B12, chlorine in water - and birth defects

[Korn]

http://www.garynull.com/Documents/er...ated_water.htm

RACHEL'S ENVIRONMENT & HEALTH NEWS




The information on this website is not a substitute¾
or diagnosis and treatment by a qualified, licensed professional.


This document was provided by:
Rachel's Environmental & Health Weekly
Environmental Research Foundation
P.O. Box 5036, Annapolis, MD 21403
Phone (410) 263-1584; Fax (732) 791-4603
E-mail: erf@rachel.org


There were just over 4 million live births in the U.S. in 1992 (4,065,000, to be exact), according to the STATISTICAL ABSTRACT OF THE UNITED STATES 1997.[1] In addition to these live births, there were 30,000 fetal deaths in 1992, the most recent year for which we have data.[2] A fetal death is one that occurs after at least 20 weeks of gestation in the womb but prior to birth. In actuality, there were very likely more than 30,000 fetal deaths in 1992. The STATISTICAL ABSTRACT (table 124) says, "There is substantial evidence that not all fetal deaths for which reporting is required are reported." In any case, life expectancy at birth in the U.S. in 1992 was 75.8 years,[3] so fetal deaths that year resulted in the loss of at least 30,000 x 75.8 = 2.27 million person-years of life. In addition, of course, many of these 30,000 fetal deaths precipitated a personal crisis for the parents.


In addition to fetal deaths, there are spontaneous abortions -- pregnancies that terminate spontaneously before the end of the 20th week of gestation. These are far more common than fetal deaths, though the exact number is not known. Various studies estimate that spontaneous abortions occur in somewhere between 6.5% and 21% of all pregnancies.[4] Thus in 1992, there may have been at least 265,000 to 855,000 spontaneous abortions in the U.S.


Together, spontaneous abortions and fetal deaths are termed "miscarriages."


Recent studies indicate that some miscarriages --as well as some serious birth defects --may be caused by the chlorine added to drinking water as a disinfectant.


In the U.S., chlorine is added to public drinking water supplies as a public health measure to kill harmful bacteria in the water. The added chlorine reacts with naturally-occurring organic matter in the raw water (chiefly humic and fulvic acids), creating a host of chlorinated chemicals as by-products. Health agencies, including the federal EPA [Environmental Protection Agency] simply ignore most of these by- products and know almost nothing about them. Instead, they focus on four by-products, allowing these four to act as surrogates for all the others. The four that EPA pays attention to are chloroform, bromoform, bromodichloromethane, and chlorodibromomethane. Together, these four are called "trihalomethanes" or THMs. According to federal drinking water regulations, if a public water supply serving over 10,000 people contains more than 100 parts per billion (ppb) of total trihalomethanes, the water is unacceptable. However, since there are usually no other available sources of drinking water, EPA is usually not in a position to do anything except urge the water supplier to try to clean up its act.


A study by the California Department of Health published in March, 1998, tracked the drinking water consumption and the pregnancy outcomes of 5144 pregnant women in a prepaid health plan during the period 1989- 1991.[5] This was a prospective study --the drinking water consumption of the women was ascertained as soon as their pregnancy was registered in the study's database. Later, the outcome of their pregnancy was compared with the amount of water they drank and the total amount of trihalomethanes they received by drinking water (information received from the water companies). The study found that 16% of women drinking 5 or more glasses of water per day containing more than 75 ppb THMs had miscarriages, whereas only 9.5% of women drinking less water, or water lower in THMs, had miscarriages. Thus among women with high exposure to THMs in drinking water, the likelihood of spontaneous abortion was 1.8 times as great as it was among women with low exposure. Furthermore, spontaneous abortion occurred, on average, a week earlier among women with high exposure (10.2 vs. 11.2 weeks of gestation). The strength of this study was its prospective nature; it did not rely on women to remember how much water they drank in the past.


To see if their results represented a real effect, the researchers compared women who filtered their water, or who let the water stand before drinking it, with women who drank it straight from the tap. (THMs are volatile and will slowly leave water that is allowed to stand.) The results were consistent with THMs causing spontaneous abortion.


In January of this year, the Agency for Toxic Substances and Disease Registry published a case-control study showing that serious birth defects --spina bifida, or neural tube defects --are associated with total trihalomethanes ingested in drinking water.[6] Neural tube defects are serious birth defects in which the spinal cord is not properly enclosed by bone.


This statewide study in New Jersey found a doubled risk of neural tube defects among those with the highest exposures to THMs in drinking water. This study pointed out that exposure to THMs can also occur through the contamination of indoor air. Flushing toilets, showering, and washing dishes and clothes, can inject THMs into household air, exposing residents.


A previous study of 75 New Jersey towns by Frank Bove had examined 80,938 live births and 594 fetal deaths that occurred during the period 1985-1988. This study examined public water company records and compared pregnancy outcomes to the amounts of THMs delivered to the home in drinking water. It did not examine the amount of water ingested. The study found no relationship to fetal deaths, but the likelihood of neural tube defects was tripled by exposure to THMs at levels exceeding 80 parts per billion.


This study provoked a letter to the editor of the AMERICAN JOURNAL OF EPIDEMIOLOGY,[8] in which the authors suggested a biological mechanism by which trihalomethanes might cause neural tube defects. Neural tube defects are known to be associated with vitamin B12 deficiency and the letter pointed to studies showing that vitamin B12 use by the body can be disrupted by chloroform, one of the four main trihalomethanes in chlorinated drinking water.


An even earlier case-control study reported on pregnancy outcomes among women who delivered babies at Brigham and Women's Hospital in Boston during the years 1977-1980. Indicators of water quality were taken from public water supply companies. No data were available on the amount of water ingested. The water quality indicators were compared among 1039 cases of babies born with birth defects, 77 stillbirths, and 55 neonatal deaths (babies that died within a week of birth) vs. 1177 controls. Stillbirths were 2.6 times as common among women exposed to chlorinated surface water, compared to controls whose water was disinfected with chloramine instead of chlorine.[9]


More recently, a study of drinking water and pregnancy outcomes in central North Carolina reported a 2.8-fold increased likelihood of miscarriage among women in the highest exposure group for trihalomethanes in drinking water.[10]


Very recently, a second study from the California Department of Health has shown that, in one area of California, women who drank cold tap water had nearly a five-fold increased risk of miscarriage, compared to women who drank mostly bottled water very low in trihalomethanes.[11] Bottled water is often disinfected by a process called ozonation instead of chlorination. Bubbling ozone through water kills bacteria effectively, avoids the distinctive taste and odor of chlorine in the treated water, and produces no dangerous trihalomethanes. Many people buy bottled water simply to avoid the taste of chlorine.


U.S. EPA is currently setting new standards for trihalomethanes in drinking water. The new regulations would apply to all water companies, not just those serving 10,000 people or more, and they would limit total THMs to 80 ppb, down from the present 100 ppb.[12] Still, since several studies link trihalomethanes at 75 ppb or even less to increased miscarriages, EPA's new standard seems dubious even before it has been established.


American water suppliers seem stuck on chlorination as the best way to disinfect drinking water. However, many European cities, and some Canadian cities, such as Ottawa, have long ago turned away from chlorination in favor of ozonation to disinfect their water. In recent years, a few smaller American cities have begun to use ozonation: Emporia, Kansas and Littleton, Massachusetts, for example. The Santa Clara Valley Water District in California has announced that it is switching to ozonation over the next 5 to 8 years, as has the city of Las Vegas, Nevada.


Still the vast majority of water supplies in the U.S. remain chlorinated. And water quality experts remain in the dark about trihalomethane levels in water delivered to customers. Kellyn S. Betts, writing in ENVIRONMENTAL SCIENCE & TECHNOLOGY quotes the EPA official in charge of the new THM regulations saying no one knows how many U.S. water systems deliver water with THMs exceeding 75 ppb.[12] Betts says the American Waterworks Association confirmed for her the absence of data on THM levels in U.S. drinking water systems. The current reporting system only keeps track of water systems that exceed 100 ppb as an annual average.


Erik Olson, a water quality expert with the Natural Resources Defense Council (NRDC), an environmental group in New York City, points out that THM levels in water supplies typically increase by as much as a factor of 1.5 to 2 during the summer months. And he says short-term exposures may be very important in producing some of the pregnancy outcomes reviewed here --spontaneous abortions, fetal deaths, and serious birth defects. "We may be totally overlooking the risk of short- term exposure," Olson said.[12]


--Peter Montague (National Writers Union, UAW Local 1981/AFL-CIO)



[1] STATISTICAL ABSTRACT OF THE UNITED STATES 1997 [117th edition] (Washington, D.C.: U.S. Government Printing Office, October, 1997). See Table 88.


[2] The STATISTICAL ABSTRACT for 1997, cited above, Table 123, says there were 7.4 fetal deaths per 1000 live births in 1992, so the total number of fetal deaths that year was 7.4 * 4,065 = 30,000.


[3] STATISTICAL ABSTRACT for 1997, cited above, table 117.


[4] S. Hamamah and others, "The effect of male factors in repeated spontaneous abortion: lessons from in-vitro fertilization and intracytoplasmic sperm injection," HUMAN REPRODUCTION UPDATE Vol. 3, No. 4 (July 1997), pgs. 393-400.


[5] Kirsten Waller and others, "Trihalomethanes in Drinking Water and Spontaneous Abortion," EPIDEMIOLOGY Vol. 9, No. 2 (March 1998), pgs. 134-140.


[6] Judith B. Klotz and Laurie A. Pyrch, A CASE-CONTROL STUDY OF NEURAL TUBE DEFECTS AND DRINKING WATER CONTAMINANTS (Atlanta, Ga.: Agency for Toxic Substances and Disease Registry, January, 1998).


[7] Frank L. Bove and others, "Public Drinking Water Contamination and Birth Outcomes," AMERICAN JOURNAL OF EPIDEMIOLOGY Vol. 141, No. 9 (May 1, 1995), pgs. 850-862.


[8] Andrew T. L. Chen and others, "RE: 'Public Drinking Water Contamination and Birth Outcomes,'" AMERICAN JOURNAL OF EPIDEMIOLOGY Vol. 143, No. 11 (June 1, 1996), pgs. 1179-1180.


[9] Ann Aschengrau and others, "Quality of Community Drinking Water and the Occurrence of Late Adverse Pregnancy Outcomes," ARCHIVES OF ENVIRONMENTAL HEALTH Vol. 48, No. 2 (March/April 1993), pgs. 105-113.


[10] David A. Savitz and others, "Drinking Water and Pregnancy Outcome in Central North Carolina: Source, Amount, and Trihalomethane Levels," ENVIRONMENTAL HEALTH PERSPECTIVES Vol. 103, No. 6 (June 1995), pgs. 592- 596.


[11] Shanna H. Swan and others, "A Prospective Study of Spontaneous Abortion: Relation to Amount and Source of Drinking Water Consumed in Early Pregnancy," EPIDEMIOLOGY Vol. 9, No. 2 (March 1998), pgs. 126- 133.


[12] Kellyn S. Betts, "Miscarriages associated with drinking water disinfection byproducts, study says," ENVIRONMENTAL SCIENCE & TECHNOLOGY [ES&T] April 1, 1998, pgs. 169A-170A.



Rachel's Environment & Health Weekly is a publication of the Environmental Research Foundation, P.O. Box 5036, Annapolis, MD 21403 .. Fax (410) 263-8944; Internet: erf@rachel.org. Back issues available by E-mail; to get instructions, send E-mail to INFO@rachel.org with the single word HELP in the message; back issues also available via ftp from ftp.std.com/periodicals/rachel, from gopher.std.com, from http://www.rachel.org. Subscriptions are free. To subscribe, E-mail the words SUBSCRIBE RACHEL-WEEKLY YOUR NAME to: listserv@rachel.org NOTICE: Environmental Research Foundation provides this electronic version of RACHEL'S ENVIRONMENT & HEALTH WEEKLY free of charge even though it costs our organization considerable time and money to produce it. We would like to continue to provide this service free. You could help by making a tax-deductible contribution (anything you can afford, whether $5.00 or $500.00). Please send your tax-deductible contribution to: Environmental Research Foundation, P.O. Box 5036, Annapolis, MD 21403-7036. Please do not send credit card information via E-mail. For further information about making tax-deductible contributions to E.R.F. by credit card please phone us toll free at 1-888-2RACHEL. --Peter Montague, Editor

[Korn]

154 women in Chesapeake, VA, have recently filed suit against the city claiming that spikes in the amount of the disinfection by-products (DBPs) in their water caused their pregnancies to terminate in miscarriages in the 1980s and 1990s. They seek $1 billion in damages.
Municipal disinfection of drinking water has brought a century of health benefits in reducing illness from pathogenic biological contaminants such as virus and bacteria. For decades, scientists have however also warned about the dangers to health of (DBPs) more specifically of the type Trihalomethanes – THMs.
The links between THMs and cancer have been studied for decades and according to a recent report from National Resources Defence Council (NRDC), an environ-mental group in New York City, about 10,700 bladder and rectal cancers in the US may each year be associated with THMs and other DBPs. That translates into about thirty cancers per day in the US.
During the last decade dozens of studies have shown that THMs also increase the risk for birth defects and miscarriages. The results of the studies are particu-larly disturbing because pregnant women are often advised by physicians to drink a lot of fluids.
A review article of these findings published in 2002 by Bove et al. in Environmental Health Perspectives 110 finds that moderate associations were found between expo-sure to THMs and effects such as small fetal size for gestational age, neural tube defects and spontaneous abortion.
Now water utilities and health officials are therefore trying to balance concern for threats to public health from infections caused by too little disinfectants against the risk of birth defects, miscarriages and cancer from too much disinfectants.
Even though the adverse effects of chlorination have been known for decades and despite pressure to consider alternative options, most water treatment facilities still use chlorine as their primary disinfectant. Results from a survey made in 2002 by the Chlorine Chemistry Council (CCC) to 350 professionals, representing utilities of varying size, show that all surveyed water treatment plants reported to use some form of chlorine as the primary method of disinfection.
Other types of treatment such as ozone (oxidation by O3) and ultraviolet light (UV-lamps) are efficient in killing microbes at the treatment plant, but will have no resid-ual effect, i.e. on microbes that enter the water after it leaves the treatment plant.
Whatever treatment the plant chooses for the primary treatment, chlorine has to be added to the purified water to protect it from contamination while it travels through the pipes of the distribution system. The chlorine that is added to the purified water is called residual chlorine.
Residual chlorine reacts with naturally-occurring organic matter in the raw water (chiefly humic and fulvic acids), creating a host of chlorinated chemicals as by-products, called Disinfection By Products (DBPs). The four DBPs that normally are
2used as markers for measuring hazards from DBPs are chloroform, bromoform, bromodichloromethane and chlorodibromomethane. Together, these four are called "Trihalomethanes" or THMs. The United States Environmental Protection Agency (EPA) has reported that THMs are present in virtually all chlorinated water sup-plies.
EPA regulates public water systems serving over10,000 people for THMs but only keeps track of water systems that exceed 100 ppb (parts per billion) as an annual average. There are therefore many hidden cases of excessive THM levels.
In 1998 the San Francisco Public Utilities Commission (SFPUC) and the San Fran-cisco Department of Public Health wrote a special report to warn women of child bearing age for possible harmful effects of THMs in drinking water. Women of child bearing age were recommended to lower the amount of THM ingested by either boiling the water, use home treatment devices or purchase bottled water.
Since SFPUC found that previous studies of the relationship between tap water and miscarriage were not definitive, they studied 5,144 pregnant women living in three areas of California. Women in the study who were exposed to high levels of THMs in their drinking water during their first trimester of pregnancy were found to be 2-3 times more at risk of miscarriage than other women in the study who were exposed to lower levels of THMs. Other factors that are known to cause increased miscar-riages - age, smoking and a history of past miscarriages - were taken into account in the study and were not found to explain the difference.
In the study, high personal exposure was defined as drinking 5 or more glasses of water a day, with the water containing an average THM level at or above 75 parts per billion (ppb) of THMs.
Although the San Francisco study, which was made in 1998, was widely distributed, water utilities did not seem to bother at that time. But things may be about to change after the $1 billion suit against the Chesapeake utilities is decided.
Also in 1998, the Agency for Toxic Substances and Disease Registry published a case-control study showing that serious birth defects -- spina bifida, or neural tube defects -- are associated with total THMs ingested in drinking water.
Neural tube defects are serious birth defects in which the spinal cord is not properly enclosed by bone. Neural tube defects are known to be associated with vitamin B12 deficiency and the study pointed to studies showing that vitamin B12 use by the body can be disrupted by chloroform, one of the four main THMs in chlorinated drinking water.
A previous study of 75 New Jersey towns by Frank Bove had examined 80,938 live births and 594 fetal deaths that occurred during the period 1985-1988. This study examined public water company records and compared pregnancy outcomes to the amounts of THMs delivered to the home in drinking water. The study found that the likelihood of neural tube defects was tripled by exposure to THMs at levels ex-ceeding 80 parts per billion.
3More recently, in 1995, a study of drinking water and pregnancy outcomes in central North Carolina reported a 2.8-fold increased likelihood of miscarriage among women in the highest exposure group for THMs in drinking water.
There are still many data gaps in the reproductive toxicology of THMs, but apart from miscarriages and spinal tube effects, studies indicate that THMs also seem to increase embryo resorption rates and sperm abnormalities.
Since THMs normally are reported as annual or monthly averages, short-term expo-sure to spiked THM levels may easily be overlooked. Erik Olson, a water quality expert with the Natural Resources Defense Council (NRDC), points out that THM levels in water supplies typically increase by as much as a factor of 1.5 to 2 during the summer months. And, he says, short-term exposures may be very important in pro-ducing spontaneous abortions, fetal deaths and serious birth defects.
The lawsuit in Cheasapeke alleges that the city did not inform the residents that levels of THMs sometimes spiked more than 10 times above supposedly safe levels. It is a landmark case in the issue over THMs, and is of course being watched closely by all water utilities.
It will be difficult for water authorities to handle the consequences of this law suite and potential follow up suits. It is well known that the amount of THMs will vary as the amounts of organic contaminants vary in the water and it will also vary from point to point in the distribution system. For instance, for it to last all the way, the dosage of chlorine must be much higher in the beginning of the water supply system than at the far end.
Reducing total amount of chlorination will also reduce THMs, but then there are even greater health dangers, caused by organic pathogens in the water. Other means of disinfecting water have also been tried, but each seems to carry a specific negative effect on health with it, either by not being sufficiently reliable or by pro-ducing other dangerous by-products. In sum, there are ways of reducing the danger, but not to eliminate it.
So, in the end, the only way out for the utilities is to warn people to be careful in their use of tap water, but this may lead to people drinking less water overall and that may be the worst damage to health of all.
In a recent public opinion survey by Orange County Water District (OCWD) in California, 75 percent of 500 registered voters in the OCWD service area said they would pay higher rates to increase reliability of their water. Safety was however more of a concern than cost and reliability of the water.
Those surveyed do not believe the current supply of water is unsafe, but they support efforts to address safety concerns, such as safeguarding against droughts and pipe-line breaks. 70 percent said they are satisfied with the quality of Orange County's tap water, although nearly 75 percent either drink bottled water or filtered water “for the taste”.
In most places of the world, people will say that their tap water is acceptable, but at the same time fewer and fewer drink it. So what can one do to avoid THMs and still keep up the consumption of water?
4
Boiling the water in a pot is not enough. Chlorine will boil off quickly, which is good, but even after five minutes of boiling only about 30 percent of THMs are removed. An electric water kettle with at least 2000 watts will however get rid of more than 50 percent of the THMs, while heating the water in a microwave oven will remove less than 15 percent.
Normal household water purification devises containing active carbon or reverse osmosis filters typically get rid of about 50% of the THMs. Buying bottled water may do the trick if one is careful. However, one must then avoid buying bottled water that is based on purified tap water, which may still contain THMs. Some bottles have been shown to contain higher amounts of THMs than ordinary tap water.
All major cities in the world are facing increasing difficulties in providing good drinking water to their citizens through the tap. This is primarily not because there is no good technology available for purifying the water. It is mainly because it is diffi-cult to distribute the water to the consumer without it being contaminated.
All pipes leak after a while. Under normal circumstances, the pressure in the clean water pipes prevents intrusion, but contamination occurs whenever there is a pres-sure drop. A recent report in February 2002 from School of Public Health at Har-vard University shows that the renovation of US municipal water systems needed to prevent waste water to get into the drinking water would cost 141 billion US dollars. Quite probably an impossible sum to finance. The situation is similar in all countries where large municipal underground water distribution systems have been built.
Although some cities are making improvements in the distribution system from time to time, there is no room in any city's budget to revamp the entire water piping sys-tem. And even with a completely renovated system, residual disinfectants are always needed to protect the water from biological contamination, and therefore there will always be dangerous THMs in the tap water.
The building of huge underground piping systems for water was a very good idea when it was done some hundred years ago or more, because it virtually obliterated cholera, typhus and a host of other nasty illnesses that were caused by water-borne bugs. As it turns out, however, it was a one shot measure that will have to be phased out for something more practical and affordable.
What we see in the future is either “distributed” water purification plants where the transmission system of water is small enough to be manageable or larger systems that produce water of good quality for watering, washing and cleaning but are cplemented by either Point-of Entry (POE) water purification devices, i.e. for the whole house, or Point-of-Use (POU) water purification devices which purify, or rather polish, just the water you want to drink. om-
Selected references for the Editor
Bove F, et al. Drinking water contaminants and adverse pregnancy out-comes: A review. Environmental Health Perspectives 110 (Suppl 1):61-74 (2002).
5A recent review article presents evidence linking maternal exposure to drink-ing water contaminants and increased risk of adverse birth outcomes. The review specifically examined the epidemiologic evidence for disinfection by-products (formed when chlorine reacts with organic matter during water treatment and distribution) and chlorinated solvents in drinking water. Mod-erate associations were found between exposure to trihalomethanes, a class of disinfection by-products, and effects such as small fetal size for gestational age, neural tube defects, and spontaneous abortion. … the evidence raises important concerns for the health effects of these drinking water contami-nants on both mother and child.
Aschengrau, A., S. Zierler and A. Cohen (1993). "Quality of community drinking water and the occurrence of late adverse pregnancy outcomes." Arch Environ Health 48(2): 105-13. Abstract: The relationship between community drinking water quality and the occurrence of late adverse preg-nancy outcomes was investigated by conducting a case-control study among women who delivered infants during August 1977 through March 1980 at Brigham and Women's Hospital in Massachusetts. Among the babies of 2,348 Massachusetts women, researchers found increased rates of stillbirth, neona-tal deaths, major congenital malformations, and respiratory and urinary tract defects associated with mothers drinking from disinfected public water sup-plies
Bove, F. J., M. C. Fulcomer, J. B. Klotz, et al. (1995). "Public drinking water contamination and birth outcomes." Am J Epidemiol 141(9): 850-62. Ab-stract: The effects of public drinking water contamination on birth outcomes were evaluated in an area of northern New Jersey. After excluding plural births and chromosomal defects, 80,938 live births and 594 fetal deaths that occurred during the period 1985-1988 were studied. contamination databases. The babies showed increased risk of low weight, central nervous system de-fects, neural tube defects, major cardiac defects, and oral cleft defects when their mothers drank tap water with high levels of THMs (>100 ppb) based on quarterly measurements
Dodds, L., W. King, C. Woolcott and J. Pole (1999). "Trihalomethanes in public water supplies and adverse birth outcomes." Epidemiology 10(3): 233-7. Abstract:
A retrospective cohort study to evaluate the relation between the level of to-tal trihalomethanes in drinking water and adverse birth outcomes. The study population comprised women residing in an area with municipal surface wa-ter who had a singleton birth in Nova Scotia between January 1, 1988, and December 31, 1995, or a pregnancy termination for a major fetal anomaly. The study included 49,842 birthsand found a drop in gestational size, and an increased risk of stillbirth, chromosomal abnormalities, and neural tube de-fects associated with a mother's drinking tap water with high levels of THMs
Gallagher, M. D., J. R. Nuckols, L. Stallones and D. A. Savitz (1998). "Expo-sure to trihalomethanes and adverse pregnancy outcomes." Epidemiology
69(5): 484-9. Performed a retrospective cohort study to examine the relation of trihalomethane exposure during the third trimester of pregnancy to low birthweight, term low birthweight, and preterm delivery. Colorado birth cer-tificates from January 1, 1990, through December 31, 1993, were matched to historical water sample data with respect to time and location of maternal residence based on census block groups. Researchers found increased risk of low birth weight associated with a mother's ingestion of high THMs in tap water during the last trimester of pregnancy
Kanitz, S., Y. Franco, V. Patrone, et al. (1996). "Association between drinking water disinfection and somatic parameters at birth." Environ Health Per-spect 104(5): 516-20.
An epidemiological study in Liguria, Italy, on the association between so-matic parameters at birth and drinking water disinfection with chlorine diox-ide and/or sodium hypochlorite. Over 2 years (1988-1989), 676 births at two public hospitals, one in Genoa (548 cases) and another in Chiavari (128 cases) were examined and data regarding both mother and child were ob-tained from hospital records. Researchers found increased rates of neonatal jaundice, low birth weight, small body length, and small heads associated with a mother's ingestion of disinfected tap water
Klotz, J. B. and L. A. Pyrch (1999). "Neural tube defects and drinking water disinfection by-products." Epidemiology 10(4): 383-90.
A population-based case control study of neural tube defects and drinking water contaminants, specifically, disinfection by- products which used public monitoring records concurrent with the first month of gestation to assess exposure. Researchers found that among 360 pregnant women studied, babies were twice as likely to have neural tube defects for tap water with greater than 40 ppb THMs than for mothers drinking water with less than 5 ppb THMs
Kramer, M. D., C. F. Lynch, P. Isacson and J. W. Hanson (1992). "The asso-ciation of waterborne chloroform with intrauterine growth retardation." Epi-demiology 3(5): 407-13.
Studied the association of waterborne chloroform with low birthweight (less than 2,500 gm), prematurity (less than 37 weeks gestation), and intrauterine growth retardation (less than 5th percentile of weight for gestational age). The study included 4,028 pregnancies among Iowa women and shows low newborn weight (intrauterine growth retardation) for babies whose mothers drank tap water containing at least 10 ppb of THMs through pregnancy.
King, W. D., L. Dodds, and A. C. Allen (2000). "Relation between Stillbirth and Specific Chlorination By-Products in Public Water Supplies." Environ-mental Health Perspectives 108(9).
Among nearly 50,000 births in Nova Scotia between 1988 and 1995, research-ers found the risk of stillbirth to be nearly double among pregnancies exposed to 20 ppb of a single chlorination byproduct called bromodichlromethane, compared to pregnancies exposed to low concentrations
7ro-
Magnus, P., J. J. Jaakkola, A. Skrondal, et al. (1999). "Water chlorination and birth defects." Epidemiology 10(5): 513-7.
Linked the Norwegian waterwork registry, containing 1994 data on chlorina-tion practice and color (an indicator for natural organic matter), with the Medical Birth Registry for 1993-1995. The proportion of the population ex-posed to chlorination and a weighted mean color number in drinking water was computed for each municipality. Among 141,077 births in Norway, a mother's reliance on a chlorinated tap water supply was linked to increased rates of all birth defects, urinary tract defects, neural tube defects, major car-diac defects, and respiratory tract defects
Savitz, D. A., K. W. Andrews and L. M. Pastore (1995). "Drinking water and pregnancy outcome in central North Carolina: source, amount, and triha-lomethane levels." Environ Health Perspect 103(6): 592-6.
Using data from a case-control study of miscarriage, preterm delivery, and low birth weight in central North Carolina, risks associated with water source, amount, and trihalomethane (THM) concentration were evaluated. The study included 1003 pregnant women and found elevated rates of miscarriage and low birth weight among women drinking high levels of THMs, based on quarterly monitoring from their water suppliers
Waller, K., S. H. Swan, G. DeLorenze and B. Hopkins (1998). "Triha-lomethanes in drinking water and spontaneous abortion." Epidemiology 9(2): 134-40.
Examined exposure to trihalomethanes and spontaneous abortion in a pspective study of 5,144 pregnant women in a prepaid health plan. Seventy-eight drinking water utilities provided concurrent trihalomethane sampling data. Total trihalomethane levels were calculated by averaging all measure-ments taken by the subject's utility during her first trimester. In a population of 5,144 pregnant women from California, researchers found increased risk of spontaneous abortion associated with high THM levels, with the highest risks associated with bromodichloromethane in particular
Aapo Sääsk 2002-09-09
Nybrogatan 12 Tel: +468 660 39 70
SE-114 39 Stockholm Fax: +468 662 96 18
Sweden E-post: aapo@scarab.se
Internet: www.scarab.se

[kokopelli]

We collect enough rainwater for a family of five from an ordinary-sized house roof. We have to do this, because there is no mains water supply here. It's stored in 1,500 litre recycled orange juice containers. Admittedly these take up quite a lot of space. It's treated with filters and a UV light unit. Anyone with enough rainfall and space for the storage containers could do the same, and avoid all the crap that ends up in municipal water supplies.

[Korn]

More about chlorinated water from http://www.yourwholenutrition.com/readon.asp?id=118 :

Rethinking Chlorinated Tap Water
By Dr. Zoltan P. Rona MD MSc

Chlorinated water can destroy polyunsaturated fatty acids and vitamin E in the body while generating toxins capable of free radical damage (oxidation). This might explain why supplementation of the diet with essential fatty acids like flax seed oil, evening primrose oil, borage oil and antioxidants like vitamin E, selenium and others helps so many cases of eczema and dry skin.

Chlorinated water destroys much of the intestinal flora, the friendly bacteria that help in the digestion of food and which protect the body from harmful pathogens.

He also quotes what some other sources say about showering (!) with chlorinated water. If only 20% of this is true, it's still pretty scary, and not good news re. the effect water chlorination has on our B12 levels....

"Taking showers is a health risk, according to research presented last week in a meeting of the American Chemical Society. Showers - and to a lesser extent baths - lead to a greater exposure to toxic chemicals contained in water supplies than does drinking water. The chemicals evaporate out of the water and are inhaled. They can also spread through the house and be inhaled by others." New Scientist -18 September 1986, Ian Anderson

"The cause of atherosclerosis and resulting heart attacks and strokes is none other than the ubiquitous chlorine in our drinking water." - Coronaries/Cholesterol/Chlorine - Dr. J. M. Price, M. D.

"Skin absorption of contaminant has been underestimated and ingestion may not constitute the sole or even primary route of exposure." - American Journal of-Public Health - Dr. Halina Brown

"Showering is suspected as the primary cause of elevated of chloroform in nearly every home because of the chlorine in the water." - Environmental Protection Agency - Dr. Lance Wallace

"A Professor of Water Chemistry at the University of Pittsburg claims that exposure to vaporized chemicals in the water supplies through showering, bathing, and inhalation is 100 greater than through drinking the water."

The Nader Report,Troubled Waters on Tap - Center for Study of Responsive Law "The National Academy of Sciences estimate that 200 to 1000 people die in the United States each year from cancers caused by ingesting the contaminants in water. The major health threat posed by these pollutants is far more likely to be from their inhalation as air pollutants. The reason that immisions are high is because water droplets dispersed by the shower head have a larger surface-to-value ratio than water streaming into the bath." Science News-Vol. 130, Janet Raloff

"People who shower frequently could be exposed through ingestion, inhalation and/or dermal absorption. Volatile organics can evaporate from water in a shower or bath. Conservative calculations indicate that the inhalation exposures can be as significant as exposure from drinking; that is, one can be exposed to just as much by inhalation during a shower as by drinking 2 liters of water a day." Is your Water Safe to Drink? - Consumer Reports Books

"A long, hot shower can be dangerous. The toxic chemicals are inhaled in high concentrations." Bottom Line - August 1987, Dr. John Andelman, Ph. D.

"Ironically, even the Chlorine widely used to disinfect water produces Carcinogenic traces. Studies indicate the suspect chemicals can also be inhaled and absorbed through the skin during showering and bathing." U. S. News & World Report - 29 July 1991, Is your Water Safe - The Dangerous State of Your Water H2O & Cancer article

[Korn]

It's known that if a woman has too low levels of folic acid (FA) at the moment she becomes pregnant, there is an increased risk of birth defects. It's also important not to have too low B12 levels. Vegans have lower levels of B12 than meat eaters, meat eaters have lower levels of folic acid than vegans.

This article discuss the relationship between folic acid, B12 and birth defects:

The Efficacy of Vitamin B6, B12 and Betaine in Prevention of Congenital Anomalies

While FA peri-conceptional supplement is universally agreed as essential for reducing NTDs and very likely also other types of congenital anomalies, the role of Vitamins B6, B12 and betaine is questionable. In theory, the potential role of vitamin B12 in preventing NTDs and other congenital anomalies is explicable by its metabolism. Vitamin B12 interacts with FA in the remethylation of homocysteine to methionine (see Figure), a key metabolic reaction in the function of FA. Indeed, there are some hints that Vitamin B12 has a role in the prevention of NTDs. Three independent studies have shown significantly lower levels of vitamin B12 in the plasma41 and amniotic fluid (42,43) in pregnancy of newborns with NTDs, compared with controls.


On the same theoretical background, betaine and vitamin B6 may also have a role in the prevention of NTD. Betaine acts as another methyl group donor in the conversion of homocysteine to methionine (see Figure), while vitamin B6 is a cofactor to cysthationase, an enzyme that degrades cystathione, a degradation product of homocysteine. Thus, both betaine and vitamin B6 act to reduce homocysteine, in parallel to the action of FA. Yet, there is no convincing evidence for the efficacy of vitamin B12, B6 and betaine in the reduction of NTDs. The MRC study demonstrated a non-significant (20%) reduction in the recurrence of NTDs by vitamin supplementation, including these vitamins (12). Presently, vitamin supplements other than FA are not included in the routine regimen of peri-conceptional supplements for the prevention of NTD, but more research is needed to evaluate their efficacy in preventing NTDs and other congenital anomalies.

20% reduction due to intake of B6, B12 and betaine is considered 'non-significant'... it might be non-significant compared with the effect of folic acid, but still very 'significant' for those babies babies born with NTD (neural tube defects) - and their parents...

[Korn]

There are several studies that associate low B12 and folic acid levels with birth defects, and - of course - nobody wants to experiment with birth defects.

Here is a surprising study that did not find a link between vitamin levels and congenital malformations:

http://www.ncbi.nlm.nih.gov/entrez/q...300&query_hl=1

The demonstrated teratogenicity of maternal zinc deficiency in rats has led to burgeoning interest in zinc and other trace elements as important factors in embryonic development. Levels of zinc, copper, manganese, magnesium, folic acid, vitamin B12 and vitamin A were evaluated at the beginning of pregnancy in the plasma of pregnant women who later delivered a malformed newborn. Fetal chromosomal anomalies and recognizable nonchromosomal syndromes were excluded. The results were compared to control women who delivered normal babies. One hundred seventy mothers had malformed children. The more frequent congenital malformations were congenital heart diseases (72 cases including 24 VSD), musculoskeletal malformations (21 cases), urogenital malformations (23 cases), spina bifida (6 cases), hydrocephaly (6 cases), and labial cleft (14 cases). Maternal plasma concentrations of zinc, copper, magnesium, manganese, folate, vitamin B12, and vitamin A of malformed children did not differ from controls. Thus vitamin profiles do not form a suitable means for identifying women at risk for having a child with congenital malformations.

[Korn]

Newfoundland has one of the highest rates of neural tube defects in North America.

Here is a study that shows that the 43.6% of 1424 pregnant women from Newfoundland were B12 deficient (or had marginal levels) at their first prenatal visit (however, the validity of the interpretive criteria for pregnant women is questionable).

[Korn]

This study found that the B12 levels of the neural tube affected pregnancies were below the range of unaffected pregnancies in four of the nine affected pregnancies, and folate levels in two of the nine affected pregnancies.

Amniotic fluid B12 and folate levels associated with neural tube defects.

Dawson EB, Evans DR, Van Hook JW.

Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, 77555-0587, USA.

Amniotic fluid levels of B12 and folate in neural tube defect (NTD) affected pregnancies were compared with the weekly group mean +/-SD changes in amniotic fluid B12 and folate levels of 10 unaffected pregnancies each week between 15 and 20 weeks' gestation age. Comparison was by analysis of variance (ANOVA) and Pearson's correlation to B12 and folate levels and to the NTD samples of corresponding gestation age. Amniotic fluid B12 and folate decreased 67 and 62%, respectively, between 15 and 20 weeks' gestation in the unaffected pregnancies, associated with an increase in amniotic fluid volume. The mean +/-SD B12 and folate of the NTD affected pregnancies (308+/-156 pg/mL and 3.1+/-1.6 ng/mL) were below the mean +/-SD B12 and folate of the total population of unaffected pregnancies (453+/-155 pg/mL and 3.9+/-1.2 ng/mL). The correlation between gestation age and amniotic fluid B12 was -0.9914 (p< or =.0001) and -0.9599 (p< or =.002) for amniotic fluid folate. The B12 levels of the affected pregnancies were below the range of unaffected pregnancies in four of the nine affected pregnancies, and folate levels in two of the nine affected pregnancies.

PMID: 9890246 [PubMed - indexed for MEDLINE]

[Korn]

Here is another study of blood folic acid and vitamin B12 in relation to neural tube defects. Their results are 'consistent with other evidence that folic acid and vitamin B12 levels are lower in women with neural tube defect pregnancies and consistent with evidence from randomised trials which showed that folic acid is protective.'

[Korn]

http://www.ncbi.nlm.nih.gov/entrez/q...561&query_hl=1 :

Homocysteine and neural tube defects.

Mills JL, Scott JM, Kirke PN, McPartlin JM, Conley MR, Weir DG, Molloy AM, Lee YJ.

Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.

It is now well established that folic acid, when taken periconceptionally, can prevent many neural tube defects. It is also becoming clear that folic acid does not work by correcting a nutritional deficiency in pregnant women. Rather, it appears that a metabolic defect is responsible for these neural tube defects and that this defect or defects can be corrected by a sufficiently large dose of folic acid. Our recent work demonstrates that homocysteine metabolism is likely to be the critical pathway affected by folic acid. We have demonstrated significantly higher homocysteine levels in women carrying affected fetuses than in control women. These findings indicate that one of the enzymes responsible for homocysteine metabolism is likely to be abnormal in affected pregnancies. Animal studies suggest that the conversion of homocysteine to methionine could be the critical step. Rat embryos in culture require methionine for neural tube closure. Methionine synthase, cystathionine synthase, and 5,10 methylene tetrahydrofolate reductase are all important in the metabolism of homocysteine in humans. If methionine synthase is the critical enzyme, it would raise the interesting public health issue that vitamin B-12 might be able to stimulate the abnormal enzyme as folic acid does. Adding vitamin B-12 might make it possible to reduce the dose of folic acid required in fortified food, thus allaying concerns about overexposure to folic acid.

[Korn]

http://www.ncbi.nlm.nih.gov/entrez/q...214&query_hl=1 :

olate metabolism and neural tube defects.

Gordon N.

Neural tube defects may due to a number of factors acting on a susceptible embryo. The most widely accepted is a lack of folic acid at a critical time of development. Studies in which folic acid supplements have been given are reviewed. The results of these support the policy of giving folic acid, starting before conception. The metabolism of folate and vitamin B12 is discussed, including specific metabolic disorders; although there is no evidence that these play any part in causing neural tube defects. The special problems that occur among women taking anti-epileptic drugs are also considered. There are slight differences in the recommendations that have been made for supplementation, and further studies are needed before there can be complete agreement.

[Korn]

http://www.ncbi.nlm.nih.gov/entrez/q...375&query_hl=1 :

[Effects of a vegetarian life style on health]

[Article in German]

Ritter MM, Richter WO.

Medizinische Klinik II, Klinikum Grosshadern der Universitat Munchen.

A vegetarian diet has a positive effect on various risk factors for coronary artery disease: these include usually lower average body weight, lower total and LDL cholesterol levels, and lower blood pressure. In conjunction with a generally more healthy way of life (more exercise, less alcohol and tobacco use), vegetarians have roughly 30% reduction in overall mortality. The prevalence of bronchial, colon and breast cancer is also lower. In particular in its strict form (total vegetarianism or veganism), a vegetarian regimen may lead to deficiency disorders, in particular vitamin B12 deficiency, which may occur especially in vegetarian children, pregnant or lactating women. Overall, however, a vegetarian regimen has a more beneficial effect on health than the usual Central European diet.

PMID: 7635375 [PubMed - indexed for MEDLINE]

[Korn]

http://www.ncbi.nlm.nih.gov/entrez/q...797&query_hl=1

Biochemical folate, B12, and iron status of a group of pregnant adolescents accessed through the public health system in southern Ontario.

Gadowsky SL, Gale K, Wolfe SA, Jory J, Gibson R, O'Connor DL.

Division of Applied Human Nutrition, University of Guelph, Ontario, Canada.

PURPOSE: This study was designed to estimate the prevalence of biochemical iron, folate, and vitamin B12 depletion among a group of Canadian pregnant adolescents accessed through the Public Health system. Further, the impact of prenatal supplement use, chronologic age, gynecologic age, living arrangement, main source of income, postpartum custody plan, time of entry into prenatal care, and cigarette smoking on laboratory indices of the three nutrients were determined. METHODS: Fifty-eight adolescents (14.5-19.0 years) were interviewed and blood samples were collected at 36 +/- 2 wk gestation. RESULTS: Thirteen (22%) of the pregnant adolescents had anemia (hemoglobin < 110 g/L) and forty-five (78%) had depleted iron stores (plasma ferritin < 26.6 pmol/L or 12.0 micrograms/L). Twenty-five subjects had plasma B12 values in the sub-optimal range (< 148 pmol/L). Five of the 16 adolescents who infrequently or never consumed a folate-containing supplement had suboptimal erythrocyte folate values. Twenty-four percent of the subjects had hypersegmented neutrophils and of these, all and 71% of subjects had plasma ferritin and B12 concentrations in the suboptimal range, respectively. Self-reported folic acid and B12 supplement intakes were correlated with the corresponding blood values for these nutrients. In contrast, supplement iron use was only weakly, or not at all associated with biochemical indices of iron status. CONCLUSIONS: Data from the present study indicate that plasma B12 and ferritin levels are low in a group of pregnant adolescents. These low values appear to be associated with a high prevalence of hypersegmented neutrophils. Prenatal supplement use appears to reduce the risk of low folate and B12 blood values but not biochemical iron status.

25 out of 48 subjects had plasma B12 values in the sub-optimal range... that's 48%.

[Korn]

http://www.ncbi.nlm.nih.gov/entrez/q...859&query_hl=1 :

Homocysteine metabolism in pregnancies complicated by neural-tube defects.

Mills JL, McPartlin JM, Kirke PN, Lee YJ, Conley MR, Weir DG, Scott JM.

Pediatric Epidemiology Section, NICHD, NIH, Bethesda, MD 20892.

Folic acid taken around the time of conception can prevent many neural-tube defects. Women with low-normal vitamin B12 values may also be at increased risk. We considered whether homocysteine metabolism via the enzyme methionine synthase, which requires both folate and B12, could be the critical defect in folate-related neural tube defects. Blood was obtained during pregnancies that produced 81 infants with neural-tube defects and 323 normal children. Samples were assayed for homocysteine, methylmalonic acid, plasma folate, red-cell folate, and B12. Mothers of children with neural-tube defects had significantly higher homocysteine values (8.62 [SD 2.8] mumol/L) than did B12-matched controls (7.96 [2.5] mumol/L, p = 0.03). The difference was significant (p = 0.004) in the lower half of the B12 distribution after adjusting for plasma folate. Our study shows that an abnormality in homocysteine metabolism, apparently related to methionine synthase, is present in many women who give birth to children with neural-tube defects. Overcoming this abnormality is likely to be the mechanism by which folic acid prevents neural-tube defects. These findings suggest that the most effective periconceptional prophylaxis to prevent neural-tube defects may require B12 as well as folic acid.

PMID: 7741859 [PubMed - indexed for MEDLINE]

[Korn]

http://www.ncbi.nlm.nih.gov/entrez/q...368&query_hl=1 :

Iron, vitamin B-12 and folate status in Mexico: associated factors in men and women and during pregnancy and lactation.

Black AK, Allen LH, Pelto GH, de Mata MP, Chavez A.

Department of Nutritional Sciences, University of Connecticut, Storrs 06269-4017.

To determine the prevalence and causes of anemia in rural Mexico, blood samples and longitudinal dietary data were collected from 187 women, some pregnant and then lactating, and from 72 men. Blood was used to measure anemia, mean cell volume, and plasma ferritin, folate and vitamin B-12. Anemia was found in 33% of the men, 54% of nonpregnant, nonlactating women, 35% of pregnant women and 41% of lactating women, and varied by season. Low iron stores (ferritin) accompanied anemia in only 8% of men compared with 38-67% of women. Low meat intake and poor dietary iron bioavailability were associated with anemia in women. There were no cases of low plasma folate. Low plasma vitamin B-12 was common in all groups, and the incidence increased from 15% at 7 mo of pregnancy to 30% at 7 mo of lactation. Vitamin B-12 was lower in the plasma and milk of anemic lactating women than in plasma and milk of non-anemic lactating women and was classified as deficient in 62% of breast milk samples.

PMID: 8064368 [PubMed - indexed for MEDLINE]

[Korn]

From http://www.balancedforhealth.com/hyd...aternative.htm

Other evidence linking chlorinated water and health problems is equally disturbing. Studies show that chlorinated water is toxic to human intestinal bacteria which convert organic compounds in our food into necessary nutrients. It may also deplete the small intestine of bacteria which produces vitamin B12.

[Frank]

Women who are strict vegetarians or vegans may be a greater risk of having a child with birth defects because they are likely to be deficient in vitamin B12, researchers warned.

By Rebecca Smith, Medical Editor
Last Updated: 12:36PM GMT 02 Mar 2009

Vitamin B12 and folic acid supplements are advised.

Research carried out in Ireland has found that women with low levels of B12, found in meat, eggs and milk, when they conceive are at greater risk of having a child with neural tube defects.

These conditions include spina bifida, which causes partial paralysis, and anencephaly where the brain does not develop and is normally fatal shortly after birth.

Women who may become pregnant or who are pregnant are advised to take folic acid supplements because it is known that the vitamin folate protects against these defects and it has been suggested that taking vitamin B12 may reduce the risk further.

A team from the National Institutes of Health, Trinity College Dublin, and the Health Research Board of Ireland found women with low levels of B12 were 2.5 to three times more likely to have a child with a neural tube defect while those classed as deficient in B12 were five times more likely to have a child with a defect.

The study is published in the journal Paediatrics.

Dr Duane Alexander, director of the National Institute of Child Health and Human Development, in Maryland, America, who took part in the research said: "Vitamin B12 is essential for the functioning of the nervous system and for the production of red blood cells.

"The results of this study suggest that women with low levels of B12 not only may risk health problems of their own, but also may increase the chance that their children may be born with a serious birth defect."

Blood taken from one group of 160 women who were pregnant with a child that had a neural tube defect at the time the sample was taken was compared to women who had previously had a child with a neural tube defect but whose current pregnancy was unaffected.

The researchers adjusted for folate levels in order to evaluate the effect of B12 levels independently of folic acid.

It is not known how deficiency in B12 and folate increases the risk of neural tube defects but the vitamins are involved in several biochemical reactions in the body.

Dr James Mills, senior investigator in the Division of Epidemiology, Statistics, and Prevention Research, in America and co-author said that critical events in the formation of the brain and spinal column occur very early in pregnancy–in the first 28 days after conception–before many women even realise they are pregnant.
"If women wait until they realise that they are pregnant before they start taking folic acid, it is usually too late," he said.

In America all women of childbearing age are recommended to consume 400 micrograms of folic acid each day to ensure they have sufficient levels if they fall pregnant unintentionally.

Dr Mills said it would be wise for women to do the same with B12.

"Our results offer evidence that women who have adequate B12 levels before they become pregnant may further reduce the occurrence of this class of birth defects," Dr. Mills said.



The link can be found here:

http://www.telegraph.co.uk/health/he...ists-warn.html

More damaging info towards a vegan way of life.

[horselesspaul]

...So get enough B12....
Idiots. Classic way to use data to make a spurious point.

Thanks for pointing that out Frank.

[Korn]

More damaging info towards a vegan way of life

The link between low levels of certain nutrients, like B12 (which vegans need to pay extra attention to) and folate (which non-vegans need to pay extra attention to) and birth defects is nothing new. It has been known for a long time.

The damage is done by the low B12 levels being explained (in the title in Daily Telegraph) as 'vegan diet'. B12 levels are reduced by dozens of elements that are common in our modern lifestyle, as discussed in many other threads. With circa 40% of the meat eating population also having low levels of B12, explaining the reason behind birth defects as 'vegan diet' and not 'low B12 levels' is simply poor journalism.

It definitely doesn't get any better when we post the same title here.


The article in Science Daily is here: Low Levels Of Vitamin B12 May Increase Risk For Neural Tube Defects Vegans aren't mentioned at all.

The US based National Institutes of Health also posted about this, here:
Low Levels of Vitamin B12 May Increase Risk for Neural Tube Defects.

It contains the following sentence about vegans:

Because Vitamin B12 comes from foods of animal origin, women who adhere to a strict vegan diet may be at risk for a B12 deficiency, said an NICHD author of the paper, James L. Mills, M.D., senior investigator in the Division of Epidemiology, Statistics, and Prevention Research. He added it is advisable for women with digestive disorders that interfere with the absorption of foods to consult a physician before getting pregnant, to make sure they are receiving adequate amounts of B12.

B12 comes from a combination of rather common bacteria and the mineral cobalt (hence the name Cobalamin), not from animals.

It's true that vegans have a higher risk of getting too low B12 levels than non-vegans, just like non-vegans have a higher risk of being low on other nutrients. It's important to have heathy B12 levels before becoming pregnant, and lots of pregnancies aren't planned. Therefore, one should always make sure that one has healthy B12 levels (and other nutrients, that vegans normally have much healthier levels of than non-vegans.


Where exactly does Vitamin B12 come from?

[Zero]

It's important for anyone, eating any diet, at any stage of their life to have a well planned diet containing all the required nutrients.

VEGETARIANISM THROUGHOUT THE LIFE CYCLE

Well-planned vegan, lacto-vegetarian, and lacto-ovo-vegetarian
diets are appropriate for all stages of the life cycle, including pregnancy and lactation. Appropriately planned vegan, lactovegetarian, and lacto-ovo-vegetarian diets satisfy nutrient needs of infants, children, and adolescents and promote normal growth (36,114,115). Vegetarian diets in childhood and adolescence can aid in the establishment of lifelong healthy eating patterns and can offer some important nutritional advantages.

Vegetarian children and adolescents have lower intakes of cholesterol, saturated fat, and total fat and higher intakes of fruits, vegetables, and fiber than nonvegetarians (2,116-118). Vegetarian children have also been reported to be leaner and to have lower serum cholesterol levels (119-121).

Source: American Dietetics Association (http://www.lpda.pt/vegetarianismo/ada_dc_veg.pdf)

As we know the B12 issue, isn't an exclusively vegan issue, it can be an issue for anyone.

[Korn]

Sure.

Here's another title from Science Daily, from the same day as that other article about link between low levels of B12 and neural tube defects:
Doctors Endorse Well-planned Vegan And Vegetarian Diets For Healthy Pregnancies

A quote (my emphasis):

The Pediatrics study is based on analysis of stored blood samples originally collected during pregnancy from three groups of Irish women between 1983 and 1990. It's not clear if any of the women were vegan, but the study clearly states that this population was deliberately chosen because vitamin supplementation and food fortification were rare at that time. The women lived in a region of traditionally high neural tube defects prevalence, suggesting a moderately high genetic predisposition.

Did anyone see any info supporting the statement about "women who are strict vegetarians or vegans may be a greater risk of having a child with birth defects"? It's known that low B12 levels are linked to higher birth defect risk, and we don't want to risk anything for ourselves or our kids, but AFAIK the original report mentioned that there's a link between low B12 levels and neural tube defects. That doesn't necessarily mean that vegans have an increased risk for B12 levels, for a number of reasons - one being that both the low B12 levels and the birth defects could be results of lifestyle issues; lifestyle issues that both cause reduced B12 levels and neural tube defects. Now, there's no reason to assume that there's no link between too low B12 levels and birth defects, but we need to get the facts and perspectives right.

So - I'm not at all saying that there's no risk, but this study from the eighties (not specifically on vegans, in an area with a traditionally high neural tube defects prevalence) doesn't tell us anything that hasn't been known for decades. The conclusion ("Women who are strict vegetarians or vegans may be a greater risk of having a child with birth defects") seem to come from the article writer (Rebecca Smith), and not from the study itself. The article reminds a little of the 'news' about vegans having a higher risk of being more or less brain damaged due to tofu-eating.

[Frank]

It definitely doesn't get any better when we post the same title here.

We've got nothing to run away from and if that brings traffic to the site people will get to understand the true facts in this matter.

Otherwise, we just make a title and put claim on the end of it.

Good organisations have already responded to this article in writing and on air.

Let's see what we get back from that.

[Korn]

We've got nothing to run away from and if that brings traffic to the site people will get to understand the true facts in this matter.

Correcting false conclusions and running away from something is two different things.

There's even a mismatch between the title and the sentence following it:

"Women who are strict vegetarians or vegans may be a greater risk of having a child with birth defects because they are likely to be deficient in vitamin B12, researchers warned."

"Vegan Diet Increases The Risk Of Birth Defects, Scientists Warn"

Good organisations have already responded to this article in writing and on air.

If that 'good organization' is The Vegan Society, we don't really know how this will end.

[Frank]

Correcting false conclusions and running away from something is two different things.

But that's my point. We get the opportunity to put a case over and we have nothing to be afraid of. We've no reason to hide. Far from it.

There's even a mismatch between the title and the sentence following it:

Great - so let people follow it up with responses to the author/editor.

If that 'good organization' is The Vegan Society, we don't really know how this will end.

I do not understand what you mean in that statement.

[Korn]

I'm too busy now to explain, but if you're interested, I've posted about TVS' way of informing about B12 before....

[Frank]

I'm too busy now to explain, but if you're interested, I've posted about TVS' way of informing about B12 before....

Oh, I see.

[Korn]

More about chlorine and side effects:

Don't let your baby swim
(SOURCE: European Respiratory Journal, online January 14, 2010.)

(I'll post another link later, which shows that some people get symptoms from using swimming pools which are very similar to symptoms of B12 deficiency.)

[Korn]

Here's a new study I just came across:
Serum vitamin B12 and homocysteine levels in pregnant women with neural tube defect :

Abstract
OBJECTIVE: The aim of the study is to investigate the importance of serum vitamin B12 levels in pregnant women with foetal neural tube defect (NTD). STUDY DESIGN: This study consists of 31 pregnant women having fetuses with NTD. The pregnant women in the study group were selected among cases with normal folate levels. Serum vitamin B12 levels were investigated. Additionally, complete blood count, serum iron level, iron binding capacity, ferritin, folate, free T(3), free T(4), thyroid stimulating hormone and plasma homocysteine levels were measured. Control group consisted of 32 pregnant women who did not have a history of NTD in previous pregnancies and did not have fetuses with NTD in present pregnancy. NTD was diagnosed between 14th and 20th gestational age. The mean gestational age of members of control group was the same as those of NTD group. RESULTS: There was no statistically significant difference between pregnants with NTD and control group according to number of cases with vitamin B12 deficiency. CONCLUSION: It seems that vitamin B12 deficiency does not play a causative role in the development of foetal NTD. Monitoring maternal homocystein levels might be important in understanding the aetiologies of foetal NTD.

[Korn]

Here's another article about chlorinated water - this time about possible risks associated with swimming in it:
http://news.discovery.com/human/chlo...ng-cancer.html
Based on the various various reports about but spending time in chlorinated water (including just standing still in it, without swimming), I guess we may see studies in the future documenting side effects of drinking it chlorinated water - and not only the related to chlorine's "B12 killer" effect.

Drinking chlorinated water regularly, and eating food cooked in it - which most of us do daily - probably have a stronger impact on our health than we now know, and I wouldn't be surprised if it will be documented that drinking chlorinated water has at at least as strong effect on our bodies as bathing in it.

If not - it's hard to believe that our health isn't effected by all the chemicals our skin is exposed to regularly: not only chlorinated water when eg. taking a shower/bath, but lotions, moisturizers, perfume, deodorants, shampoos and so on.

And who knows - maybe we'll see some sort of documentation one day that *not* walking barefoot in healthy soil - an activity most humans stopped with as a part of how we have evolved - means getting less healthy soil nutrients (and healthy bacteria?) through the skin...

Studies have shown that using B12 cream may improve eczema symptoms. This could suggest that if B12 is in touch with the skin in some sort of humid context, the B12 doesn't remain on the outside the skin, but is absorbed at least into the skin itself.

Since chlorine's chemical byproducts (and possibly the chlorine itself) can get into our bodies through the skin, why shouldn't B12 also be able to enter our bodies that way? According to the article above, chlorine exposure also comes from breathing air at the surface of the water - so if we should speculate about future findings, maybe someone will find that humans who are swimming in the sea or a lake absorb nutrients from the water not only through the skin, but from "breathing air at the surface of the water" as well. And we do know that there's B12 in the ocean, because B12 is essential for marine life: "The presence or absence of B12 in the ocean plays a vital and previously overlooked role in determining where, how much, and what kinds of microscopic algae (called phytoplankton) will bloom in the sea, according to a study published in the May issue of the journal Limnology and Oceanography."

ETA: the B12 levels in ocean water varies a lot, depending on temperature/season, how far away from the coast you are, how deep down the samples are taken etc. ("The range of vitamin B12 concentrations from all reported assays has been between an undetectable amount and 200 mcg/liter, but most were less than 10 mcg/liter"). 10 mcg is much higher than "everybody's" recommended daily B12 intake (as in "pretty much everybody except Jack Norris"), but please...

a) don't drink a liter of ocean water every time you swim, and
b) don't rely on ocean swimming as a reliable B12 source!