Groundwater Recharge with Reclaimed Water

Birth Outcomes in Los Angeles County, 1982-1993

by Elizabeth M. Sloss, Daniel F. McCaffrey, Ronald D. Fricker, Sandy A. Geschwind, Beate R. Ritz


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This book is an assessment of the effects on human health of reclaimed water. The assessment focuses on adverse outcomes among liveborn infants, including low birth weight, preterm birth, infant mortality, and birth defects, from 1982 to 1993. Outcome rates in the Montebello Forebay area, which has received some reclaimed water in its water supply since 1962, are compared with a control area that received no reclaimed water. Using a cohort study design, this epidemiologic assessment analyzes outcome data on individuals classified by a ZIP code-level percentage of reclaimed water. The results of the study do not provide evidence of an association between reclaimed water and adverse birth outcomes.

Table of Contents

  • Chapter One


  • Chapter Two

    Literature Review

  • Chapter Three


  • Chapter Four


  • Chapter Five

    Summary and Discussion

  • Appendix A

    Epidemiologic Studies of Drinking Water and Adverse Birth Outcomes

  • Appendix B

    Methods Used to Estimate the Percentage of Reclaimed Water in Montebello Forebay Groundwater Supplies

  • Appendix C

    Percentage of Reclaimed Water in Montebello Forebay Water System Service Areas and Zip Codes by Year, 1982-1993

  • Appendix D

    Minimum Detectable Odds Ratio for Each Outcome and Exposure Group

  • Appendix E

    Results of Sensitivity Analyses Using Logistic Regression Models of Prenatal Development Outcomes and Infant Mortality

  • Appendix F

    Results of Sensitivity Analyses Using Logistic Regression Models for Birth Defect Outcomes

The research described in this report was sponsored by the Water Replenishment District of Southern California and performed under the auspices of RAND Health.

This report is part of the RAND Corporation Monograph report series. The monograph/report was a product of the RAND Corporation from 1993 to 2003. RAND monograph/reports presented major research findings that addressed the challenges facing the public and private sectors. They included executive summaries, technical documentation, and synthesis pieces.

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