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Occupational and Environmental Medicine 2004;61:454-460; doi:10.1136/oem.2003.007351
Copyright © 2004 by the BMJ Publishing Group Ltd.
Occupational and Environmental Medicine 2004;61:454-460
© 2004 BMJ Publishing Group Ltd

ORIGINAL ARTICLE

Exposure of pregnant women to tap water related activities

S Kaur1, M J Nieuwenhuijsen1, H Ferrier1, P Steer2

1 Imperial College London, Faculty of Life Sciences, Department of Environmental Science & Technology, South Kensington, London SW7 2AZ, UK
2 Academic Department of Obstetrics & Gynaecology, Imperial College London, Chelsea & Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK

Correspondence to:
Correspondence to:
Dr M J Nieuwenhuijsen
Department of Environmental Science & Technology, Imperial College London, Royal School of Mines, South Kensington, Prince Consort Road, London SW7 2AZ, UK; m.nieuwenhuijsen{at}imperial.ac.uk

Background: Evidence for an association between exposure of pregnant women to chlorination disinfection by-products and adverse birth outcomes is inconsistent and inconclusive.

Aims: To evaluate the use of a questionnaire in a population of pregnant women to assess their exposure to water, examine the validity of the questionnaire by a seven day diary, and to obtain a better understanding of the exposure of pregnant women to water in Central London.

Methods: A total of 147 pregnant women were asked to complete a questionnaire. Information was requested on their exposure to water from cooking and washing up, showering and bathing, food and drink, and swimming. Demographic and socioeconomic information were also recorded. For validation purposes, women were asked to complete a seven day diary at home.

Results: The average exposure duration was 338.5 min/week for cooking and washing up, 172.2 min/week for bathing and showering, and 67.9 min/month for swimming. The total fluid intake was 18.9 l/week of which, on average, 18% was cold tap water; 30% of this tap water was consumed outside the home. The correlation between questionnaire and diary data was generally good to very good, although women tended to overestimate their exposure in the questionnaire compared to the diary.

Conclusions: Information was obtained on the daily exposure of pregnant women in Central London to chlorinated water at home, work, and elsewhere. The questionnaire was found to be a valid method to assess the exposure of pregnant women to water and the response rate was higher than for diaries.

Keywords: water; exposure; disinfection by-products

Abbreviations: DBPs, disinfection by-products; THM, trihalomethane


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  • Villanueva, C M, Cantor, K P, Grimalt, J O, Castano-Vinyals, G, Malats, N, Silverman, D, Tardon, A, Garcia-Closas, R, Serra, C, Carrato, A, Rothman, N, Real, F X, Dosemeci, M, Kogevinas, M (2006). Assessment of lifetime exposure to trihalomethanes through different routes.. Occup. Environ. Med. 63: 273-277 [Abstract] [Full Text]  
  • Nieuwenhuijsen, M J (2005). Design of exposure questionnaires for epidemiological studies. Occup. Environ. Med. 62: 272-280 [Full Text]  

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