Toxic metal mixtures in private well water and increased risk for preterm birth in North Carolina
Abstract Background Prenatal exposure to metals in private well water may increase the risk of preterm birth (PTB) (delivery < 37 weeks’ gestation). In this study, we estimated associations between arsenic, manganese, lead, cadmium, chromium, copper, and zinc concentrations in private well water...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | Environmental Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12940-023-01021-7 |
| _version_ | 1797451582492639232 |
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| author | Lauren A. Eaves Alexander P. Keil Anne Marie Jukic Radhika Dhingra Jada L. Brooks Tracy A. Manuck Julia E. Rager Rebecca C. Fry |
| author_facet | Lauren A. Eaves Alexander P. Keil Anne Marie Jukic Radhika Dhingra Jada L. Brooks Tracy A. Manuck Julia E. Rager Rebecca C. Fry |
| author_sort | Lauren A. Eaves |
| collection | DOAJ |
| description | Abstract Background Prenatal exposure to metals in private well water may increase the risk of preterm birth (PTB) (delivery < 37 weeks’ gestation). In this study, we estimated associations between arsenic, manganese, lead, cadmium, chromium, copper, and zinc concentrations in private well water and PTB incidence in North Carolina (NC). Methods Birth certificates from 2003–2015 (n = 1,329,071) were obtained and pregnancies were assigned exposure using the mean concentration and the percentage of tests above the maximum contaminant level (MCL) for the census tract of each individuals’ residence at the time of delivery using the NCWELL database (117,960 well water tests from 1998–2019). We evaluated associations between single metals and PTB using adjusted logistic regression models. Metals mixtures were assessed using quantile-based g-computation. Results Compared with those in other census tracts, individuals residing in tracts where > 25% of tests exceeded the MCL for lead (aOR 1.10, 95%CI 1.02,1.18) or cadmium (aOR 1.11, 95% CI 1.00,1.23) had an increased odds of PTB. Conversely, those residing in areas with > 25% MCL for zinc (aOR 0.77 (95% CI: 0.56,1.02) and copper (aOR 0.53 (95% CI: 0.13,1.34)) had a reduced odds of PTB. A quartile increase in the concentrations of a mixture of lead, cadmium, and chromium was associated with a small increased odds for PTB (aOR 1.02, 95% CI 1.01, 1.03). This metal mixture effect was most pronounced among American Indian individuals (aOR per quartile increase in all metals: 1.19 (95% CI 1.06,1.34)). Conclusions In a large study population of over one million births, lead and cadmium were found to increase the risk of PTB individually and in a mixture, with additional mixtures-related impacts estimated from co-exposure with chromium. This study highlights critical racial and ethnic health disparities in relation to private well water thereby emphasizing the urgent need for improved private well water quality to protect vulnerable populations. |
| first_indexed | 2024-03-09T14:56:44Z |
| format | Article |
| id | doaj.art-05fff0128acc4c30a56c6a744ef80c59 |
| institution | Directory Open Access Journal |
| issn | 1476-069X |
| language | English |
| last_indexed | 2024-03-09T14:56:44Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Environmental Health |
| spelling | doaj.art-05fff0128acc4c30a56c6a744ef80c592023-11-26T14:07:47ZengBMCEnvironmental Health1476-069X2023-10-0122111510.1186/s12940-023-01021-7Toxic metal mixtures in private well water and increased risk for preterm birth in North CarolinaLauren A. Eaves0Alexander P. Keil1Anne Marie Jukic2Radhika Dhingra3Jada L. Brooks4Tracy A. Manuck5Julia E. Rager6Rebecca C. Fry7Department of Environmental Sciences & Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel HillDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel HillEpidemiology Branch, National Institute of Environmental Health SciencesDepartment of Environmental Sciences & Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel HillSchool of Nursing, University of North Carolina at Chapel HillInstitute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina at Chapel HillDepartment of Environmental Sciences & Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel HillDepartment of Environmental Sciences & Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel HillAbstract Background Prenatal exposure to metals in private well water may increase the risk of preterm birth (PTB) (delivery < 37 weeks’ gestation). In this study, we estimated associations between arsenic, manganese, lead, cadmium, chromium, copper, and zinc concentrations in private well water and PTB incidence in North Carolina (NC). Methods Birth certificates from 2003–2015 (n = 1,329,071) were obtained and pregnancies were assigned exposure using the mean concentration and the percentage of tests above the maximum contaminant level (MCL) for the census tract of each individuals’ residence at the time of delivery using the NCWELL database (117,960 well water tests from 1998–2019). We evaluated associations between single metals and PTB using adjusted logistic regression models. Metals mixtures were assessed using quantile-based g-computation. Results Compared with those in other census tracts, individuals residing in tracts where > 25% of tests exceeded the MCL for lead (aOR 1.10, 95%CI 1.02,1.18) or cadmium (aOR 1.11, 95% CI 1.00,1.23) had an increased odds of PTB. Conversely, those residing in areas with > 25% MCL for zinc (aOR 0.77 (95% CI: 0.56,1.02) and copper (aOR 0.53 (95% CI: 0.13,1.34)) had a reduced odds of PTB. A quartile increase in the concentrations of a mixture of lead, cadmium, and chromium was associated with a small increased odds for PTB (aOR 1.02, 95% CI 1.01, 1.03). This metal mixture effect was most pronounced among American Indian individuals (aOR per quartile increase in all metals: 1.19 (95% CI 1.06,1.34)). Conclusions In a large study population of over one million births, lead and cadmium were found to increase the risk of PTB individually and in a mixture, with additional mixtures-related impacts estimated from co-exposure with chromium. This study highlights critical racial and ethnic health disparities in relation to private well water thereby emphasizing the urgent need for improved private well water quality to protect vulnerable populations.https://doi.org/10.1186/s12940-023-01021-7MetalsMixturesPreterm birthDrinking waterPrivate well |
| spellingShingle | Lauren A. Eaves Alexander P. Keil Anne Marie Jukic Radhika Dhingra Jada L. Brooks Tracy A. Manuck Julia E. Rager Rebecca C. Fry Toxic metal mixtures in private well water and increased risk for preterm birth in North Carolina Environmental Health Metals Mixtures Preterm birth Drinking water Private well |
| title | Toxic metal mixtures in private well water and increased risk for preterm birth in North Carolina |
| title_full | Toxic metal mixtures in private well water and increased risk for preterm birth in North Carolina |
| title_fullStr | Toxic metal mixtures in private well water and increased risk for preterm birth in North Carolina |
| title_full_unstemmed | Toxic metal mixtures in private well water and increased risk for preterm birth in North Carolina |
| title_short | Toxic metal mixtures in private well water and increased risk for preterm birth in North Carolina |
| title_sort | toxic metal mixtures in private well water and increased risk for preterm birth in north carolina |
| topic | Metals Mixtures Preterm birth Drinking water Private well |
| url | https://doi.org/10.1186/s12940-023-01021-7 |
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