Drinking water effects on Pregnancy/Infertility & miscarriage
RESEARCH PAPER
DUE: AUGUST 3 BY MIDNIGHT
LENGTH: 10 pp. double-spaced, plus list of cited sources
PLAGIARISM PREVENTION. TURNITIN will be available to you on the course D2L site to self-assess your paper for originality. The instructor will also use this program to assess compliance with the plagiarism policy as stated on the course syllabus. Please review the pertinent sections of the syllabus.
CITATION FORMAT: Use one of the major formats in a consistent manner.
RECALL: OTHER EXCERPTS FROM THE SYLLABUS AND ONE-ON-ONE DISCUSSION
In format, the research paper will at least ten pages. It should contain at least ten literature citations, no more than two of which may be http:// sites. Citations to the peer-reviewed literature, such as those accessible through the PubMed website, are strongly preferred…
The instructor is committed to working with each student to make this an assignment that is helpful to the student's career or serves the student's interest in some other way…
SUPPLEMENTARY MATERIALS
Bibliographic Databases
www(dot)pubmed(dot)gov Skilled execution of Pubmed search strategies and the retrieval of fulltext, peer-reviewed journal articles are essential skills emphasized in ENVH 3040
Environment Complete Online via Sherrod Library “Research Tools -> Find articles, search databases
National Academy Press www(dot)nap(dot)edu
U.S. Government Printing Office www(dot)fdsys(dot)gov An “Advanced Search” limited to the “Collection” of “Congressional Hearings” will greatly benefit students whose final term papers address policy-related issues
Journals (This is a partial list of high quality journals)
American Journal of Public Health (Washington, D.C.: APHA) Online via Sherrod Library catalogue
Environmental Health Perspectives (Research Triangle Park, NC: NIEHS) www(dot)ehponline(dot)org
Environmental Research (Orlando, FL: Academic Press) Online via Sherrod Library catalogue
Environmental Science and Technology (Washington, D.C.: ACS) Online via Sherrod Library catalogue
Morbidity and Mortality Weekly Report (Atlanta, GA: CDC) www(dot)cdc(dot)gov/mmwr
Risk Analysis (Malden, MA: Blackwell) Online via Sherrod Library catalogue
Sherrod Library Books (This is a partial list)
Hilgenkamp, Kathryn , Environmental health : ecological perspectives,
(Sudbury, Mass. : Jones and Bartlett) 2006 RA565 .H52 2006
Koren, Herman, Handbook of Environmental Health, 4th ed. (Boca Raton, FL: Lewis Publishers, 2003) REFERENCE RA565 .K67 2003
Levenstein, Charles, At the Point of Production: The Social Analysis of Occupational and Environmental Health (Amityville, NY: Baywood, 2009) T59.77 .A85 2009
Morgan, Monroe T., Environmental Health, 2nd ed. (Englewood, CO: Morton, 1997) RA566 .M67 1997
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** sources I found that needs to be used**
ems 1 - 9 of 9 (Display the 9 citations in PubMed)
1. Fertil Steril. 2008 Feb;89(2 Suppl):e111-6; discussion e117.
Environmental contaminants and pregnancy outcomes.
Windham G, Fenster L.
Source
Division of Environmental and Occupational Disease Control, California Department of Public Health, Richmond, California 94804, USA.
Abstract
OBJECTIVE:
To review selected environmental, occupational, and other important risk factors for the following adverse pregnancy outcomes: low birth weight (LBW), intrauterine growth retardation (IUGR), and preterm delivery (PTD).
DESIGN:
The evidence is explored in greater detail for environmental tobacco smoke, drinking water disinfection byproducts, and organochlorine (DDT) and organophosphate pesticides, partly using a weight of evidence approach.
MAIN OUTCOME MEASURE(S):
Low birth weight and IUGR are surrogate measures of fetal growth that are determined at delivery. Low birth weight is defined as <2,500 grams, and occurs in about 7% of US births. Intrauterine growth retardation is commonly defined as birth weight less than the tenth percentile for gestational week, using a standard population. Preterm delivery is birth at <37 weeks gestational age, and occurs in approximately 12% of US births.
RESULT(S):
Numerous factors are associated with these endpoints that may be important to consider in studies of environmental exposures, such as young or old maternal age, race/ethnicity, multiple births, low socioeconomic status, inadequate prenatal care, low maternal weight gain, and infections and premature rupture of the membranes. Environmental contaminants found associated with increased risk of one or more of the endpoints include: tobacco smoke, carbon monoxide, air pollutants, heavy metals, pesticides, chlorination byproducts, and solvents.
CONCLUSION(S):
Future research directions include measurement of exposure biomarkers during critical windows and consideration of genetic polymorphisms.
PMID: 18308050 [PubMed - indexed for MEDLINE]
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2. J Expo Anal Environ Epidemiol. 2004 Nov;14(6):466-72.
Exposure assessment in epidemiologic studies of adverse pregnancy outcomes and disinfection byproducts.
King WD, Dodds L, Armson BA, Allen AC, Fell DB, Nimrod C.
Source
Department of Community Health and Epidemiology, Queen\'s University, Kingston, Ontario, Canada.
Abstract
A major challenge in studies that examine the association between disinfection byproducts in drinking water and pregnancy outcomes is the accurate representation of a subject\'s exposure. We used household water samples and questionnaire information on water-use behavior to examine several aspects of exposure assessment: (i) the distribution and correlation of specific disinfection byproducts, (ii) spatial distribution system and temporal variation in byproduct levels, and (iii) the contribution of individual water-use behavior. The level of specific trihalomethanes (THMs) and haloacetic acids (HAAs) was determined for 360 household water samples in Eastern Ontario and Nova Scotia. Subjects were interviewed regarding tap water ingestion and showering and bathing practices. In both provinces, total THMs correlated highly with chloroform (correlation coefficient (r) >0.95) and less so with total HAAs (r = 0.74 in Nova Scotia and r = 0.52 in Ontario). The correlation between total THMs and bromodichloromethane was high in Nova Scotia (r = 0.63), but low in Ontario (r = 0.26). The correlation was between THM level in individual household samples, and the mean THM level during the same time period from several distribution system samples was 0.63, while a higher correlation in THM level was observed for samples taken at the same location 1 year apart (r = 0.87). A correlation of 0.73 was found between household THM level and a total exposure measure incorporating ingestion, showering, and bathing behaviors. These results point to the importance of: measurement of different classes of byproducts; household rather than distribution system sampling; and, incorporation of subject behaviors in exposure assessment in epidemiologic studies of disinfection byproducts and adverse pregnancy outcomes.
Free Article
PMID: 15026776 [PubMed - indexed for MEDLINE]
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3. Epidemiology. 2002 Sep;13(5):540-4.
Assessing the exposure of pregnant women to drinking water disinfection byproducts.
Barbone F, Valent F, Brussi V, Tomasella L, Triassi M, Di Lieto A, Scognamiglio G, Righi E, Fantuzzi G, Casolari L, Aggazzotti G.
Source
Istituto di Igiene ed Epidemiologia, DPMSC, Università di Udine, Italy.
Abstract
BACKGROUND:
To evaluate associations between exposure to disinfection byproducts in drinking water and adverse birth outcomes, personal exposure to disinfection byproducts must take into consideration multiple routes of exposure.
METHODS:
We assessed the reproducibility and validity of a questionnaire measuring water consumption, showering and bathing habits, use of chlorine-based products, and swimming pool attendance in 237 pregnant Italian women enrolled between June and December 1999. The questionnaire was completed during the last trimester of pregnancy (preQ) and again a few days after delivery (postQ). Data from postQ were compared with a 7-day diary completed during the last trimester.
RESULTS:
According to postQ, total water intake was 2.6 liters per day, whereas tap water intake was 0.6 liters per day. Intraclass correlation coefficients of postQ compared with preQ were 0.85 for tap water daily intake and 0.77 for duration of showering and bathing. Pearson\'s correlation coefficients were 0.84 for tap water daily intake, 0.81 for frequency of showering, and 0.94 for bathing. The kappa statistics were 0.76 (95% confidence limits = 0.68, 0.85) for use of domestic chlorine-based products and 0.82 (0.70, 0.94) for indoor swimming. Pearson\'s coefficients for postQ compared with the diary were 0.78 for tap water daily intake, 0.62 for frequency of showering, and 0.64 for bathing. Compared with the diary, the sensitivity and specificity of postQ in assessing indoor swimming were 75% and 90%, respectively.
The effects of drinking water on pregnancy
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Abstract
A number of researches have been conducted in order to address the subject of water contaminants and the role played by them in detrimental consequences of pregnancy due to the growing public interest in this matter. Water is a significant element of pregnancy which lessens the side effects of pregnancy, helps prepare the body for physiological transformations and has a positive impact on the health of the pregnant lady and the infant. However, maternal exposure to infected water can have severe consequences. This study seeks to establish a relationship between the contaminated drinking water with chlorine disinfectants, their byproducts, arsenic, lead and other impurities and the adverse birth outcomes which include small for gestational age (SGA) or low birth weight, premature birth, birth defects, involuntary abortions, and prenatal fatality. Earlier researches performed on animals proposed that some of these contaminants are teratogenic. A qualitative review was performed as diverse literature is available on this topic and researchers have classified and investigated the birth consequences and risk factors both.
The effects of drinking water on pregnancy
Introduction
With time, people have shown concern regarding the role of drinking water as a possible risk factor during pregnancy. Although researches on animals signified some of the pollutants to be teratogenic, still many queries are left unanswered by the present researches on this topic (Hunter ES et al., 1996, pg 57-64). The aim of this research paper is to review the available literature and identify the link between pregnancy complications and polluted drinking water. What facilitates the researches in United States of America is the maintenance of proper records of tap water samples in most of the states. According to the federal and state drinking water policies, these samples are tested by water utilities. Furthermore, information on gestational age, birth weight, other characteristics of the birth, and parental risk factors can be found in the individuals databases established in every state. More information can be gathered from prenatal (less than 20 week`s gestation) death certificates. All of this data can be helpful in the desired evaluation. However, it can be insufficient in terms of data related to birth defects (Watkins et al, 1996, pg 731-734).
The study will consider the contaminations such as chlorine disinfectants, their byproducts, arsenic, lead and other impurities that cause the adverse birth outcomes like small for gestational age (SGA), low birth weight, premature birth, birth defects, involuntary abortions, and prenatal fatality.
Importance of drinking water during pregnancy
Water is an essential requirement of our body, particularly during pregnancy. The physical needs and the physiological variation associated with pregnancy require hydration throughout the day. According to the American Pregnancy Association (2008), during pregnancy the body experiences a rise of about 40 to 50 percent in the blood volume and in order to adjust this increase is blood volume, one need to increase the water intake. Drinking water can be significant in reducing the risk factors and difficulties like premature delivery or miscarriage.
Many complications like headaches, nausea, cramps, edema and dizziness occur during pregnancy if the mother is dehydrated. The harmful effects increase particularly in the third trimester when dehydration can in fact be a cause of contractions that can prompt preterm labor. However, the benefits of drinking water can turn into deadly disadvantages during pregnancy if the water is polluted. It is extremely important to consider the water sources and monitor the concentration of harmful substances present in it. A mother drinking lots of water to be healthy during pregnancy and her baby can become the targets of critical complications if the purity of water is not ensured. In the following paragraphs we will try to elaborate the possible health hazards and some common contaminants found in water in order to develop a better understanding of the subject.
Water Contaminants
Disinfectants and it`s by products
According to 1990 census, approximately 84% (86 million) of the household drinking water in United States comes from the public water system which involves disinfection. Since many years Chlorination was considered to be an efficient water disinfection method. However, in 1974, Rook for the first time proved that when the water having organic material is chlorinated, some volatile halogenated organic compounds, such as chloroform are produced. Successive studies discovered several other by-products of chlorination such as trihalomethanes, haloacetic acids, chlorophenols, chloral hydrate, and haloacetonitriles.
Although the purpose of disinfectants is to safeguard drinking water from disease-causing microorganisms still there are certain complications associated with the use of disinfectants. Some microbial pathogens, like Cryptosporidium, are not easily removed by customary disinfection practices. In addition, there is a chance of reaction between the disinfectants and naturally-occurring substances in the water and this will cause the formation of byproducts, which may be the causes of possible health hazards (United States Environmental protection agency - EPA).
In the cases where the public water systems are directly linked to the ground water, they must keep a predetermined quantity of residual disinfectant in the distribution system. There exists an enforced ruling about the amount of disinfectants which is known as a maximum residual disinfectant level (MRDL). The water suppliers are required to keep a check on the concentration of disinfectants so that they may not exceed the MRDL. However, if it happens then the authorities must take some action to bring it below that level. As soon as the authorities identify the breach of the rule, they must notify the people as well as ensure the provision of alternative water supplies.
Arsenic
A number of people globally are drinking water with high arsenic concentrations. Arsenic is as a metalloid and is distributed throughout the earth`s crust as arsenic sulfide or metal arsenates and arsenide. Arsenic is naturally found in groundwater due to natural sources. Its principle sources are medicinal (anti-syphilis drugs), Agricultural (pesticides, insecticides, cattle, sheep dips, etc.), weathering of arsenic-containing rocks, processing of glass, ceramics, paints, pigments, dyes, soaps, textiles, etc. and mining of ores and management of waste materials associated with mining operations.
The Safe Drinking Water Act was passed in 1974 by the Congress of United States. According to this law, EPA was asked to verify the level of contaminants in drinking water at which the drinkers will be safe from the adverse health effects. These non- enforceable health goals, established primarily on the basis of potential health hazards and exposure over a life span with a sufficient degree of safety, are called maximum contaminant level goals (MCLG). The MCLG for arsenic is zero. On the basis of this MCLG, EPA has stated an imposed regulation for arsenic, called a maximum contaminant level (MCL), at 0.010 mg/L or 10 ppb (EPA).
Nitrates and Nitrides
Another contaminant is nitrates and nitrites present in the drinking water. Nitrates and nitrites are nitrogen-oxygen chemical units which mix with different organic and inorganic compounds. Water, soil, plants, and food are naturally rich in nitrates and nitrites. Groundwater has higher concentrations of nitrates and nitrites than surface water. Fertilizers, septic tank waste, livestock manure, and erosion of natural deposits are their principle sources. When a person consumes nitrates, they are converted into nitrites.
According to the statistics provided by EPA, infants younger than six months who take in nitrite with drinking water having nitrite more than the maximum contaminant level (MCL) are likely to fall ill and neglecting this can result in death. The symptoms are difficulty in breathing and blue baby syndrome.
Complications during pregnancy
Small for Gestational Age (SGA) or Low birth weight
Pediatricians generally define the Children born small for gestational age as a newborn with birth weight or birth length below 2 SD for gestational age. The term Intrauterine Growth Retardation (IUGR) is used synonymously with SGA as it refers to a reduced fetal growth. In simpler terms it can be said that SGA means ...
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