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Nieuwenhuijsen, M. J., Martinez, D., Grellier, J., Bennett, J., Best, N., Iszatt, N., Vrijheid, M., Toledano, M. B

Chlorination disinfection by-products in drinking water and congenital anomalies: review and meta-analyses

Cien.Saude Colet., 2010, 15 Suppl 2, 3109, 3123, IF: --, PMID: 21049151

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

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