Waller K, Swan S H, DeLorenze G, Hopkins B
Reproductive Epidemiology Section, California Department of Health Services, Emeryville, USA.
Epidemiology. 1998 Mar;9(2):134-40.
Trihalomethanes (chloroform, bromoform, bromodichloromethane, and chlorodibromomethane) are common contaminants of chlorinated drinking water. Although animal data indicate that these compounds may be reproductive toxicants, little information exists on their relation to spontaneous abortion in humans. We examined exposure to trihalomethanes and spontaneous abortion in a prospective study of 5,144 pregnant women in a prepaid health plan. Seventy-eight drinking water utilities provided concurrent trihalomethane sampling data. We calculated total trihalomethane levels by averaging all measurements taken by the subject's utility during her first trimester. We calculated exposures to individual trihalomethanes in an analogous manner. Women who drank > or = 5 glasses per day of cold tapwater containing > or = 75 micrograms per liter total trihalomethanes had an adjusted odds ratio (OR) of 1.8 for spontaneous abortion [95% confidence interval (CI) = 1.1-3.0]. Of the four individual trihalomethanes, only high bromodichloromethane exposure (consumption of > or = 5 glasses per day of cold tapwater containing > or = 18 micrograms per liter bromodichloromethane) was associated with spontaneous abortion both alone (adjusted OR = 2.0; 95% CI = 1.2-3.5) and after adjustment for the other trihalomethanes (adjusted OR = 3.0; 95% CI = 1.4-6.6).
三卤甲烷（氯仿、溴仿、二溴一氯甲烷和一溴二氯甲烷）是氯化饮用水中的常见污染物。虽然动物实验数据表明这些化合物可能是生殖毒性物质，但关于它们与人类自然流产之间关系的信息却很少。我们在一项针对某预付健康计划中5144名孕妇的前瞻性研究中，调查了三卤甲烷暴露与自然流产的情况。78家饮用水供应公司提供了同期的三卤甲烷采样数据。我们通过对受试者所在供应公司在其孕早期所进行的所有测量值求平均，来计算总三卤甲烷水平。我们以类似方式计算个体三卤甲烷的暴露量。每天饮用≥5杯总三卤甲烷含量≥75微克/升的冷自来水的女性，自然流产的校正比值比（OR）为1.8 [95%置信区间（CI）= 1.1 - 3.0]。在四种个体三卤甲烷中，只有高剂量二溴一氯甲烷暴露（每天饮用≥5杯二溴一氯甲烷含量≥18微克/升的冷自来水）单独与自然流产相关（校正OR = 2.0；95% CI = 1.2 - 3.5），并且在对其他三卤甲烷进行校正后依然相关（校正OR = 3.0；95% CI = 1.4 - 6.6）。
