A wide range of chemical disinfection by-products (DBPs) are produced by the interaction between chlorine, natural organic material and/or bromide ions in drinking water. Potentially ingested, inhaled and/or dermally absorbed via drinking, eating, cooking, and washing/bathing/swimming, DBPs are thought to be of concern to health. Common indicators of suboptimal growth during the fetal period include birth weight (BW), low birth weight (LBW), term LBW, intra uterine growth restriction (IUGR), and small size for gestational age (SGA). More subtle definitions such as customised SGA and fetal growth restriction (FGwR) have been developed in the last decade.
Experimental work suggest that prenatal exposure to some DBPs (in particular, chloroform, DBCM, DCAA, TCAA, and haloacetonitriles (HANs)) may have an adverse effect on fetal growth and development, as measured by fetal weight and length. However, the epidemiologic evidence of the association between DBPs and impaired growth is inconsistent, but suggestive overall of a positive association between exposure to chlorinated water or THMs and SGA. The evidence for an association between HAAs and fetal growth is inconclusive.
The aim of this study is to complete an epidemiological analysis investigating the relation between prenatal exposure to chlorination disinfection by-products (DBPs) in water and fetal growth restriction at birth in the Born-in-Bradford (BiB) cohort, taking into account known potential confounders. This project has the unique opportunity in addition to:
- study measurement error in a DBP study,
- define sounder outcome measures, and
- study the relationship between socioeconomic status, ethnicity and birth outcomes.
These strengths constitute a truly unique opportunity to take the field of DBP epidemiology forward.
