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

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.
AuthorsIbrahim Zaganjor, Thomas J Luben, Tania A Desrosiers, Alexander P Keil, Lawrence S Engel, Adrian M Michalski, Suzan L Carmichael, Wendy N Nembhard, Gary M Shaw, Jennita Reefhuis, Mahsa M Yazdy, Peter H Langlois, Marcia L Feldkamp, Paul A Romitti, Andrew F Olshan, The National Birth Defects Prevention Study
JournalInternational journal of environmental research and public health (Int J Environ Res Public Health) Vol. 17 Issue 24 (12 21 2020) ISSN: 1660-4601 [Electronic] Switzerland
PMID33371304 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Disinfectants
  • Trihalomethanes
  • Water Pollutants, Chemical
Topics
  • Case-Control Studies
  • Disinfectants (adverse effects, analysis)
  • Disinfection
  • Female
  • Humans
  • Hypospadias (chemically induced, epidemiology)
  • Male
  • Maternal Exposure (adverse effects, statistics & numerical data)
  • Pregnancy
  • Trihalomethanes (analysis, toxicity)
  • Water Pollutants, Chemical (analysis)

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