Academic journal article Environmental Health Perspectives

Disinfection Question: How Should We Measure Exposure?

Academic journal article Environmental Health Perspectives

Disinfection Question: How Should We Measure Exposure?

Article excerpt

Chlorination of public water supplies began in the early 1900s and quickly led to a massive reduction in waterborne diseases. At the same time, chlorination and other disinfection methods introduced a subtler threat to public health: disinfection by-products (DBPs), chemicals formed when disinfectants react with organic or inorganic matter in the water. Several DBPs cause carcinogenic, mutagenic, reproductive, or developmental effects, and many DBP studies have focused on effects of exposure in utero. Traditionally, total trihalomethane (THM) exposure is used as a surrogate in epidemiological studies to estimate maternal DBP exposure during pregnancy, partly because of data availability (THMs have been measured since the late 1970s) and partly because THMs are so prevalent. However, research led by J. Michael Wright of the U.S. Environmental Protection Agency's National Center for Environmental Assessment suggests that estimating DBP exposure from total THM concentrations alone provides insufficient information about risks to public health [EHP 112:920-925].

Wright and his colleagues focused on potential DBP-associated developmental effects, using specific end points including birth weight among full-term newborns (born at 37-45 weeks of pregnancy), birth before 37 weeks (preterm delivery), and pregnancy duration (gestational age). Birth weight and gestational age were further used to identify small-for-gestational-age (SGA) infants, defined as being in the 10th percentile for birth weight given gestational age. Preterm delivery and low birth weight are strongly associated with significant infant health problems--U.S, infant mortality is largely attributable to preterm delivery.

Birth certificates from Massachusetts towns with 10,000 or more residents provided Wright's group with information on 196,000 infants born during 1995-1998 and their mothers. …

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