Editorial

An Environmental Cause of Orofacial Cleft Defects or an Unexplained Cluster?

Authors: Dominik D. Alexander, PhD, MSPH

Abstract

The prevalence of orofacial cleft birth defects is approximately 0.5 to 3 per 1000 births worldwide, and rates vary by geographic region, gender, race/ethnicity, and socioeconomic status.1,2 Asian and American-Indian populations are reported to have the highest frequency of cleft defects, followed by Caucasian populations and African-Americans.2 Several potential causal factors have been identified, including genetic syndromes, gene-environment interactions, and prenatal maternal exposures such as medication, alcohol, smoking, occupational and environmental toxins, and in utero nutritional deficiencies.1–3

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References

1. Krapels IP, Vermeij-Keers C, Muller M, et al. Nutrition and genes in the development of orofacial clefting. Nutr Rev 2006;64:280–288.
 
2. Murray JC. Gene/environment causes of cleft lip and/or palate. Clin Genet 2002;61:248–256.
 
3. Bille C, Skytthe A, Vach W, et al. Parent's age and the risk of oral clefts. Epidemiology 2005;16:311–316.
 
4. Cech I, Burau K, Walston J,. Spatial distribution of orofacial cleft defect births in Harris County, Texas, 1989–1994, and historical evidence for the presence of low-level radioactivity in tap water. South Med J 2007;100:560–569.
 
5. U.S. Environmental Protection Agency. Toxic Release Inventory (TRI) Program. Available at: http://www.epa.gov/tri/index.htm.
 
6. Conley FL, Thomas RL, Wilson BL. Measurement of volatile organic compounds in the urban atmosphere of Harris County, Texas, USA. J Environ Sci Health A Tox Hazard Subst Environ Eng 2005;40:1689–1699.