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Int. J. Environ. Res. Public Health 2018, 15(10), 2096; https://doi.org/10.3390/ijerph15102096

Environmental Contaminants and Congenital Heart Defects: A Re-Evaluation of the Evidence

Department of Public Health and Clinical Medicine, Umeå University, SE 901-87 Umeå, Sweden
Received: 12 August 2018 / Revised: 19 September 2018 / Accepted: 21 September 2018 / Published: 25 September 2018
(This article belongs to the Section Environmental Health)
Full-Text   |   PDF [356 KB, uploaded 25 September 2018]

Abstract

Congenital heart defects (CHDs) are a common birth defect of largely unknown etiology, with high fetal and neonatal mortality. A review of CHDs and environmental contaminant exposure found that meta-analyses showed only modest associations for smoking, vehicle exhaust components, disinfectant by-products and proximity to incinerators, with stronger results from the newer, larger and better quality studies masked by the typical absence of effect in older studies. Recent studies of exposure to agricultural pesticides, solvents, metals and landfill sites also showed associations. Certain contaminants have been associated with certain CHDs, with septal defects being the most common. Frequent methodological problems include failure to account for potential confounders or maternal/paternal preconception exposure, differences in diagnosing, defining and classifying CHDs, grouping of defects to increase power, grouping of contaminants with dissimilar mechanisms, exclusion of pregnancies that result in death or later life diagnosis, and the assumption that maternal residence at birth is the same as at conception. Furthermore, most studies use measurement estimates of one exposure, ignoring the many additional contaminant exposures in daily life. All these problems can distort and underestimate the true associations. Impaired methylation is a common mechanism, suggesting that supplementary folate may be protective for any birth defect. View Full-Text
Keywords: congenital heart defects; environmental toxins; smoking; air pollution; disinfectant byproducts; waste sites; toxic metals; persistent organic pollutants; pesticides congenital heart defects; environmental toxins; smoking; air pollution; disinfectant byproducts; waste sites; toxic metals; persistent organic pollutants; pesticides
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Nicoll, R. Environmental Contaminants and Congenital Heart Defects: A Re-Evaluation of the Evidence. Int. J. Environ. Res. Public Health 2018, 15, 2096.

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