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

Ibrahim 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 and The National Birth Defects Prevention Study
Additional contact information
Ibrahim Zaganjor: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Thomas J. Luben: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Tania A. Desrosiers: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Alexander P. Keil: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Lawrence S. Engel: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Adrian M. Michalski: New York State Department of Health, Bureau of Environmental and Occupational Epidemiology, Albany, NY 12237, USA
Suzan L. Carmichael: Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA
Wendy N. Nembhard: Arkansas Center for Birth Defects Research and Prevention, Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
Gary M. Shaw: Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA
Jennita Reefhuis: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
Mahsa M. Yazdy: Massachusetts Department of Public Health, Boston, MA 02108, USA
Peter H. Langlois: Division of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Austin, TX 78701, USA
Marcia L. Feldkamp: Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT 84108, USA
Paul A. Romitti: Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA 52242, USA
Andrew F. Olshan: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
The National Birth Defects Prevention Study: The National Birth Defects Prevention Study is mentioned in acknowledgements.

IJERPH, 2020, vol. 17, issue 24, 1-16

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.

Keywords: disinfection by-products; hypospadias; birth defects; epidemiology (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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