{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T14:35:59Z","timestamp":1782916559032,"version":"3.54.5"},"reference-count":39,"publisher":"IWA Publishing","issue":"6","license":[{"start":{"date-parts":[[2019,11,22]],"date-time":"2019-11-22T00:00:00Z","timestamp":1574380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"South African National Research Foundation","award":["SFH150625121049"],"award-info":[{"award-number":["SFH150625121049"]}]}],"content-domain":{"domain":["iwaponline.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The current study aimed to determine the association between trichloroacetic acid (TCAA) levels and adverse pregnancy outcomes among third-trimester pregnant women who were exposed to chlorinated drinking water. A total of 205 pregnant women who participated in the disinfection by-products exposure and adverse pregnancy outcome study in South Africa were randomly asked to participate in this study by providing their morning urine sample voids. Samples were analysed for urinary creatinine and TCAA. Furthermore, participants gave individual data using a structured questionnaire. The mean (median) concentration of creatinine-adjusted urinary TCAA was 2.34 (1.95) \u03bcg\/g creatinine. Elevated levels of creatinine-adjusted TCAA concentrations showed an increased risk of premature birth, small for gestational age (SGA) and low birth weight. There was no significant statistical correlation observed between creatinine-adjusted TCAA concentrations and the total volume of cold water ingested among the study population. No statistically significant association was observed between creatinine-adjusted urinary TCAA and premature birth, SGA and low birth weight newborns among the study subjects. However, the urinary TCAA concentrations identified in this study suggest potential health risks towards women and foetus. Therefore, further studies are warranted to prevent further adverse pregnancy outcomes.<\/jats:p>","DOI":"10.2166\/wh.2019.109","type":"journal-article","created":{"date-parts":[[2019,11,22]],"date-time":"2019-11-22T15:20:56Z","timestamp":1574436056000},"page":"884-895","update-policy":"https:\/\/doi.org\/10.2166\/iwapcrossmarkpolicypage","source":"Crossref","is-referenced-by-count":11,"title":["Maternal urinary levels of trichloroacetic acid and association with adverse pregnancy outcomes"],"prefix":"10.2166","volume":"17","author":[{"given":"Funanani","family":"Mashau","sequence":"first","affiliation":[{"name":"School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Private Bag x323, Pretoria 0002, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esper Jacobeth","family":"Ncube","sequence":"first","affiliation":[{"name":"School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Private Bag x323, Pretoria 0002, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuku","family":"Voyi","sequence":"first","affiliation":[{"name":"School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Private Bag x323, Pretoria 0002, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"945","published-online":{"date-parts":[[2019,11,22]]},"reference":[{"key":"2020032616231873200_JWH-D-19-00109C1","volume-title":"Toxicological Profile for 1,1,1-Trichloroethane","author":"Agency for Toxic Substances and Disease Registry (ATSDR)","year":"1995"},{"key":"2020032616231873200_JWH-D-19-00109C2","volume-title":"Toxicological Profile for Tetrachloroethylene","author":"Agency for Toxic Substances and Disease Registry (ATSDR)","year":"1996"},{"key":"2020032616231873200_JWH-D-19-00109C3","volume-title":"Toxicological Profile for Trichloroethylene","author":"Agency for Toxic Substances and Disease Registry (ATSDR)","year":"1997"},{"issue":"2","key":"2020032616231873200_JWH-D-19-00109C4","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.ijheh.2012.03.004","article-title":"Umbilical cord blood levels of perfluoroalkyl acids and polybrominated flame retardants","volume":"216","year":"2013","journal-title":"International Journal of Hygiene and Environmental Health"},{"key":"2020032616231873200_JWH-D-19-00109C5","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1136\/oem.2003.008698","article-title":"Urinary excretion half-life of trichloroacetic acid as a biomarker of exposure to chlorinated drinking water disinfection by-products","volume":"61","year":"2004","journal-title":"Journal of Occupational and Environmental Medicine"},{"issue":"5","key":"2020032616231873200_JWH-D-19-00109C6","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1097\/00001648-200209000-00009","article-title":"Assessing the exposure of pregnant women to drinking water disinfection byproducts","volume":"13","year":"2002","journal-title":"Epidemiology"},{"issue":"2","key":"2020032616231873200_JWH-D-19-00109C7","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1007\/s004200000198","article-title":"Study on the cytochrome P-450- and glutathione-dependent biotransformation of trichloroethylene in humans","volume":"74","year":"2001","journal-title":"International Archives of Occupational and Environmental Health"},{"issue":"1","key":"2020032616231873200_JWH-D-19-00109C8","first-page":"207","article-title":"Drinking water disinfection byproducts: review and approach to toxicity evaluation","volume":"107","year":"1999","journal-title":"Environmental Health Perspectives"},{"issue":"1","key":"2020032616231873200_JWH-D-19-00109C9","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/1476-072X-6-18","article-title":"Case control study of the geographic variability of exposure to disinfectant byproducts and risk for rectal cancer","volume":"6","year":"2007","journal-title":"International Journal of Health Geographics"},{"issue":"2","key":"2020032616231873200_JWH-D-19-00109C10","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1093\/toxsci\/28.2.155","article-title":"Water chlorination: essential process or cancer hazard?","volume":"28","year":"1995","journal-title":"Toxicological Sciences"},{"issue":"2","key":"2020032616231873200_JWH-D-19-00109C11","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1289\/ehp.5644","article-title":"Urinary levels of trichloroacetic acid, a disinfection by-product in chlorinated drinking water, in a human reference population","volume":"111","year":"2003","journal-title":"Environmental Health Perspectives"},{"issue":"1","key":"2020032616231873200_JWH-D-19-00109C12","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1097\/00001648-199801000-00007","article-title":"Drinking water source and chlorination byproducts I. Risk of bladder cancer","volume":"9","year":"1998","journal-title":"Epidemiology"},{"issue":"4","key":"2020032616231873200_JWH-D-19-00109C13","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1289\/ehp.1409234","article-title":"Blood biomarkers of late pregnancy exposure to trihalomethanes in drinking water and fetal growth measures and gestational age in a Chinese cohort","volume":"124","year":"2016","journal-title":"Environmental Health Perspectives"},{"issue":"4","key":"2020032616231873200_JWH-D-19-00109C14","first-page":"263","article-title":"Environmental and urinary markers of prenatal exposure to drinking water disinfection by-products, fetal growth, and duration of gestation in the PELAGIE birth cohort (Brittany, France, 2002\u20132006)","volume":"175","year":"2011","journal-title":"American Journal of Epidemiology"},{"issue":"2","key":"2020032616231873200_JWH-D-19-00109C15","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1006\/taap.1998.8486","article-title":"A human physiologically based pharmacokinetic model for trichloroethylene and its metabolites, trichloroacetic acid and free trichloroethanol","volume":"152","year":"1998","journal-title":"Toxicology and Applied Pharmacology"},{"key":"2020032616231873200_JWH-D-19-00109C16","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1289\/ehp.02110679","article-title":"Trichloroacetic acid as a biomarker of exposure to disinfection by-products in drinking water: a human exposure trial in Adelaide, Australia","volume":"110","year":"2002","journal-title":"Environmental Health Perspectives"},{"issue":"1","key":"2020032616231873200_JWH-D-19-00109C17","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/1476-069X-10-32","article-title":"Individual exposures to drinking water trihalomethanes, low birth weight and small for gestational age risk: a prospective Kaunas cohort study","volume":"10","year":"2011","journal-title":"Environmental Health"},{"issue":"10","key":"2020032616231873200_JWH-D-19-00109C18","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1097\/JOM.0b013e31822b8334","article-title":"The effect of water disinfection by-products on pregnancy outcomes in two southeastern US communities","volume":"53","year":"2011","journal-title":"Journal of Occupational and Environmental Medicine\/American College of Occupational and Environmental Medicine"},{"issue":"5","key":"2020032616231873200_JWH-D-19-00109C19","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1136\/oem.2003.007351","article-title":"Exposure of pregnant women to tap water-related activities","volume":"61","year":"2004","journal-title":"Occupational and Environmental Medicine"},{"issue":"2","key":"2020032616231873200_JWH-D-19-00109C20","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1006\/enrs.1998.3896","article-title":"Evaluation of biomarkers of environmental exposures: urinary haloacetic acids associated with ingestion of chlorinated drinking water","volume":"80","year":"1999","journal-title":"Environmental Research"},{"issue":"4","key":"2020032616231873200_JWH-D-19-00109C21","first-page":"487","article-title":"Implementing a protocol for selection and prioritisation of organic contaminants in the drinking water value chain: case study of Rand Water, South Africa","volume":"38","year":"2012","journal-title":"Water SA"},{"issue":"1904","key":"2020032616231873200_JWH-D-19-00109C22","doi-asserted-by":"crossref","first-page":"4043","DOI":"10.1098\/rsta.2009.0116","article-title":"The epidemiology and possible mechanisms of disinfection by-products in drinking water","volume":"367","year":"2009","journal-title":"Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences"},{"issue":"2","key":"2020032616231873200_JWH-D-19-00109C23","doi-asserted-by":"crossref","first-page":"185","DOI":"10.2166\/wh.2009.073","article-title":"Health impacts of long-term exposure to disinfection by-products in drinking water in Europe: HIWATE","volume":"7","year":"2009","journal-title":"Journal of Water and Health"},{"issue":"3","key":"2020032616231873200_JWH-D-19-00109C24","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1002\/1097-0274(200103)39:3<320::AID-AJIM1020>3.0.CO;2-8","article-title":"Urinary concentrations of trichloroacetic acid in Danish workers exposed to trichloroethylene, 1947\u20131985","volume":"39","year":"2001","journal-title":"American Journal of Industrial Medicine"},{"issue":"19","key":"2020032616231873200_JWH-D-19-00109C25","doi-asserted-by":"crossref","first-page":"3378","DOI":"10.1021\/es9900297","article-title":"Identification of new drinking water disinfection byproducts formed in the presence of bromide","volume":"33","year":"1999","journal-title":"Environmental Science & Technology"},{"issue":"1","key":"2020032616231873200_JWH-D-19-00109C26","first-page":"178","article-title":"Occurrence, genotoxicity, and carcinogenicity of regulated and emerging disinfection by-products in drinking water: a review and roadmap for research","volume":"636","year":"2007","journal-title":"Mutation Research\/Reviews in Mutation Research"},{"issue":"5","key":"2020032616231873200_JWH-D-19-00109C27","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1289\/ehp.1104347","article-title":"Comparison of trihalomethanes in tap water and blood: a case study in the United States","volume":"120","year":"2012","journal-title":"Environmental Health Perspectives"},{"key":"2020032616231873200_JWH-D-19-00109C28","first-page":"234","article-title":"Formation of haloforms during chlorination of natural waters","volume":"23","year":"1974","journal-title":"Water Treatment and Examination"},{"key":"2020032616231873200_JWH-D-19-00109C29","volume-title":"South African Bureau of Standards Drinking Water- Part 1: Microbiological, Physical, Aesthetic and Chemical Determinands","author":"SANS 241-1","year":"2015"},{"key":"2020032616231873200_JWH-D-19-00109C30","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.envres.2013.05.004","article-title":"Validation of trichloroacetic acid exposure via drinking water during pregnancy using a urinary TCAA biomarker","volume":"126","year":"2013","journal-title":"Environmental Research"},{"key":"2020032616231873200_JWH-D-19-00109C31","volume-title":"Guidelines for Maternity","author":"South African Department of Health (DoH)","year":"2015"},{"issue":"4","key":"2020032616231873200_JWH-D-19-00109C32","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1080\/15287390590895847","article-title":"Characterization of the metabolic interaction between trihalomethanes and chloroacetic acids using rat liver microsomes","volume":"68","year":"2005","journal-title":"Journal of Toxicology and Environmental Health, Part A"},{"issue":"2","key":"2020032616231873200_JWH-D-19-00109C33","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1093\/aje\/kwj364","article-title":"Bladder cancer and exposure to water disinfection by-products through ingestion, bathing, showering, and swimming in pools","volume":"165","year":"2006","journal-title":"American Journal of Epidemiology"},{"issue":"2","key":"2020032616231873200_JWH-D-19-00109C34","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1289\/ehp.99107103","article-title":"Exposure estimates to disinfection by-products of chlorinated drinking water","volume":"107","year":"1999","journal-title":"Environmental Health Perspectives"},{"issue":"3","key":"2020032616231873200_JWH-D-19-00109C39","first-page":"17","article-title":"Training course on child growth assessment","volume":"31","author":"World Health Organization","year":"2008"},{"issue":"1","key":"2020032616231873200_JWH-D-19-00109C35","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1038\/sj.jea.7500374","article-title":"Human respiratory uptake of chloroform and haloketones during showering","volume":"15","year":"2005","journal-title":"Journal of Exposure Science and Environmental Epidemiology"},{"key":"2020032616231873200_JWH-D-19-00109C36","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1016\/j.scitotenv.2014.06.067","article-title":"Predictors of urinary trichloroacetic acid and baseline blood trihalomethanes concentrations among men in China","volume":"493","year":"2014","journal-title":"Science of the Total Environment"},{"issue":"3","key":"2020032616231873200_JWH-D-19-00109C37","doi-asserted-by":"crossref","first-page":"359","DOI":"10.2166\/wh.2009.009","article-title":"Validation of urinary trichloroacetic acid as a biomarker of exposure to drinking water disinfection by-products","volume":"7","year":"2009","journal-title":"Journal of Water and Health"},{"key":"2020032616231873200_JWH-D-19-00109C38","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.scitotenv.2011.10.073","article-title":"Decreased birth weight in relation to maternal urinary trichloroacetic acid levels","volume":"416","year":"2012","journal-title":"Science of the Total Environment"}],"container-title":["Journal of Water and Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/iwaponline.com\/jwh\/article-pdf\/17\/6\/884\/637363\/jwh0170884.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/iwaponline.com\/jwh\/article-pdf\/17\/6\/884\/637363\/jwh0170884.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,3,26]],"date-time":"2020-03-26T23:16:16Z","timestamp":1585264576000},"score":1,"resource":{"primary":{"URL":"https:\/\/iwaponline.com\/jwh\/article\/17\/6\/884\/70998\/Maternal-urinary-levels-of-trichloroacetic-acid"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,22]]},"references-count":39,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,11,22]]},"published-print":{"date-parts":[[2019,12,1]]}},"URL":"https:\/\/doi.org\/10.2166\/wh.2019.109","relation":{},"ISSN":["1477-8920","1996-7829"],"issn-type":[{"value":"1477-8920","type":"print"},{"value":"1996-7829","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,22]]}}}