Prenatal Exposure to Nitrate in Drinking Water and the Risk of Congenital Anomalies

Details

• Personal Author:
  Almberg KS ; Blaisdell J ; Jones RM ; Stayner, Leslie T. ; Turyk ME
• Description:
  Background: Nitrate is a common water contaminant that has been associated with birth defects, although the evidence is limited. The purpose of this study was to examine whether maternal consumption of nitrate through drinking water is associated with an increased risk of congenital anomalies. Methods: The study included a total of 348,250 singletons births from the state of Missouri between January 1, 2004 and December 31, 2008. Individual-level birth defect data and maternal and child characteristics were obtained from the Missouri birth defects registry and state vital statistics records. Outcomes were linked with county-specific monthly estimates of the nitrate concentration in finished water, based on data collected for compliance with the Safe Drinking Water Standard. Poisson models were fit to examine the association between nitrate exposure and birth defects. Average nitrate exposure during the first trimester and over 12 months prior to birth were modeled as continuous variables. Sensitivity analyses included restriction of the sample to counties with <20% and <10% private well usage to reduce exposure misclassification as well as limiting the analyses to residents of rural counties only to account for potential confounding by urbanicity. Results: Estimated water concentrations of nitrate were generally low and below the Environmental Protection Agency's maximum contaminant level of 10 mg/L. Nitrate exposure was associated with a significantly increased risk of limb deficiencies (RR for 1 mg/L (RR1) = 1.26, 95% CI = 1.05, 1.51) in models without well restriction. Nitrate was also weakly associated with an increased risk of congenital heart defects (RR1 = 1.13, 95%CI = 0.93, 1.51) and neural tube defects (RR1 = 1.18, 95%CI = 0.93, 1.51) in models with well restriction (<10%). Conclusion: The positive associations found between nitrate exposure via drinking water and congenital abnormalities are largely consistent with some previous epidemiologic studies. The results of this study should be interpreted with caution given limitations in our ability to estimate exposures and the lack information on some risk factors for congenital abnormalities. Our findings may have serious policy implications given that exposure levels in our study were well below current EPA standards for nitrate in drinking water. [Description provided by NIOSH]
• Subjects:
  Environmental Pollution Epidemiology Nitrates Occupational Health Pregnancy Safety
• Keywords:
  Author Keywords: Nitrate Birth Defects Children Congenital Abnormalities Congenital Effects Drinking Water Environmental Contamination Prenatal Exposure Water Supply
• ISSN:
  0013-9351
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Illinois ; Missouri ; OSHA Region 5 ; OSHA Region 7
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  176
• NIOSHTIC Number:
  nn:20063632
• Citation:
  Environ Res 2019 Sep; 176:108553
• Contact Point Address:
  Leslie T. Stayner, Division of Epidemiology and Biostatistics, University of Illinois at Chicago, School of Public Health, 1603 West Taylor Street (MC923), Chicago, IL, USA
• Email:
  lstayner@uic.edu
• CAS Registry Number:
  Nitrate (CAS RN 14797-55-8)
• Federal Fiscal Year:
  2019
• Performing Organization:
  University of Illinois at Chicago
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Environmental Research
• End Date:
  20290630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:6e54113bbcc837831004449c7a56e90616830787b1256fc6bcf204873143e241b04375f528ee9750d763d155585d64f9fb68ccdce7ec4b181c4806d5e071f9a3
• Download URL:
  https://stacks.cdc.gov/view/cdc/222204/cdc_222204_DS1.pdf
• File Type:
  [PDF - 392.39 KB ]