Chlorination disinfection by-products in drinking water and congenital anomalies: review and meta-analyses

This study aims to review epidemiologic evidence of the association between exposure to chlorination disinfection by-products (DBPs) and congenital anomalies. All epidemiologic studies that evaluated a relationship between an index of DBP exposure and risk of congenital anomalies were analyzed. For all congenital anomalies combined, the meta-analysis gave a statistically significant excess risk for high versus low exposure to water chlorination or TTHM (17%; 95% CI, 3-34) based on a small number of studies. The meta-analysis also suggested a statistically significant excess risk for ventricular septal defects (58%; 95% CI, 21-107), but based on only three studies, and there was little evidence of an exposure-response relationship. It was observed no statistically significant relationships in the other meta-analyses and little evidence for publication bias, except for urinary tract defects and cleft lip and palate. Although some individual studies have suggested an association between chlorination disinfection by-products and congenital anomalies, meta-analyses of all currently available studies demonstrate little evidence of such association.

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Bibliographic Details
Main Authors: Nieuwenhuijsen,Mark J., Martinez,David, Grellier,James, Bennett,James, Best,Nicky, Iszatt,Nina, Vrijheid,Martine, Toledano,Mireille B.
Format: Digital revista
Language:English
Published: ABRASCO - Associação Brasileira de Saúde Coletiva 2010
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232010000800015
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