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Reproductive and developmental effects of disinfection by-products in drinking water.
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MedLine Citation:
PMID:  8930546     Owner:  NLM     Status:  MEDLINE    
Recent epidemiologic studies have reported associations between the consumption of chlorinated drinking water and reproductive and developmental effects. Here we review the available epidemiologic data, assess the hazard potential posed by exposure to disinfection by-products, identify critical data gaps, and offer recommendations for further research. The epidemiologic evidence supporting associations between exposure to water disinfection by-products (DBPs) and adverse pregnancy outcomes is sparse, and positive findings should be interpreted cautiously. The methods used during the early stages of research in this area have been diverse. Variability in exposure assessment and endpoints makes it difficult to synthesize or combine the available data. Exposure misclassification and unmeasured confounding may have lead to bias in risk estimation. Future studies of reproductive outcome and exposure to chlorinated water should use improved methods for exposure assessment to 1) assure selection of appropriate exposure markers, 2) assess seasonal and annual fluctuations in DBPs, 3) assess variability within the distribution system, and 4) assess exposure through multiple routes such as bathing and showering, as well as consumption. Population-based studies should be conducted to evaluate male and female fertility, conception delay, growth retardation, and specific birth defects. The reproductive and developmental effects of exposure to DBPs could be efficiently explored in ongoing investigations by incorporating valid exposure markers and relevant questionnaire information. Future studies should make use of naturally occurring variability in the concentrations of DBPs and may incorporate biomarkers of exposure and effect in their design. Epidemiologic investigations should be conducted in parallel with laboratory-based and animal studies in a coordinated, multidisciplinary approach.
J S Reif; M C Hatch; M Bracken; L B Holmes; B A Schwetz; P C Singer
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Environmental health perspectives     Volume:  104     ISSN:  0091-6765     ISO Abbreviation:  Environ. Health Perspect.     Publication Date:  1996 Oct 
Date Detail:
Created Date:  1997-02-20     Completed Date:  1997-02-20     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0330411     Medline TA:  Environ Health Perspect     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1056-61     Citation Subset:  IM    
Department of Environmental Health, Colorado State University, Fort Collins 80523, USA.
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MeSH Terms
Abnormalities, Drug-Induced*
Chlorine / adverse effects*
Fertility / drug effects
Fetal Growth Retardation / chemically induced
Fetus / drug effects*
Water Purification*
Water Supply / standards*
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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Journal Information
Journal ID (nlm-ta): Environ Health Perspect
ISSN: 0091-6765
Article Information
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Print publication date: Month: 10 Year: 1996
Volume: 104 Issue: 10
First Page: 1056 Last Page: 1061
ID: 1469476
PubMed Id: 8930546

Reproductive and developmental effects of disinfection by-products in drinking water.
J S Reif
M C Hatch
M Bracken
L B Holmes
B A Schwetz
P C Singer
Department of Environmental Health, Colorado State University, Fort Collins 80523, USA.

Article Categories:
  • Research Article

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