Savitz D A, Andrews K W, Pastore L M
Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill 27599, USA.
Environ Health Perspect. 1995 Jun;103(6):592-6. doi: 10.1289/ehp.95103592.
In spite of the recognition of potentially toxic chemicals in chlorinated drinking water, few studies have evaluated reproductive health consequences of such exposure. Using data from a case-control study of miscarriage, preterm delivery, and low birth weight in central North Carolina, we evaluated risk associated with water source, amount, and trihalomethane (THM) concentration. Water source was not related to any of those pregnancy outcomes, but an increasing amount of ingested water was associated with decreased risks of all three outcomes (odds ratios around 1.5 for 0 glasses per day relative to 1-3 glasses per day, falling to 0.8 for 4+ glasses per day). THM concentration and dose (concentration x amount) were not related to pregnancy outcome, with the possible exception of an increased risk of miscarriage in the highest sextile of THM concentration (adjusted odds ratio = 2.8, 95% confidence interval = 1.1-2.7), which was not part of an overall dose-response gradient. These data do not indicate a strong association between chlorination by-products and adverse pregnancy outcome, but given the limited quality of our exposure assessment and the increased miscarriage risk in the highest exposure group, more refined evaluation is warranted.
尽管人们已认识到氯化饮用水中存在潜在有毒化学物质，但很少有研究评估此类接触对生殖健康的影响。利用北卡罗来纳州中部一项关于流产、早产和低出生体重的病例对照研究的数据，我们评估了与水源、饮水量和三卤甲烷（THM）浓度相关的风险。水源与任何一种妊娠结局均无关联，但饮水量增加与所有三种结局的风险降低相关（每天饮用0杯相对于每天饮用1 - 3杯的优势比约为1.5，每天饮用4杯及以上时降至0.8）。THM浓度和剂量（浓度×量）与妊娠结局无关，可能的例外是在THM浓度最高的六分位数中流产风险增加（调整后的优势比 = 2.8，95%置信区间 = 1.1 - 2.7），但这并非整体剂量反应梯度的一部分。这些数据并未表明氯化副产物与不良妊娠结局之间存在强烈关联，但鉴于我们接触评估的质量有限以及最高暴露组中流产风险增加，有必要进行更精细的评估。
