Association between arsenic, cadmium, manganese, and lead levels in private wells and birth defects prevalence in North Carolina: a semi-ecologic study Public Deposited

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Creator
  • Warren, Joshua
    • Affiliation: Gillings School of Global Public Health, Department of Biostatistics
    • Other Affiliation: Current affiliation: Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, CT, USA
  • Sanders, Alison P
    • Affiliation: Gillings School of Global Public Health, Department of Environmental Sciences and Engineering
    • Other Affiliation: Current affiliation: Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
  • Enright, Dianne
    • Other Affiliation: Division of Public Health, Health and Spatial Analysis Branch, State Center for Health Statistics, Raleigh, NC, USA
  • Desrosiers, Tania
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
    • Other Affiliation: Division of Public Health, North Carolina Birth Defects Monitoring Program, State Center for Health Statistics, Raleigh, NC, USA
  • Meyer, Robert
    • Affiliation: Gillings School of Global Public Health, Department of Maternal and Child Health
    • Other Affiliation: Division of Public Health, North Carolina Birth Defects Monitoring Program, State Center for Health Statistics, Raleigh, NC, USA
  • Fry, Rebecca
    • Affiliation: Gillings School of Global Public Health, Department of Environmental Sciences and Engineering
  • Olshan, Andrew
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
  • Herring, Amy
    • Affiliation: Gillings School of Global Public Health, Department of Biostatistics
Abstract
  • Abstract: Background: Toxic metals including arsenic, cadmium, manganese, and lead are known human developmental toxicants that are able to cross the placental barrier from mother to fetus. In this population-based study, we assess the association between metal concentrations in private well water and birth defect prevalence in North Carolina. Methods: A semi-ecologic study was conducted including 20,151 infants born between 2003 and 2008 with selected birth defects (cases) identified by the North Carolina Birth Defects Monitoring Program, and 668,381 non-malformed infants (controls). Maternal residences at delivery and over 10,000 well locations measured for metals by the North Carolina Division of Public Health were geocoded. The average level of each metal was calculated among wells sampled within North Carolina census tracts. Individual exposure was assigned as the average metal level of the census tract that contained the geocoded maternal residence. Prevalence ratios (PR) with 95% confidence intervals (CI) were calculated to estimate the association between the prevalence of birth defects in the highest category (≥90th percentile) of average census tract metal levels and compared to the lowest category (≤50th percentile). Results: Statewide, private well metal levels exceeded the EPA Maximum Contaminant Level (MCL) or secondary MCL for arsenic, cadmium, manganese, and lead in 2.4, 0.1, 20.5, and 3.1 percent of wells tested. Elevated manganese levels were statistically significantly associated with a higher prevalence of conotruncal heart defects (PR: 1.6 95% CI: 1.1-2.5). Conclusions: These findings suggest an ecologic association between higher manganese concentrations in drinking water and the prevalence of conotruncal heart defects.
Date of publication
Identifier
  • 25224535
  • doi:10.1186/1471-2458-14-955
Resource type
  • Article
Rights statement
  • In Copyright
Rights holder
  • Alison P Sanders et al.; licensee BioMed Central Ltd.
License
Journal title
  • BMC Public Health
Journal volume
  • 14
Journal issue
  • 1
Page start
  • 955
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1471-2458
Bibliographic citation
  • BMC Public Health. 2014 Sep 15;14(1):955
Access
  • Open Access
Publisher
  • BioMed Central Ltd
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