Infant-Child Health Facts

General Information on Birth Defects

  • According to the U.S. Centers for Disease Control, one out of 33 infants in the U.S. is born with a birth defect or congenital malformation, and birth defects are responsible for one in five infant deaths. Structural defects are the leading cause of infant mortality in California and the United States.
  • There are many unknowns about the causes of birth defects as the fetus can be exposed to a wide array of unknown genetic and other factors (nutritional, personal habits and behaviors, infections and other illnesses, and environmental factors), and the extent of exposures and individual susceptibility to potential factors that could harm a fetus can be difficult to ascertain. The prevailing thought, however, is that birth defects arise from a combination of genetic and non-genetic factors.
  • Some of the most familiar non-genetic factors contributing to increased risk of birth defects include infectious agents (such as measles and rubella during pregnancy), maternal diabetes, drugs, alcohol, smoking, obesity and increased maternal age.
  • Genetic and/or non-genetic factors often come into play before women are aware that they are pregnant or seek prenatal care.  Research shows that a critical period to prevent some birth defects is Day 17 to Day 56 of gestation.  The heart begins to beat at 22 days after conception; the neural tube closes by 28 days after conception; the palate fuses at 56 days after conception. 
  • Both California and the U.S. Federal Government have created programs to research, monitor and help prevent birth defects.  California established its Birth Defects Monitoring Program in 1982, and the U.S. established the National Centers for Birth Defects Research and Prevention in 1996.

Birth Defects in Kettleman City

  • In response to citizens’ concerns about a rash of birth defects, in February 2010, the California Department of Public Health (CDPH) determined that the number of birth defects occurring in Kettleman City from 1997 through 2008 was statistically similar to what would be expected in comparable communities outside of Kettleman City.  This analysis was based on data collected by the California Birth Defects Monitoring Program (CBDMP) through 2008.
    • To understand whether the rate of birth defects in Kettleman City was unusual, CDPH compared this rate to the baseline rate of birth defects in nearby communities (in Avenal; in Kings County; and in five counties grouped together, namely Kings, Fresno, Kern, Madera, and Tulare) for the years between 1987 and 2008.  Using this comparison, CDPH determined that the number of birth defects seen in Kettleman City was not higher than what would be expected normally.
  • To address continuing community concerns, CDPH and the California Environmental Protection Agency (CalEPA) conducted another study, conducted in Dec. 2010.  CDPH further sought to identify all cases of birth defects, including potential cases reported by the community, from 2007 to March 31st, 2010.  A total of 11 eligible cases were identified born with major, structural birth defects during this time period to mothers who had lived in Kettleman City during their pregnancies.
    • To understand whether any patterns existed among these cases that could be related to, or point to, a common cause of the birth defects, CDPH conducted in-person interviews with mothers of the affected children to search for known or suspected genetic, medical or pregnancy-related factors; known or suspected behavioral and lifestyle risk factors; and environmental and occupational exposures that could potentially increase the risk of birth defects.  The mothers of six affected children consented to be interviewed, three declined, and two could not be reached.
    •  Working with the CalEPA, CDPH did not find a specific cause or environmental exposure among the mothers interviewed that could explain the increase in the number of children born with birth defects in Kettleman City.
    •  CDPH found that the birth defects represented different underlying conditions, although a few shared some features.  The reported birth defects were of types often seen in birth defects surveillance in California and elsewhere.  According to CDPH, these observations, coupled with the lack of any shared unusual exposures, suggested that the birth defects in Kettleman City did not have a common cause.
  • Among the many factors that can contribute to birth defects are several environmental factors at play in Kings County and Kettleman Hills, starting with the city’s origins as an “oil town” and continuing issues with water supply, among others. Several of these factors, including pesticide exposures in the homes and the water supply, are currently under investigation.
  • CalEPA conducted air monitoring around the Kettleman Hills Hazardous Waste Facility and concluded it is unlikely that any airborne contaminants measured in the conducted study pose any risks to the residents of Kettleman City.
  • Waste Management fully supports federal, state, and local efforts to investigate Kettleman City’s health concerns and is committed to sharing updates on the findings of these investigations.
  • Waste Management fully supports federal, state, and local efforts to investigate Kettleman City’s health concerns and is committed to sharing updates on the findings of these investigations.

LINK TO CDPH/CalEPA REPORT: http://www.calepa.ca.gov/EnvJustice/Documents/2010/KCDocs/ReportFinal/FinalReport.pdf

For questions on this topic, please contact Rosanne B. McTyre, PhD, MPH, at rbmctyre@semaforescience.com