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Exposure to chloroform in swimming pools during pregnancy and risk for intrauterine growth retardation: The UMass swimmers study
The association of intrauterine growth retardation (IUGR) and exposure to chloroform in swimming pools during pregnancy was evaluated in 808 live born infants. Female subjects of childbearing age were recruited from the membership roster of the United States Masters Swimming Association and surveyed about their swimming experience during pregnancies resulting in live born infants. Information about other risk factors for IUGR was also collected, with special emphasis on assessment of energy expenditure from exercise and physical fitness activities. Both exposure and energy expenditure were ascertained separately for each trimester of each pregnancy. The risk for IUGR was compared using two surrogate measures of chloroform exposure: duration of swimming and a weighted exposure score (CEU or Chloroform Exposure Unit) which accounted for increased exposure via respiratory absorption while swimming in indoor pools. There was a moderately elevated crude risk (OR 2.13; 95% CI 1.01, 4.49) for those pregnancies with high hours of indoor pool exposure during the third trimester. However, the effect was attenuated after adjustment for parity, prepregnant weight and third trimester energy expenditure (OR 1.38; 95% CI 0.57, 3.37). The crude risk was similar for pregnancies that accumulated high CEUs during the third trimester (OR 1.92; 95% CI 0.87, 4.26), with the effect again attenuated after adjustment for parity, prepregnant weight and third trimester energy expenditure (OR 1.03; 95% CI 0.39, 2.71). For both exposure measures, most of the reduction in crude risk occurred after adjustment for third trimester energy expenditure alone. The effect of intra-mother correlation in birth weight was explored but did not change the results significantly. The conclusion of a modest increase in risk for IUGR with chloroform exposure is reassuring when weighed against the benefits of swimming for pregnant women: weightless exercise, dissipation of body heat, and maintenance of flexibility and well-being. Suggestions for future research include more sophisticated approaches to exposure assessment through water quality models and rigorous epidemiologic study.
Public health|Toxicology|Cellular biology|Womens studies
Silverman, Bonnie Lang, "Exposure to chloroform in swimming pools during pregnancy and risk for intrauterine growth retardation: The UMass swimmers study" (1998). Doctoral Dissertations Available from Proquest. AAI9909220.