Biomaterial Database

Water chlorination and birth defects: a systematic review and meta-analysis. 2003

Bing-Fang Hwang, and Jouni J K Jaakkola

Department of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland, USA.

The authors used the Medline data retrieval system for 1966-2001 to identify and synthesize the epidemiological evidence for adverse effects of prenatal exposure to chlorination byproducts on birth defects. For 5 studies that provided estimates of the effect of exposure on 1 or several birth defects, the authors calculated summary odds ratios and 95% confidence intervals using the Mantel-Haenszel method for a fixed-effects model, and the DerSimonian-Laird method for a random-effects model. The results of this meta-analysis provide evidence for an effect of exposure to chlorination byproducts on the risk of any birth defect, and of neural tube and urinary system defects. The results for respiratory system, major cardiac, and oral cleft defects were heterogeneous and inconclusive. Differences in the susceptibility of populations, and different approaches in exposure assessment, may explain the heterogeneity of the results.

UI	MeSH Term	Description	Entries
D007231	Infant, Newborn	An infant during the first 28 days after birth.	Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D011247	Pregnancy	The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.	Gestation,Pregnancies
D002713	Chlorine	An element with atomic symbol Cl, atomic number 17, and atomic weight 35, and member of the halogen family.	Chlorine Gas,Chlorine-35,Cl2 Gas,Chlorine 35,Gas, Chlorine,Gas, Cl2
D004781	Environmental Exposure	The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals.	Exposure, Environmental,Environmental Exposures,Exposures, Environmental
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000013	Congenital Abnormalities	Malformations of organs or body parts during development in utero.	Birth Defects,Congenital Defects,Deformities,Fetal Anomalies,Fetal Malformations,Abnormalities, Congenital,Defects, Congenital,Abnormality, Congenital,Anomaly, Fetal,Birth Defect,Congenital Abnormality,Congenital Defect,Defect, Birth,Defect, Congenital,Deformity,Fetal Anomaly,Fetal Malformation,Malformation, Fetal
D012307	Risk Factors	An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent.	Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D016017	Odds Ratio	The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases.	Cross-Product Ratio,Risk Ratio,Relative Odds,Cross Product Ratio,Cross-Product Ratios,Odds Ratios,Odds, Relative,Ratio, Cross-Product,Ratio, Risk,Ratios, Cross-Product,Ratios, Risk,Risk Ratios
D018508	Water Purification	Any of several processes in which undesirable impurities in water are removed or neutralized; for example, chlorination, filtration, primary treatment, ion exchange, and distillation. It includes treatment of WASTEWATER to provide potable and hygienic water in a controlled or closed environment as well as provision of public drinking water supplies.	Waste Water Purification,Waste Water Treatment,Wastewater Purification,Wastewater Treatment,Water Treatment,Purification, Waste Water,Purification, Wastewater,Purification, Water,Treatment, Waste Water,Treatment, Wastewater,Treatment, Water,Waste Water Purifications,Waste Water Treatments,Water Purification, Waste