Información de la revista
Vol. 20. Núm. S2.
Revisiones en salud pública
Páginas 1-9 (Diciembre 2006)
Respuestas rápidas
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 20. Núm. S2.
Revisiones en salud pública
Páginas 1-9 (Diciembre 2006)
Open Access
Medida de contaminantes del agua y usos del agua durante el embarazo en un estudio de cohortes en España
Measurement of drinking water contaminants and water use activities during pregnancy in a cohort study in Spain
Visitas
376
Cristina M. Villanuevaa,
Autor para correspondencia
cvillanueva@imim.es

Correspondencia: Cristina Villanueva Belmonte. CREAL-IMIM. Parc de Recerca Biomédica de Barcelona. Doctor Aiguader, 88. 08003 Barcelona. España.
, Joan O. Grimaltb, Ferran Ballesterc, Jesús Ibarluzead, Maria Salae, Adonina Tardónf, Elena Romero-Aliagag, Marieta Fernándezh, Núria Ribas-Fitóa, Manolis Kogevinasa
a Centre de Recerca en Epidemiologia Ambiental (CREAL). Institut Municipal d’Investigació Mèdica (IMIM). Barcelona. España
b Institut d’Investigacions Químiques i Ambientals. CSIC. Barcelona. España
c Escola Valenciana d’Estudis en Salut (EVES). Valencia. España
d Subdirección de Salud Pública de Guipúzcoa. San Sebastián. España
e Ayuntamiento de Sabadell. Sabadell. España
f Universidad de Oviedo. Oviedo. España
g Departamento de Salud Pública. UMH. Alicante. España
h Hospital Universitario San Cecilio. Granada. España
Este artículo ha recibido

Under a Creative Commons license
Información del artículo
Resumen
Objetivos

La evidencia que hay no permite establecer causalidad entre la exposición a subproductos de la cloración (SPC) durante la gestación y los efectos reproductivos. Los trihalometanos, uno de los subproductos de la cloración, son muy prevalentes en algunas zonas españolas. En el marco del estudio INMA (INfancia y Medio Ambiente) se describe: 1) los hábitos personales de uso y consumo de agua, y 2) el valor de trihalometanos en el agua de las zonas de estudio.

Métodos

Estudio de cohortes de seguimiento de mujeres embarazadas en Valencia (n=800), Sabadell (n=800), País Vasco (n=600), Asturias (n=500) y Granada (n=700). Con entrevistas en el tercer trimestre del embarazo se obtiene información personal acerca del origen y cantidad de agua consumida, frecuencia de ducha, baño y asistencia a piscinas. Se toman muestras de agua para analizar los trihalometanos.

Resultados

El origen del agua consumida dentro y fuera de casa es la embotellada (el 82 y el 94%, respectivamente). El agua para cocinar es principalmente municipal (91%). El 98,2% de las mujeres embarazadas toman preferentemente duchas 6,8 veces/semana durante 11,7min. Un 58,5% de las mujeres se bañan en piscinas durante el embarazo, en promedio 9,4 veces/mes en piscinas descubiertas en verano y 3,1 veces/mes en cubiertas el resto del año, durante 32,6 y 21,7min, respectivamente. Los valores medios de trihalometanos oscilan entre 4g/l en la provincia de Granada y 117g/l en Sabadell.

Conclusión

Los resultados provisionales sugieren que las principales vías de exposición a trihalometanos durante el embarazo son la absorción dérmica y la inhalación, y la ingestion es una vía poco relevante.

Palabras clave:
Exposición ambiental
Agua
Desinfección
Piscinas
Trihalometanos
Efectos sobre el embarazo
Peso bajo al nacer
Abstract
Objectives

Exposure to chlorination by-products during pregnancy has been associated with reproductive outcomes but the evidence remains inconclusive. Levels of trihalomethanes, the most prevalent chlorination by-products, are high in some areas of Spain. Within the framework of a follow-up study in pregnant women, we describe: 1) the personal habits of water use and consumption, and 2) trihalomethane levels in the drinking water of the study areas.

Methods

We performed a follow-up cohort study in pregnant women in Valencia (n=800), Sabadell (n=800), the Basque Country (n=600), Asturias (n=500), and Granada (n=700). Interviews were conducted in the third trimester of pregnancy to obtain individual information on the sources and amounts of drinking water, and on the frequency of showering, bathing, and swimming pool attendance. Water samples were collected to analyze trihalomethane levels.

Results

The main source of drinking water was bottled water, both inside and outside the home (82% and 94% of the women, respectively). Drinking water for cooking was mainly municipal (91%). Women preferred to take showers (98.2%) and did so, on average, 6.8 times/week for 11.7 minutes. A total of 58.5% of the women went to swimming pools during pregnancy, on average 9.4 times/month to outdoor swimming pools in the summer and 3.1 times/month the rest of the year for 32.6 and 21.7 minutes, respectively. Average trihalomethane levels ranged from 4 g/l in the province of Granada to 117 g/l in Sabadell.

Conclusion

These preliminary results suggest that the main routes of trihalomethane exposure during pregnancy are dermal absorption and inhalation. Ingestion is a minor exposure route.

Key words:
Environmental exposure
Water
Disinfection
Swimming pools
Trihalomethanes
Pregnancy outcomes
Low birth weight
El Texto completo está disponible en PDF
Bibliografía
[1.]
C.M. Villanueva, J.O. Grimalt, M. Kogevinas.
Haloacetic acids and trihalomethane concentrations in finished drinking waters from different sources.
Water Res, 37 (2003), pp. 954-959
[2.]
G. Premazzi, C. Cardoso, O. Conio, F. Palumbo, G. Ziglio, A. Borgioli, et al.
Exposure of the european population to trihalomethanes (THMs) in drinking water.
European Commission, (1997),
[3.]
G. Aggazzotti, G. Fantuzzi, E. Righi, G. Predieri.
Environmental and biological monitoring of chloroform in indoor swimming pools.
J Chromatogr A, 710 (1995), pp. 181-190
[4.]
J.R. Nuckols, D.L. Ashley, C. Lyu, S.M. Gordon, A.F. Hinckley, P. Singer.
Influence of tap water quality and household water use activities on indoor air and internal dose levels of trihalomethanes.
Environ Health Perspect, 113 (2005), pp. 863-870
[5.]
H. Kim, J. Shim, S. Lee.
Formation of disinfection by-products in chlorinated swimming pool water.
Chemosphere, 46 (2002), pp. 123-130
[6.]
G.R. Klinefelter, L.F. Strader, J.D. Suárez, N.L. Roberts.
Bromochloroacetic acid exerts qualitative effects on rat sperm: implications for a novel biomarker.
Toxicol Sci, 68 (2002), pp. 164-173
[7.]
S.R. Bielmeier, D.S. Best, D.L. Guidici, M.G. Narotsky.
Pregnancy loss in the rat caused by bromodichloromethane.
Toxicol Sci, 59 (2001), pp. 309-315
[8.]
M.K. Smith, J.L. Randall, E.J. Read, J.A. Stober.
Teratogenic activity of trichloroacetic acid in the rat.
Teratology, 40 (1989), pp. 445-451
[9.]
S. Teramoto, K. Takahashi, M. Kikuta, H. Kobayashi.
Potential teratogenicity of 3-chloro-4-(dichloromethyl)-5-hydroxy-2(5H)-furanone (MX) in micromass in vitro test.
J Toxicol Environ Health, 53 (1998), pp. 607-614
[10.]
J.M. Wright, J. Schwartz, D.W. Dockery.
Effect of trihalomethane exposure on fetal development.
Occup Environ Med, 60 (2003), pp. 173-180
[11.]
M.B. Toledano, M.J. Nieuwenhuijsen, N. Best, H. Whitaker, P. Hambly, C. De Hoogh, et al.
Relation of trihalomethane concentrations in public water supplies to stillbirth and birth weight in three water regions in England.
Environ Health Perspect, 113 (2005), pp. 225-232
[12.]
C. Lewis, I.H. Suffet, B. Ritz.
Estimated effects of disinfection by-products on birth weight in a population served by a single water utility.
Am J Epidemiol, 163 (2006), pp. 38-47
[13.]
J.M. Wight, J. Schwartz, D.W. Dockery.
The effect of disinfection by-products and mutagenic activity on birth weight and gestational duration.
Environ Health Perspect, 112 (2004), pp. 920-925
[14.]
C.K. Porter, S.D. Putnam, K.L. Hunting, M.R. Riddle.
The effect of trihalomethane and haloacetic acid exposure on fetal growth in a Maryland county.
Am J Epidemiol, 162 (2005), pp. 334-344
[15.]
L. Dodds, W.D. King.
Relation between trihalomethane compounds and birth defects.
Occup Environ Med, 58 (2001), pp. 443-446
[16.]
B.F. Hwang, P. Magnus, J.J. Jaakkola.
Risk of specific birth defects in relation to chlorination and the amount of natural organic matter in the water supply.
Am J Epidemiol, 156 (2002), pp. 374-382
[17.]
G.M. Shaw, D. Ranatunga, T. Quach, E. Neri, A. Correa, R.R. Neutra.
Trihalomethane exposures from municipal water supplies and selected congenital malformations.
Epidemiology, 14 (2003), pp. 191-199
[18.]
F. Bove, Y. Shim, P. Zeitz.
Drinking water contaminants and adverse pregnancy outcomes: a review.
Environ Health Perspect, 110 (2002), pp. 61-74
[19.]
M.J. Nieuwenhuijsen, M.B. Toledano, N. Eaton, J. Fawell, P. Elliott.
Chlorination disinfection byproducts in water and their association with adverse reproductive outcomes: a review.
Occup Environ Med, 57 (2000), pp. 73-85
[20.]
K.M. Thickett, J.S. McCoach, J.M. Gerber, S. Sadhra, P.S. Burge.
Occupational asthma caused by chloramines in indoor swimming-pool air.
Eur Respir J, 19 (2002), pp. 827-832
[21.]
I. Helenius, T. Haahtela.
Allergy and asthma in elite summer sport athletes.
J Allergy Clin Immunol, 106 (2000), pp. 444-452
[22.]
A. Bernard, S. Carbonnelle, O. Michel, S. Higuet, C. De Burbure, J.P. Buchet, et al.
Lung hyperpermeability and asthma prevalence in schoolchildren: unexpected associations with the attendance at indoor chlorinated swimming pools.
Occup Environ Med, 60 (2003), pp. 385-394
[23.]
L.A. Croen, K. Todoroff, G.M. Shaw.
Maternal exposure to nitrate from drinking water and diet and risk for neural tube defects.
Am J Epidemiol, 153 (2001), pp. 325-331
[24.]
T.E. Arbuckle, G.J. Sherman, P.N. Corey, D. Walters, B. Lo.
Water nitrates and CNS birth defects: a population-based case-control study.
Arch Environ Health, 43 (1988), pp. 162-167
[25.]
J. Bukowski, G. Somers, J. Bryanton.
Agricultural contamination of groundwater as a possible risk factor for growth restriction or prematurity.
J Occup Environ Med, 43 (2001), pp. 377-383
[26.]
C. Hopenhayn, C. Ferreccio, S.R. Browning, B. Huang, C. Peralta, H. Gibb, et al.
Arsenic exposure from drinking water and birth weight.
Epidemiology, 14 (2003), pp. 593-602
[27.]
C.Y. Yang, C.C. Chang, S.S. Tsai, H.Y. Chuang, C.K. Ho, T.N. Wu.
Arsenic in drinking water and adverse pregnancy outcome in an arseniasis-endemic area in northeastern Taiwan.
Environ Res, 91 (2003), pp. 29-34
[28.]
S.A. Ahmad, M.H. Sayed, S. Barua, M.H. Khan, M.H. Faruquee, A. Jalil, et al.
Arsenic in drinking water and pregnancy outcomes.
Environ Health Perspect, 109 (2001), pp. 629-631
[29.]
C. Hopenhayn-Rich, S.R. Browning, I. Hertz-Picciotto, C. Ferreccio, C. Peralta, H. Gibb.
Chronic arsenic exposure and risk of infant mortality in two areas of chile.
Environ Health Perspect, 108 (2000), pp. 667-673
[30.]
P.C. Chen, I.J. Pan, J.D. Wang.
Parental exposure to lead and small for gestational age births.
Am J Ind Med, 49 (2006), pp. 417-422
[31.]
R. Ramón, F. Ballester, M. Rebagliato, N. Ribas, M. Torrent, M. Fernández, et al.
La red de investigación “Infancia y Medio Ambiente” (red INMA): protocolo de estudio.
Rev Esp Salud Pub, 79 (2005), pp. 203-220
[32.]
Amaral OC. Análisis y comportamiento de compuestos orgánicos halogenados volátiles en agua, aire y sedimentos de zonas rurales, urbanas e industriales. Tesis Doctoral. Barcelona: Universitat de Barcelona; 1994.
Copyright © 2006. Sociedad Española de Salud Pública y Administración Sanitaria
Idiomas
Gaceta Sanitaria
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?