面裂、单纯腭裂（CP）和唇裂合并腭裂（CL/P）的多源母体暴露<1/2 或≥1/2 总三卤甲烷（TTHM）和 HAA5 以及单独的 THM 和 HAA 的 MCLG 与所有口腔颌面裂、单纯腭裂和唇裂合并腭裂的相关性。
与对照组相比，母体 TTHM、HAA5 和单独的 THM 暴露与所有口腔颌面裂、单纯腭裂和唇裂合并腭裂的相关性接近或低于 1，单独的 HAA 与除唇裂合并腭裂外的每个口腔颌面裂结局组也呈负相关，除唇裂合并腭裂外，其他组的相关性均接近或低于 1，且呈统计学意义。
本研究检测了母体报告的饮用水过滤和消费以及母体从饮用水中摄入 DBP 与后代口腔颌面裂的相关性。观察到的相关性接近或低于 1，且大多无统计学意义。使用母体个体水平暴露数据进行持续、改进的研究，将有助于更好地描述这些相关性。
