Original Article
Spatial Distribution of Orofacial Cleft Defect Births in Harris County, Texas, 1990 to 1994, and Historical Evidence for the Presence of Low-level Radioactivity in Tap Water
Abstract
Background: While both ionizing and nonionizing radiation are known to impair human reproductive capacity, the role of low-level domestic radiation continues to be an unsettled issue.
Objectives: We examined the geostatistical distribution (residential longitude and latitude) of orofacial cleft birth cases adjusted for the underlying population distribution. Furthermore, we examined the cleft birth rates enumerated by zip codes for possible associations with levels of radium and radon in drinking water.
Methods: Cleft births and unaffected live births in Harris County, Texas, from 1990 to 1994, were geocoded by residential addresses and tested for spatial clusters using the space-time clustering program SaTScan. Historical sample data on local variations in water quality facilitated the assessment of the association of orofacial cleft defect births with low-level radiation exposure.
Results: A cluster of significantly greater than expected numbers of cleft defect births was identified in northwest Harris County, (relative risk = 3.0, P = 0.043), where the presence of elevated levels of radium (>3 pCi/L) and radon (>300 pCi/L) in the tap water has been known since the 1980s.
Conclusions: Despite the ecological design of the study, lacking individual exposure measurements for cleft birth residences, there was strong suggestive evidence of an association between elevated radiation levels in tap water and elevated cleft birth prevalence rates by zip codes. Attention of physicians is invited to environmental causes as potential risk factors for orofacial cleft. This would aid in genetic counseling and the development of future preventive measures.
Key Points
* Rapid urban expansion involves the risk of encroachment into areas where previous land uses might not have been fully compatible with the development of residential water wells.
* Attention of physicians is invited to radium and radon as unsuspected and unnecessary health risk factors in some tap water.
* A cluster of significantly greater numbers of cleft defect births relative to the total numbers of live births has been documented in the northwest part of Harris County, Texas, where elevated levels of radium and radon have been known since the 1980s.
* Geographic areas with a high probability of exposure to elevated levels of domestic radiation need to be targeted for studies of cleft and other cranioskeletal birth defects.
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