{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T07:06:40Z","timestamp":1791011200355,"version":"4.1.0"},"reference-count":57,"publisher":"American Chemical Society (ACS)","issue":"2","license":[{"start":{"date-parts":[[2017,12,29]],"date-time":"2017-12-29T00:00:00Z","timestamp":1514505600000},"content-version":"vor","delay-in-days":4817,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We investigated the association between total trihalomethanes (TTHMs) and risk of stillbirth and low and very low birth weight in three water regions in England, 1992\u20131998; associations with individual trihalomethanes (THMs) were also examined. Modeled estimates of quarterly TTHM concentrations in water zones, categorized as low (&amp;lt; 30 \u03bcg\/L), medium (30\u201359 \u03bcg\/L), or high (\u226560 \u03bcg\/L), were linked to approximately 1 million routine birth and stillbirth records using maternal residence at time of birth. In one region, where there was a positive socioeconomic deprivation gradient across exposure categories, there was also a positive, significant association of TTHM with risk of stillbirth and low and very low birth weight. Overall summary estimates across the three regions using a random-effects model to allow for between-region heterogeneity in exposure effects showed small excess risks in areas with high TTHM concentrations for stillbirths [odds ratio (OR) = 1.11; 95% confidence interval (CI), 1.00\u20131.23), low birth weight (OR = 1.09; 95% CI, 0.93\u20131.27), and very low birth weight (OR = 1.05; 95% CI, 0.82\u20131.34). Among the individual THMs, chloroform showed a similar pattern of risk as TTHM, but no association was found with concentrations of bromodichloromethane or total brominated THMs. Our findings overall suggest a significant association of stillbirths with maternal residence in areas with high TTHM exposure. Further work is needed looking at cause-specific stillbirths and effects of other disinfection by-products and to help differentiate between alternative (noncausal) explanations and those that may derive from the water supply.<\/jats:p>","DOI":"10.1289\/ehp.7111","type":"journal-article","created":{"date-parts":[[2004,10,21]],"date-time":"2004-10-21T13:55:39Z","timestamp":1098366939000},"page":"225-232","source":"Crossref","is-referenced-by-count":97,"title":["Relation of Trihalomethane Concentrations in Public Water Supplies to Stillbirth and Birth Weight in Three Water Regions in England"],"prefix":"10.1021","volume":"113","author":[{"given":"Mireille B.","family":"Toledano","sequence":"first","affiliation":[{"name":"1Small Area Health Statistics Unit, Department of Epidemiology and Public Health, Faculty of Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Nieuwenhuijsen","sequence":"additional","affiliation":[{"name":"1Small Area Health Statistics Unit, Department of Epidemiology and Public Health, Faculty of Medicine, and"},{"name":"2Department of Environmental Science and Technology, Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicky","family":"Best","sequence":"additional","affiliation":[{"name":"1Small Area Health Statistics Unit, Department of Epidemiology and Public Health, Faculty of Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Whitaker","sequence":"additional","affiliation":[{"name":"1Small Area Health Statistics Unit, Department of Epidemiology and Public Health, Faculty of Medicine, and"},{"name":"3Department of Statistics, Open University, Milton Keynes, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Hambly","sequence":"additional","affiliation":[{"name":"1Small Area Health Statistics Unit, Department of Epidemiology and Public 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