母体暴露于消毒副产物与国家出生缺陷预防研究(2000-2005 年)中尿道下裂风险的关系。

Maternal Exposure to Disinfection By-Products and Risk of Hypospadias in the National Birth Defects Prevention Study (2000-2005).

机构信息

Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.

New York State Department of Health, Bureau of Environmental and Occupational Epidemiology, Albany, NY 12237, USA.

出版信息

Int J Environ Res Public Health. 2020 Dec 21;17(24):9564. doi: 10.3390/ijerph17249564.

Abstract

The purpose of this study was to estimate the association between 2nd and 3rd degree hypospadias and maternal exposure to disinfection by-products (DBPs) using data from a large case-control study in the United States. Concentration estimates for total trihalomethanes (TTHMs), the sum of the five most prevalent haloacetic acids (HAA5), and individual species of each were integrated with data on maternal behaviors related to water use from the National Birth Defects Prevention Study (NBDPS) to create three different exposure metrics: (1) household DBP concentrations; (2) estimates of DBP ingestion; (3) predicted uptake (i.e., internal dose) of trihalomethanes (THMs) via ingestion, showering, and bathing. The distribution of DBP exposure was categorized as follows: (Q1/referent) < 50%; (Q2) ≥ 50% to < 75%; and (Q3) ≥ 75%. Logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Generally, null associations were observed with increasing TTHM or HAA5 exposure. An increased risk was observed among women with household bromodichloromethane levels in the second quantile (aOR: 1.8; 95% CI: 1.2, 2.7); however, this association did not persist after the inclusion of individual-level water-use data. Findings from the present study do not support the hypothesis that maternal DBP exposures are related to the occurrence of hypospadias.

摘要

本研究旨在利用美国一项大型病例对照研究的数据,评估母亲暴露于消毒副产物(DBPs)与二、三度尿道下裂之间的关系。总三卤甲烷(TTHMs)、五种最常见的卤乙酸(HAA5)总和以及每种物质的个体浓度,与国家出生缺陷预防研究(NBDPS)中与水使用相关的母体行为数据相结合,创建了三种不同的暴露指标:(1)家庭 DBP 浓度;(2)DBP 摄入估计值;(3)通过摄入、淋浴和沐浴来预测三卤甲烷(THMs)的摄取量(即内剂量)。DBP 暴露分布如下:(Q1/参考值)<50%;(Q2)≥50%至<75%;和(Q3)≥75%。逻辑回归用于估计调整后的优势比(aOR)和 95%置信区间(CI)。一般来说,随着 TTHM 或 HAA5 暴露量的增加,观察到的关联为零。在家庭溴二氯甲烷水平处于第二分位数的女性中观察到风险增加(aOR:1.8;95%CI:1.2,2.7);然而,在纳入个体水平的水使用数据后,这种关联不再存在。本研究的结果不支持母亲 DBP 暴露与尿道下裂发生有关的假设。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4528/7766973/8f91d63698a3/ijerph-17-09564-g001.jpg

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