Abstract | BACKGROUND: Some disinfection byproducts ( DBPs) are teratogens based on toxicological evidence. Conventional use of predominant DBPs as proxies for complex mixtures may result in decreased ability to detect associations in epidemiological studies. OBJECTIVE: We assessed risks of obstructive genitourinary birth defects (OGDs) in relation to 12 DBP mixtures and 13 individual component DBPs. METHODS: We designed a nested registry-based case-control study (210 OGD cases; 2100 controls) in Massachusetts towns with complete quarterly 1999-2004 data on four trihalomethanes (THMs) and five haloacetic acids (HAAs). We estimated temporally-weighted average DBP exposures for the first trimester of pregnancy. We estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for OGD in relation to individual DBPs, unweighted mixtures, and weighted mixtures based on THM/HAA relative potency factors (RPF) from animal toxicology data for full-litter resorption, eye defects, and neural tube defects. RESULTS: We detected elevated aORs for OGDs for the highest of bromodichloromethane (aOR = 1.75; 95% CI: 1.15-2.65), dibromochloromethane (aOR = 1.71; 95% CI: 1.15-2.54), bromodichloroacetic acid (aOR = 1.56; 95%CI: 0.97-2.51), chlorodibromoacetic acid (aOR = 1.97, 95% CI: 1.23-3.15), and tribromoacetic acid (aOR = 1.90; 95%CI: 1.20-3.03). Across unweighted mixture sums, the highest aORs were for the sum of three brominated THMs (aOR = 1.74; 95% CI: 1.15-2.64), the sum of six brominated HAAs (aOR = 1.43; 95% CI: 0.89-2.31), and the sum of nine brominated DBPs (aOR = 1.80; 95% CI: 1.05-3.10). Comparing eight RPF-weighted to unweighted mixtures, the largest aOR differences were for two HAA metrics, which both were higher with RPF weighting; other metrics had reduced or minimally changed ORs in RPF-weighted models.
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Authors | John A Kaufman, J Michael Wright, Amanda Evans, Zorimar Rivera-Núñez, Amy Meyer, David A Reckhow, Michael G Narotsky |
Journal | Journal of exposure science & environmental epidemiology
(J Expo Sci Environ Epidemiol)
Vol. 34
Issue 1
Pg. 34-46
(01 2024)
ISSN: 1559-064X [Electronic] United States |
PMID | 37700034
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Copyright | © 2023. The Author(s), under exclusive licence to Springer Nature America, Inc. |
Chemical References |
- Disinfectants
- Trihalomethanes
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Topics |
- Pregnancy
- Female
- Animals
- Disinfection
- Case-Control Studies
- Disinfectants
(adverse effects)
- Trihalomethanes
(toxicity)
- Epidemiologic Studies
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