%0 Journal Article
%T Chlorination disinfection by-products in drinking water and congenital anomalies: review and meta-analyses
%A Nieuwenhuijsen
%A Mark J.
%A Martinez
%A David
%A Grellier
%A James
%A Bennett
%A James
%A Best
%A Nicky
%A Iszatt
%A Nina
%A Vrijheid
%A Martine
%A Toledano
%A Mireille B.
%J Ci¨ºncia & Sa¨²de Coletiva
%D 2010
%I Associa??o Brasileira de P¨®s-Gradua??o em Sa¨²de Coletiva
%R 10.1590/S1413-81232010000800015
%X 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.
%K birth defects
%K congenital anomalies
%K disinfection by-products
%K fetal development
%K reproductive health
%K trihalomethanes.
%U http://www.scielosp.org/scielo.php?script=sci_abstract&pid=S1413-81232010000800015&lng=en&nrm=iso&tlng=en