Examining the Relationship between Safe Drinking Water Act Violations and Adverse Birth Outcomes in Virginia

Authors: Holly Young*, , Korine Kolivras, Virginia Tech, Julia Gohlke, Virginia Tech, Leigh Anne Krometis, Virginia Tech
Topics: Medical and Health Geography
Keywords: medical geography, spatial epidemiology
Session Type: Virtual Paper
Day: 4/7/2021
Start / End Time: 1:30 PM / 2:45 PM
Room: Virtual 18
Presentation File: No File Uploaded


The Safe Drinking Water Act (SDWA) was established to protect consumers from potential exposure to over 90 water contaminants. Each contaminant is assigned a health-based standard meant to reflect the maximum level at which an adverse human health outcome is unlikely. While extensive research has been done on the human health implications of water contaminants, few examinations have specifically examined the risk to fetal health under real world monitoring conditions. Therefore, the objective of this study is to assess whether drinking water violations are related to fetal health in the Commonwealth of Virginia, by examining the association between SDWA violations and preterm birth (PTB), low birth weight (LBW), and term-low birth weight (tLBW). Singleton births occurring between 2007 and 2015 in Virginia were geocoded and assigned to their corresponding water service area. Health-based (HB) and monitoring and reporting (MR) violations were acquired from the USEPA Safe Drinking Water Information System, and exposure to contaminants was defined at the service area level to limit exposure misclassification. Potential relationships were evaluated using logistic regression. When examining the relationship between individual MR violations and PTB, Nitrate-Nitrite and Disinfectant Byproducts Stage 2 were both positively associated with PTB. When examining the relationship between individual HB violations and birth outcomes, the total coliform rule was negatively associated with tLBW. These findings indicate that specific drinking water violations, specifically monitoring and reporting, could have a potential negative impact on fetal health.

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