Water disinfection by-products and bladder cancer: is there a European specificity? A pooled and meta-analysis of European case-control studies

Modelling and optimization of membrane process for removal of biologics (pathogens) from water and wastewater: Current perspectives and challenges

As one of the 17 sustainable development goals, the United Nations (UN) has prioritized "clean water and sanitation" (Goal 6) to reduce the discharge of emerging pollutants and disease-causing agents into the environment. Contamination of water by pathogenic microorganisms and their existence in treated water is a global public health concern. Under natural conditions, water is frequently prone to contamination by invasive microorganisms, such as bacteria, viruses, and protozoa. This circumstance has therefore highlighted the critical need for research techniques to prevent, treat, and get rid of pathogens in wastewater. Membrane systems have emerged as one of the effective ways of removing contaminants from water and wastewater However, few research studies have examined the synergistic or conflicting effects of operating conditions on newly developing contaminants found in wastewater. Therefore, the efficient, dependable, and expeditious examination of the pathogens in the intricate wastewater matrix remains a significant obstacle. As far as it can be ascertained, much attention has not recently been given to optimizing membrane processes to develop optimal operation design as related to pathogen removal from water and wastewater. Therefore, this state-of-the-art review aims to discuss the current trends in removing pathogens from wastewater by membrane techniques. In addition, conventional techniques of treating pathogenic-containing water and wastewater and their shortcomings were briefly discussed. Furthermore, derived mathematical models suitable for modelling, simulation, and control of membrane technologies for pathogens removal are highlighted. In conclusion, the challenges facing membrane technologies for removing pathogens were extensively discussed, and future outlooks/perspectives on optimizing and modelling membrane processes are recommended.

Trihalomethanes in global drinking water: Distributions, risk assessments, and attributable disease burden of bladder cancer

This study aimed to assess the global spatiotemporal variations of trihalomethanes (THMs) in drinking water, evaluate their cancer and non-cancer risks, and THM-attributable bladder cancer burden. THM concentrations in drinking water around fifty years on a global scale were integrated. Health risks were assessed using Monte Carlo simulations and attributable bladder cancer burden was estimated by comparative risk assessment methodology. The results showed that global mean THM concentrations in drinking water significantly decreased from 78.37 μg/L (1973-1983) to 51.99 μg/L (1984-2004) and to 21.90 μg/L (after 2004). The lifestage-integrative cancer risk and hazard index of THMs through all exposure pathways were acceptable with the average level of 6.45 × 10-5 and 7.63 × 10-2, respectively. The global attributable disability adjusted of life years (DALYs) and the age-standardized DALYs rate (ASDR) dropped by 16% and 56% from 1990-1994 to 2015-2019, respectively. A big decline in the attributable ASDR was observed in the United Kingdom (62%) and the United States (27%), while China experienced a nearly 3-fold increase due to the expanded water supply coverage and increased life expectancy. However, China also benefited from the spread of chlorination, which helped reduce nearly 90% of unsafe-water-caused mortality from 1998 to 2018.

Chlorination of Aromatic Amino Acids: Elucidating Disinfection Byproducts, Reaction Kinetics, and Influence Factors

In the face of ongoing water pollution challenges, the intricate interplay between dissolved organic matter and disinfectants like chlorine gives rise to potentially harmful disinfection byproducts (DBPs) during water treatment. The exploration of DBP formation originating from amino acids (AA) is a critical focus of global research. Aromatic DBPs, in particular, have garnered considerable attention due to their markedly higher toxicity compared to their aliphatic counterparts. This work seeks to advance the understanding of DBP formation by investigating chlorination disinfection and kinetics using tyrosine (Tyr), phenylalanine (Phe), and tryptophan (Trp) as precursors. Via rigorous experiments, a total of 15 distinct DBPs with accurate molecular structures were successfully identified. The chlorination of all three AAs yielded highly toxic chlorophenylacetonitriles (CPANs), and the disinfectant dosage and pH value of the reaction system potentially influence chlorination kinetics. Notably, Phe exhibited the highest degradation rate compared to Tyr and Trp, at both the CAA:CHOCl ratio of within 1:2 and a wide pH range (6.0 to 9.0). Additionally, a neutral pH environment triggered the maximal reaction rates of the three AAs, while an acidic condition may reduce their reactivity. Overall, this study aims to augment the DBP database and foster a deeper comprehension of the DBP formation and relevant kinetics underlying the chlorination of aromatic AAs.

Assessing the Health Impact of Disinfection Byproducts in Drinking Water

This study provides a comprehensive investigation of the impact of disinfection byproducts (DBPs) on human health, with a particular focus on DBPs present in chlorinated drinking water, concentrating on three primary DBP categories (aliphatic, alicyclic, and aromatic). Additionally, it explores pivotal factors influencing DBP formation, encompassing disinfectant types, water source characteristics, and environmental conditions, such as the presence of natural materials in water. The main objective is to discern the most hazardous DBPs, considering criteria such as regulation standards, potential health impacts, and chemical diversity. It provides a catalog of 63 key DBPs alongside their corresponding parameters. From this set, 28 compounds are meticulously chosen for in-depth analysis based on the above criteria. The findings strive to guide the advancement of water treatment technologies and intelligent sensory systems for the efficient water quality surveillance. This, in turn, enables reliable DBP detection within water distribution networks. By enriching the understanding of DBP-associated health hazards and offering valuable insights, this research is aimed to contribute to influencing policy-making in regulations and treatment strategies, thereby protecting public health and improving safety related to chlorinated drinking water quality.

Perspectives and understanding on the occurrence, toxicity and abatement technologies of disinfection by-products in drinking water

Disinfection by-products (DBPs) are one of the significant emerging contaminants that have caught the attention of researchers worldwide due to their pervasiveness. Their presence in drinking water, even in shallow concentrations (in levels of parts per billion), poses considerable health risks. Therefore, it is crucial to understand their kinetics to understand better their formation and persistence in the water supply systems. This manuscript demonstrates different aspects of research carried out on DBPs in the past. A systematic approach was adopted for the bibliographical research that started with choosing appropriate keywords and identifying the most relevant manuscripts through the screening process. This follows a quantitative assessment of the extracted literature sample, which included the most productive and influential journal sources, the most widely used keywords, the most influential authors active in the research domain, the most cited articles, and the countries most actively engaged in the research field. Critical observations on the literature sample led to the qualitative assessment, wherein the past and current research trends were observed and reported. Finally, we identified the essential gaps in the available literature, which further led to recommending the course ahead in the research domain. This study will prove fruitful for young and established researchers who are or wish to work in this emerging field of research.

Exposure to disinfection by-products and risk of cancer: A systematic review and dose-response meta-analysis

Disinfection by-products (DBPs), including trihalomethanes (THMs) and haloacetic acids (HAAs), have attracted attention due to their carcinogenic properties, leading to varying conclusions. This meta-analysis aimed to evaluate the dose-response relationship and the dose-dependent effect of DBPs on cancer risk. We performed a selective search in PubMed, Web of Science, and Embase databases for articles published up to September 15th, 2023. Our meta-analysis eventually included 25 articles, encompassing 8 cohort studies with 6038,525 participants and 10,668 cases, and 17 case-control studies with 10,847 cases and 20,702 controls. We observed a positive correlation between increased cancer risk and higher concentrations of total trihalomethanes (TTHM) in water, longer exposure durations, and higher cumulative TTHM intake. These associations showed a linear trend, with relative risks (RRs) and 95 % confidence intervals (CIs) being 1.02 (1.01-1.03), 1.04 (1.02-1.06), and 1.02 (1.00-1.03), respectively. Gender-specific analyses revealed slightly U-shaped relationships in both males and females, with males exhibiting higher risks. The threshold dose for TTHM in relation to cancer risk was determined to be 55 µg/L for females and 40 µg/L for males. A linear association was also identified between bladder cancer risk and TTHM exposure, with an RR and 95 % CI of 1.08 (1.05-1.11). Positive linear associations were observed between cancer risk and exposure to chloroform, bromodichloromethane (BDCM), and HAA5, with RRs and 95 % CIs of 1.02 (1.01-1.03), 1.33 (1.18-1.50), and 1.07 (1.03-1.12), respectively. Positive dose-dependent effects were noted for brominated THMs above 35 µg/L and chloroform above 75 µg/L. While heterogeneity was observed in the studies for quantitative synthesis, no publication bias was detected. Exposure to TTHM, chloroform, BDCM, or HAA5 may contribute to carcinogenesis, and the risk of cancer appears to be dose-dependent on DBP exposure levels. A cumulative effect is suggested by the positive correlation between TTHM exposure and cancer risk. Bladder cancer and endocrine-related cancers show dose-dependent and positive associations with TTHM exposure. Males may be more susceptible to TTHM compared to females.

Stormwater discharge: An overlooked source of disinfection byproduct precursors

Discharge from the stormwater system is as an important pathway for contaminant transport, impacting the quantity and characteristics of dissolved organic matter (DOM) in surface water, and thus the formation of disinfection byproducts (DBPs) during downstream drinking water disinfection. In this study, DOM in stormwater pipes was characterized by size-exclusion chromatography, and the formation of 27 DBPs and halogen-specific total organic halogen (TOX) following chlorination was investigated. Overall, DOM in stormwater pipes was characterized by low molecular weight compounds and microbial-derived organics. Total DBP concentrations in chlorinated stormwaters were ∼1-15 times higher than in chlorinated surface waters. DBPs formed in stormwaters were dominated by trihalomethanes and haloacetic acids. Moreover, the DBP-associated toxicity of chlorinated stormwaters was ∼1-38 times higher than in chlorinated surface waters, and mainly due to the presence of large amount of haloacetaldehydes and haloacetonitriles. Sampling during a rainfall event suggested that stormwater discharge significantly increased DBP precursors in the surface water. The high formation and estimated toxicity of DBPs in stormwater discharge indicates this is an overlooked source of DBP precursors, posing a threat to the aquatic environment and potentially drinking water quality.

Insights to estimate exposure to regulated and non-regulated disinfection by-products in drinking water

BACKGROUND

Knowledge about human exposure and health effects associated with non-routinely monitored disinfection by-products (DBPs) in drinking water is sparse.

OBJECTIVE

To provide insights to estimate exposure to regulated and non-regulated DBPs in drinking water.

METHODS

We collected tap water from homes (N = 42), bottled water (N = 10), filtered tap water with domestic activated carbon jars (N = 6) and reverse osmosis (N = 5), and urine (N = 39) samples of participants from Barcelona, Spain. We analyzed 11 haloacetic acids (HAAs), 4 trihalomethanes (THMs), 4 haloacetonitriles (HANs), 2 haloketones, chlorate, chlorite, and trichloronitromethane in water and HAAs in urine samples. Personal information on water intake and socio-demographics was ascertained in the study population (N = 39) through questionnaires. Statistical models were developed based on THMs as explanatory variables using multivariate linear regression and machine learning techniques to predict non-regulated DBPs.

RESULTS

Chlorate, THMs, HAAs, and HANs were quantified in 98-100% tap water samples with median concentration of 214, 42, 18, and 3.2 μg/L, respectively. Multivariate linear regression models had similar or higher goodness of fit (R2) compared to machine learning models. Multivariate linear models for dichloro-, trichloro-, and bromodichloroacetic acid, dichloroacetonitrile, bromochloroacetonitrile, dibromoacetonitrile, trichloropropnanone, and chlorite showed good predictive ability (R2 = 0.8-0.9) as 80-90% of total variance could be explained by THM concentrations. Activated carbon filters reduced DBP concentrations to a variable extent (27-80%), and reverse osmosis reduced DBP concentrations ≥98%. Only chlorate was detected in bottled water samples (N = 3), with median = 13.0 µg/L. Creatinine-adjusted trichloroacetic acid was the most frequently detected HAA in urine samples (69.2%), and moderately correlated with estimated drinking water intake (r = 0.48).

SIGNIFICANCE

Findings provide valuable insights for DBP exposure assessment in epidemiological studies. Validation of predictive models in a larger number of samples and replication in different settings is warranted.

IMPACT STATEMENT

Our study focused on assessing and describing the occurrence of several classes of DBPs in drinking water and developing exposure models of good predictive ability for non-regulated DBPs.

US drinking water quality: exposure risk profiles for seven legacy and emerging contaminants

BACKGROUND

Advances in drinking water infrastructure and treatment throughout the 20th and early 21st century dramatically improved water reliability and quality in the United States (US) and other parts of the world. However, numerous chemical contaminants from a range of anthropogenic and natural sources continue to pose chronic health concerns, even in countries with established drinking water regulations, such as the US.

OBJECTIVE/METHODS

In this review, we summarize exposure risk profiles and health effects for seven legacy and emerging drinking water contaminants or contaminant groups: arsenic, disinfection by-products, fracking-related substances, lead, nitrate, per- and polyfluorinated alkyl substances (PFAS) and uranium. We begin with an overview of US public water systems, and US and global drinking water regulation. We end with a summary of cross-cutting challenges that burden US drinking water systems: aging and deteriorated water infrastructure, vulnerabilities for children in school and childcare facilities, climate change, disparities in access to safe and reliable drinking water, uneven enforcement of drinking water standards, inadequate health assessments, large numbers of chemicals within a class, a preponderance of small water systems, and issues facing US Indigenous communities.

RESULTS

Research and data on US drinking water contamination show that exposure profiles, health risks, and water quality reliability issues vary widely across populations, geographically and by contaminant. Factors include water source, local and regional features, aging water infrastructure, industrial or commercial activities, and social determinants. Understanding the risk profiles of different drinking water contaminants is necessary for anticipating local and general problems, ascertaining the state of drinking water resources, and developing mitigation strategies.

IMPACT STATEMENT

Drinking water contamination is widespread, even in the US. Exposure risk profiles vary by contaminant. Understanding the risk profiles of different drinking water contaminants is necessary for anticipating local and general public health problems, ascertaining the state of drinking water resources, and developing mitigation strategies.

Lifetime exposure to brominated trihalomethanes in drinking water and swimming pool attendance are associated with chronic lymphocytic leukemia: a Multicase-Control Study in Spain (MCC-Spain)

BACKGROUND

Chronic lymphocytic leukemia (CLL) etiology is poorly understood, and carcinogenic chemicals in drinking and recreational water are candidates.

OBJECTIVE

To evaluate the association between drinking-water exposure to trihalomethanes (THMs) and nitrate as well as lifetime swimming pool attendance and CLL.

METHODS

During 2010-2013, hospital-based CLL cases and population-based controls were recruited in Spain, providing information on residential histories, type of water consumed and swimming pool attendance. Average THMs and nitrate levels in drinking water were linked to lifetime water consumption. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using mixed models.

RESULTS

Final samples for residential tap water analyses and swimming pool attendance analyses were 144 cases/1230 controls and 157 cases/1240 controls, respectively. Mean (SD) values for average lifetime residential brominated THMs and chloroform in tap water (μg/L), and ingested nitrate (mg/day) were 48.1 (35.6), 18.5 (6.7) and 13.7 (9.6) respectively in controls; and 72.9 (40.7), 17.9 (5.4), and 14.1 (8.8) in CLL cases. For each 10 μg/L increase of brominated THMs and chloroform lifetime-average levels, the ORs (95% CI) were 1.22 (1.14, 1.31) and 0.54 (0.34, 0.87), respectively. For each 5 mg/day increase of ingested nitrate, the OR of CLL was 0.91 (0.80, 1.04). The OR of lifetime pool users (vs. non-users) was 2.38 (1.61, 3.52). Upon performing annual frequency of attending pools analysis through categorization, the second and third categories showed an ORs of 2.36 (1.49, 3.72) and 2.40 (1.51, 3.83), respectively, and P-trend of 0.001.

IMPACT STATEMENT

This study identifies an association of long-term exposure to THMs in drinking water, at concentrations below the regulatory thresholds and WHO guidelines, and swimming pool attendance, with chronic lymphocytic leukemia (CLL). These unprecedented findings are highly relevant since CLL is an incurable cancer with still unknown etiology and because the widespread exposure to chlorination by-products that remain in drinking and recreational water worldwide. Despite the demonstrated carcinogenicity in animals of several chlorination by-products, little is known about their potential risks on human health. This study makes a significant contribution to the search for environmental factors involved in the etiology of CLL and to the evidence of the health impact of these high prevalent water contaminants.

Disinfection by-products in drinking water and risk of colorectal cancer: a population-based cohort study

BACKGROUND

Colorectal cancer is the third most common malignancy worldwide and is strongly linked to lifestyle and environmental risk factors. Although several drinking-water disinfection by-products are confirmed rodent carcinogens, the evidence in humans for carcinogenicity associated with these by-products, including colorectal cancer, is still inconclusive.

METHODS

We assessed the association of long-term exposure to trihalomethanes (THMs), the most prevalent disinfection by-products in chlorinated drinking water, with incidence of colorectal cancer in 58 672 men and women in 2 population-based cohorts. Exposure was assessed by combining long-term information of residential history with drinking water-monitoring data. Participants were categorized according to no exposure, low exposure (<15 µg/L), and high exposure (≥15 µg/L). Incident cases of colorectal cancer were ascertained by use of the Swedish National Cancer Register.

RESULTS

During an average follow-up of 16.8 years (988 144 person-years), 1913 cases of colorectal cancer were ascertained (1176 cases in men and 746 in women, respectively). High THM concentrations in drinking water (≥15 µg/L) were associated with increased risk of colorectal cancer in men (hazard ratio = 1.26, 95% confidence interval = 1.05-1.51) compared with no exposure. When subsites were assessed, the association was statistically significant for proximal colon cancer (hazard ratio = 1.59, 95% confidence interval = 1.11 to 2.27) but not for distal colon cancer or rectal cancer. In women, we observed overall no association of THMs with colorectal cancer.

CONCLUSION

These results add further evidence that disinfection by-products in drinking water may be a possible risk factor for proximal colon cancer in men. This observation was made at THM concentrations lower than those in most previous studies.

Occurrence, formation, and proteins perturbation of disinfection byproducts in indoor air resulting from chlorine disinfection

Increased amounts of chlorine disinfectant have been sprayed to inactivate viruses in the environment since the COVID-19 pandemic, and the health risk from chemicals, especially disinfection byproducts (DBPs), has unintentionally increased. In this study, we characterized the occurrence of haloacetic acids (HAAs) and trihalomethanes (THMs) in indoor air and evaluated their formation potential from typical indoor ingredients. Subsequently, the adverse effect of chloroacetic acid on A549 cells was depicted at the proteomic, transcriptional and silico levels. The results revealed that the total concentrations of HAAs and THMs ranged from 1.46 to 4.20 μg/m3 in ten indoor environments. Both classes of DBPs could be generated during the chlorination of prevalent terpenes by competing reactions, which are associated with the volatile state of indoor ingredients after disinfection. The C-type lectin receptor signaling pathway and cellular senescence were significantly perturbed pathways, which interfered with the development of lung fibrosis. The negative effect was further investigated by molecular docking and transcription, which showed that HAAs can interact with four C-type lectin receptor proteins by hydrogen bonds and inhibit the mRNA expression of related proteins. This study highlights the potential secondary biological risk caused by intensive DBPs generated from chlorination and draws our attention to the potential environmental factors leading to chronic respiratory disease.

Bromoform exposure is associated with non-melanoma skin cancer: evidence from NHANES 2011-2020

Background

Non-melanoma skin cancer (NMSC) is a prevalent skin malignancy. It has been indicated in many studies that trihalomethanes (THMs) exposure has a strong association with tumors but has not been associated with NMSC. Our investigation aims to explore the association between THMs exposure and NMSC.

Methods

Cross-sectional data from the 2011 to 2020 National Health and Nutrition Examination Survey (NHANES) was collected. Poisson regression and subgroup analyses were performed to evaluate the association between individual THMs components and NMSC. Fitted smoothing curves and generalized additive models were also used.

Results

This study involved 5,715 individuals, 98 (1.7%) of whom self-reported NMSC. After adjusting for covariates, Poisson regression showed that higher blood TBM levels were associated with an increased likelihood of NMSC (OR = 1.03; 95% CI: 1.01-1.05, p = 0.002). However, the correlation between the blood levels of TCM, DBCM, and BDCM and the likelihood of NMSC was not statistically significant (all p > 0.05). Subgroup analysis and interaction tests showed no significant differences between blood TBM concentration and the likelihood of NMSC, indicating that age, gender, and race were significantly independent of this positive association (all p < 0.05).

Conclusions

Our results implied that among adults older than 65 years old in the U.S., elevated blood TBM concentrations were positively associated with NMSC. More prospective investigations are required to validate this relationship with the early prevention of NMSC.

NaHCO3 addition enhances water permeance and Ca/haloacetic acids selectivity of nanofiltration membranes for drinking water treatment

The existence of disinfection by-products such as haloacetic acids (HAAs) in drinking water severely threatens water safety and public health. Nanofiltration (NF) is a promising strategy to remove HAAs for clean water production. However, NF often possesses overhigh rejection of essential minerals such as calcium. Herein, we developed highly selective NF membranes with tailored surface charge and pore size for efficient rejection of HAAs and high passage of minerals. The NF membranes were fabricated through interfacial polymerization (IP) with NaHCO3 as an additive. The NaHCO3-tailored NF membranes exhibited high water permeance up to ∼24.0 L m - 2 h - 1 bar-1 (more than doubled compared with the control membrane) thanks to the formation of stripe-like features and enlarged pore size. Meanwhile, the tailored membranes showed enhanced negative charge, which benefitted their rejection of HAAs and passage of Ca and Mg. The higher rejection of HAAs (e.g., > 90%) with the lower rejection of minerals (e.g., < 30% for Ca) allowed the NF membranes to achieve higher minerals/HAAs selectivity, which was significantly higher than those of commercially available NF membranes. The simultaneously enhanced membrane performance and higher minerals/HAAs selectivity would greatly boost water production efficiency and water quality. Our findings provide a novel insight to tailor the minerals/micropollutants selectivity of NF membranes for highly selective separation in membrane-based water treatment.

Chloroform exposure in air and water in Swedish indoor swimming pools-urine as a biomarker of occupational exposure

INTRODUCTION

Disinfection by-products are produced in water disinfected with chlorine-based products. One such group is trihalomethanes, and chloroform is the most abundant trihalomethane in swimming pool areas. Chloroform can be absorbed by inhalation, ingestion, and dermal absorption, and is classified as possibly carcinogenic.

AIM

To investigate if chloroform concentrations in air and water affect the chloroform concentration in urine samples of exposed swimming pool workers.

METHODS

Workers from 5 adventure indoor swimming pools carried personal chloroform air samplers and provided up to 4 urine samples during one workday. Chloroform concentrations were analyzed with a linear mixed model analysis to investigate a possible correlation between air and urine concentrations.

RESULTS

The geometric mean chloroform concentration was 11 μg/m3 in air and 0.009 µg/g creatinine in urine among individuals with ≤2 h at work, 0.023 µg/g creatinine among those with >2-5 working hours, and 0.026 µg/g creatinine in the group with >5-10 working hours. A risk of higher levels of chloroform in urine was associated with longer hours at work (≤2 h versus >5-10 h, odds ratio [OR] 2.04, 95% confidence interval [CI] 1.25-3.34), personal chloroform concentrations in air (≤17.00 µg/m3 versus >28.00 µg/m3, OR 9.23, 95% CI 3.68-23.13) and working at least half the working day near the swimming pools (OR 3.16, 95% CI 1.33-7.55). Executing work tasks in the swimming pool water was not associated with higher chloroform concentrations in urine compared to only working on land (OR 0.82, 95% CI 0.27-2.45).

CONCLUSION

There is an accumulation of chloroform concentrations in urine during a workday and a correlation between personal air and urine concentrations of chloroform among workers in Swedish indoor swimming pools.

Impacts of hydraulic fracturing wastewater from oil and gas industries on drinking water: Quantification of 69 disinfection by-products and calculated toxicity

Oil and gas production generates large amounts of brine wastewater called "produced water" with various geogenic and synthetic contaminants. These brines are generally used in hydraulic fracturing operations to stimulate production. They are characterized by elevated halide levels, particularly geogenic bromide and iodide. Such salt concentrations in produced water may be as high as thousands of mg/L of bromide and tens of mg/L of iodide. Large volumes of produced water are stored, transported, reused in production operations, and ultimately disposed of by deep well injection into saline aquifers. Improper disposal may potentially contaminate shallow freshwater aquifers and impact drinking water sources. Because conventional produced water treatment typically does not remove halides, produced water contamination of groundwater aquifers may cause the formation of brominated and iodinated disinfection by-products (I-DBPs) at municipal water treatment plants. These compounds are of interest because of their higher toxicity relative to their chlorinated counterparts. This study reports a comprehensive analysis of 69 regulated and priority unregulated DBPs in simulated drinking waters fortified with 1 % (v/v) oil and gas wastewater. Impacted waters produced 1.3×-5× higher levels of total DBPs compared to river water after chlorination and chloramination. Individual DBP levels ranged from (<0.1-122 μg/L). Overall, chlorinated waters formed highest levels, including trihalomethanes that would exceed the U.S. EPA regulatory limit of 80 μg/L. Chloraminated waters had more I-DBP formation and highest levels of haloacetamides (23 μg/L) in impacted water. Calculated cytotoxicity and genotoxicity were higher for impacted waters treated with chlorine and chloramine than corresponding treated river waters. Chloraminated impacted waters had the highest calculated cytotoxicity, likely due to higher levels of more toxic I-DBPs and haloacetamides. These findings demonstrate that oil and gas wastewater if discharged to surface waters could adversely impact downstream drinking water supplies and potentially affect public health.

Toxicological aspect of water treated by chlorine-based advanced oxidation processes: A review

As well established in the literature, residual toxicity is an important parameter for evaluating the sanitary and environmental safety of water treatment processes, and this parameter becomes even more crucial when chlorine-based processes are applied for water treatment. Eliminating initial toxicity or preventing its increase after water treatment remains a huge challenge mainly due to the formation of highly toxic disinfection by-products (DBPs) that stem from the degradation of organic contaminants or the interaction of the chlorine-based oxidants with different matrix components. In this review, we present a comprehensive discussion regarding the toxicological aspects of water treated using chlorine-based advanced oxidation processes (AOPs) and the recent findings related to the factors influencing toxicity, and provide directions for future research in the area. The review begins by shedding light on the advances made in the application of free chlorine AOPs and the findings from studies conducted using electrochemical technologies based on free chlorine generation. We then delve into the insights and contributions brought to the fore regarding the application of NH₂Cl- and ClO₂-based treatment processes. Finally, we broaden our discussion by evaluating the toxicological assays and predictive models employed in the study of residual toxicity and provide an overview of the findings reported to date on this subject matter, while giving useful insights and directions for future research on the topic.

Algae impacted drinking water: Does switching to chloramination produce safer drinking water?

Harmful algal (cyanobacterial) blooms (HABs) are increasing throughout the world. HABs can be a direct source of toxins in freshwater sources, and associated algal organic matter (AOM) can act as precursors for the formation of disinfection by-products (DBPs) in drinking water. This study investigated the impacts of algae on DBP formation using treatment with chloramine, which has become a popular disinfectant in the U.S. and in several other countries because it can significantly lower the levels of regulated DBPs formed. Controlled laboratory chloraminations were conducted using live field-collected algal biomass dominated by either Phormidium sp. or Microseira wollei (formerly known as Lyngbya wollei) collected from Lake Wateree and Lake Marion, SC. Sixty-six priority, unregulated or regulated DBPs were quantified using gas chromatography (GC)-mass spectrometry (MS). The presence of HAB-dominated microbial communities in source waters led to significant increases in more toxic nitrogen-containing DBPs (1.5-5 fold) relative to lake waters collected in HAB-free waters. Compared to chlorinated Phormidium-impacted waters, chloraminated waters yielded lower total DBP levels (up to 123 μg/L vs. 586 μg/L for low Br^-/I^- waters), but produced a greater number of brominated, iodinated, and mixed halogenated DBPs in high Br^-/I^- waters. Among the DBPs formed in Phormidium-impacted chloraminated waters, dichloroacetic acid, trichloromethane, chloroacetic acid, chloropropanone, and dichloroacetamide were dominant. For Microseira wollei-impacted chloraminated waters, total DBP concentrations ranged from 33 to 145 μg/L (approximately 3-5 times lower than chlorination), with dichloroacetic acid, dichloroacetamide, and trichloromethane dominant. Overall, chloramination significantly reduced calculated cytotoxicity and genotoxicity in low Br^- and I^- waters, but produced 1.3 fold higher calculated cytotoxicity (compared to chlorine) with high Br^-/I^- waters due to increased formation of more toxic iodo- and mixed halogenated DBPs.

Comparative cytotoxicity analyses of disinfection byproducts in drinking water using dimensionless parameter scaling method: Effect of halogen substitution type and number

Up to date, over 700 disinfection byproducts (DBPs) have been detected and identified in drinking water. It has been recognized that cytotoxicity of DBPs varied significantly among groups. Even within the same group, cytotoxicity of different DBP species was also different due to different halogen substitution types and numbers. However, it is still difficult to quantitatively determine the inter-group cytotoxicity relationships of DBPs under the effect of halogen substitution in different cell lines, especially when a large number of DBP groups and multiple cytotoxicity cell lines are involved. In this study, a powerful dimensionless parameter scaling method was adopted to quantitatively determine the relationship of halogen substitution and the cytotoxicity of various DBP groups in three cell lines (i.e., the human breast carcinoma (MVLN), Chinese hamster ovary (CHO), and human hepatoma (Hep G2) cell cytotoxicity) with no need to consider their absolute values and other influences. By introducing the dimensionless parameters D_{x-orn-species}^cellline and D¯_{x-orn-species}^cellline, as well as their corresponding linear regression equation coefficients k_typeornumber^cellline and k¯_typeornumber^cellline, the strength and trend of halogen substitution influences on the relative cytotoxic potency could be determined. It was found that the effect of halogen substitution type and number on the cytotoxicity of DBPs followed the same patterns in the three cell lines. The CHO cell cytotoxicity was the most sensitive cell line to evaluate the effect of halogen substitution on the aliphatic DBPs, whereas the MVLN cell cytotoxicity was the most sensitive cell line to evaluate the effect of halogen substitution on the cyclic DBPs. Notably, seven quantitative structure activity relationship (QSAR) models were established, which could not only predict the cytotoxicity data of DBPs, but also help to explain and verify the patterns of halogen substitution effect on cytotoxicity of DBPs.

Revisiting Disinfection Byproducts with Supercritical Fluid Chromatography-High Resolution-Mass Spectrometry: Identification of Novel Halogenated Sulfonic Acids in Disinfected Drinking Water

High resolution mass spectrometry (HRMS) coupled to either gas chromatography or reversed-phase liquid chromatography is the generic method to identify unknown disinfection byproducts (DBPs) but can easily overlook their highly polar fractions. In this study, we applied an alternative chromatographic separation method, supercritical fluid chromatography-HRMS, to characterize DBPs in disinfected water. In total, 15 DBPs were tentatively identified for the first time as haloacetonitrilesulfonic acids, haloacetamidesulfonic acids, and haloacetaldehydesulfonic acids. Cysteine, glutathione, and p-phenolsulfonic acid were found as precursors during lab-scale chlorination, with cysteine providing the highest yield. A mixture of the labeled analogues of these DBPs was prepared by chlorination of ¹³C₃-¹⁵N-cysteine and analyzed using nuclear magnetic resonance spectroscopy for structural confirmation and quantification. A total of 6 drinking water treatment plants utilizing various source waters and treatment trains produced sulfonated DBPs upon disinfection. Those were widespread in the tap water of 8 cities across Europe, with estimated concentrations up to 50 and 800 ng/L for total haloacetonitrilesulfonic acids and haloacetaldehydesulfonic acids, respectively. Up to 850 ng/L haloacetonitrilesulfonic acids were found in 3 public swimming pools. Considering the stronger toxicity of haloacetonitriles, haloacetamides, and haloacetaldehydes than the regulated DBPs, these newly found sulfonic acid derivatives may also pose a health risk.

Chlorination disinfection by-products in Southeast Asia: A review on potential precursor, formation, toxicity assessment, and removal technologies

This review discusses disinfection by-products' (DBPs) potential precursors, formation, and toxicity, alongside available research on the treatment of DBPs in Southeast Asian countries' water sources. Although natural organic matter (NOM) in the form of humic and fulvic acids is the major precursor of DBPs formation, the presence of anthropogenic organic matter (AOM) also plays essential roles during disinfection using chlorine. NOM has been observed in water sources in Southeast Asian countries, with a relatively high concentration in peat-influenced water sources and a relatively low concentration in non-peat-influenced water sources. Similarly, AOMs, such as microplastics, pharmaceuticals, pesticides, and endocrine-disrupting chemicals (EDCs), have also been detected in water sources in Southeast Asian countries. Although studies regarding DBPs in Southeast Asian countries are available, they focus on regulated DBPs. Here, the formation potential of unregulated DBPs is also discussed. In addition, the toxicity associated with extreme DBPs' formation potential, as well as the effectiveness of treatments such as conventional coagulation, filtration, adsorption, and ozonation in reducing DBPs' formation potential in Southeast Asian sources of water, is also analyzed.

Long-Term Exposure to Nitrate and Trihalomethanes in Drinking Water and Prostate Cancer: A Multicase-Control Study in Spain (MCC-Spain)

BACKGROUND

Nitrate and trihalomethanes (THMs) in drinking water are widespread and are potential human carcinogens.

OBJECTIVE

We evaluated the association between drinking-water exposure to nitrate and THMs and prostate cancer.

METHODS

During the period 2008-2013, 697 hospital-based incident prostate cancer cases (97 aggressive tumors) and 927 population-based controls were recruited in Spain, providing information on residential histories and type of water consumed. Average nitrate and THMs levels in drinking water were linked with lifetime water consumption to calculate waterborne ingestion. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using mixed models with recruitment area as random effect. Effect modification by tumor grade (Gleason score), age, education, lifestyle, and dietary factors was explored.

RESULTS

Mean (±standard deviation) adult lifetime waterborne ingested nitrate (milligrams per day), brominated (Br)-THMs (micrograms per day), and chloroform (micrograms per day) were 11.5 (±9.0), 20.7 (±32.4), and 15.1 (±14.7) in controls. Waterborne ingested nitrate >13.8 vs. <5.5mg/d was associated with an OR of 1.74 (95% CI: 1.19, 2.54) overall, and 2.78 (95% CI: 1.23, 6.27) for tumors with Gleason scores ≥8. Associations were higher in the youngest and those with lower intakes of fiber, fruit/vegetables, and vitamin C. Waterborne ingested THMs were not associated with prostate cancer. Residential tap water levels of Br-THMs and chloroform showed, respectively, inverse and positive associations with prostate cancer.

CONCLUSIONS

Findings suggest long-term waterborne ingested nitrate could be a risk factor of prostate cancer, particularly for aggressive tumors. High intakes of fiber, fruit/vegetables and vitamin C may lower this risk. Association with residential levels but not ingested chloroform/Br-THM may suggest inhalation and dermal routes could be relevant for prostate cancer. https://doi.org/10.1289/EHP11391.

Global assessment of chemical quality of drinking water: The case of trihalomethanes

BACKGROUND

Trihalomethanes (THM), a major class of disinfection by-products, are widespread and are associated with adverse health effects. We conducted a global evaluation of current THM regulations and concentrations in drinking water.

METHODS

We included 120 countries (∼7000 million inhabitants in 2016), representing 94% of the world population. We searched for country regulations and THM routine monitoring data using a questionnaire addressed to referent contacts. Scientific and gray literature was reviewed where contacts were not identified or declined participation. We obtained or estimated annual average THM concentrations, weighted to the population served when possible.

RESULTS

Drinking water regulations were ascertained for 116/120 (97%) countries, with 89/116 (77%) including THM regulations. Routine monitoring was implemented in 47/89 (53%) of countries with THM regulations. THM data with a varying population coverage was obtained for 69/120 (58%) countries consisting of ∼5600 million inhabitants (76% of world's population in 2016). Population coverage was ≥90% in 14 countries, mostly in the Global North, 50-89% in 19 countries, 11-49% among 21 countries, and ≤10% in 14 countries including India, China, Russian Federation and Nigeria (40% of world's population).

DISCUSSION

An enormous gap exists in THM regulatory status, routine monitoring practice, reporting and data availability among countries, especially between high- vs. low- and middle-income countries (LMICs). More efforts are warranted to regulate and systematically assess chemical quality of drinking water, centralize, harmonize, and openly report data, particularly in LMICs.

Anthracite Releases Aromatic Carbons and Reacts with Chlorine to Form Disinfection Byproducts in Drinking Water Production

Anthracite is globally used as a filter material for water purification. Herein, it was found that up to 15 disinfection byproducts (DBPs) were formed in the chlorination of anthracite-filtered pure water, while the levels of DBPs were below the detection limit in the chlorination of zeolite-, quartz sand-, and porcelain sandstone-filtered pure water. In new-anthracite-filtered water, the levels of dissolved organic carbon (DOC), dissolved organic nitrogen (DON), and ammonia nitrogen (NH₃-N) ranged from 266.3 to 305.4 μg/L, 37 to 61 μg/L, and 8.6 to 17.1 μg/L, respectively. In aged anthracite (collected from a filter at a DWTP after one year of operation) filtered water, the levels of the above substances ranged from 475.1 to 597.5 μg/L, 62.1 to 125.6 μg/L, and 14 to 28.9 μg/L, respectively. Anthracite would release dissolved substances into filtered water, and aged anthracite releases more substances than new anthracite. The released organics were partly (around 5%) composed by the μg/L level of toxic and carcinogenic aromatic carbons including pyridine, paraxylene, benzene, naphthalene, and phenanthrene, while over 95% of the released organics could not be identified. Organic carbon may be torn off from the carbon skeleton structure of anthracite due to hydrodynamic force in the water filtration process.

Epidemiology, Screening, and Prevention of Bladder Cancer

CONTEXT

Bladder cancer (BC) represents a significant health problem due to the potential morbidity and mortality associated with disease burden, which has remained largely unaltered over time.

OBJECTIVE

To provide an expert collaborative review and describe the incidence, prevalence, and mortality of BC and to evaluate current evidence for BC screening and prevention.

EVIDENCE ACQUISITION

Data on the estimated incidence and mortality of BC for 2020 in 185 countries were derived from the International Agency for Research on Cancer GLOBOCAN database. A review of English-language articles published over the past 5 yr was conducted using PubMed/MEDLINE to identify risk factors in addition to contemporary evidence on BC screening and prevention.

EVIDENCE SYNTHESIS

BC is the tenth most common cancer worldwide, with 573 278 cases in 2020. BC incidence is approximately fourfold higher in men than women. Tobacco smoking remains the principal risk factor, accounting for approximately 50% of cases. There is insufficient evidence to recommend routine BC screening. However, targeted screening of high-risk individuals (defined according to smoking history or occupational exposure) may reduce BC mortality and should be the focus of prospective randomized trials. In terms of disease prevention, smoking cessation represents the most important intervention, followed by a reduction in exposure to occupational and environmental carcinogens.

CONCLUSIONS

BC confers a significant disease burden. An understanding of BC epidemiology and risk factors provides an optimal foundation for disease prevention and the care of affected patients.

PATIENT SUMMARY

Bladder cancer is the tenth most common cancer worldwide and is approximately four times more common among men than among women. The main risk factors are tobacco smoking, followed by exposure to carcinogens in the workplace or the environment. Routine screening is not currently recommended, but may be beneficial in individuals at high risk, such as heavy smokers. Primary prevention is extremely important, and smoking cessation represents the most important action for reducing bladder cancer cases and deaths.

A censorious review on the role of natural lignocellulosic fiber waste as a low-cost adsorbent for removal of diverse textile industrial pollutants

BACKGROUND

Textile industries produce fabricated colored products using toxic dyes and other harsh chemicals. It is the responsibility of the textile industries to treat and eliminate these hazardous pollutants. However, due to the growing population demand, the treatment of these hazardous effluents is ineffective and imposes the treatment cost over the end users. The release of partially treated effluents in the environment may cause a severe threat to the ecology and its biota. The critical objective is to treat textile effluents efficiently using agricultural natural fiber waste. Generation of agricultural lignocellulosic fibrous waste increases every year due to growing population demand. Its use in the modern world is limited due to synthetic products. An alternative has enumerated to avoid wastage of fibrous resources and its clean disposal.

OBJECTIVE

The main objective of this review paper discussed the feasibility of lignocellulosic fibers and other lignocellulosic materials as natural low-cost adsorbent.

METHODS

The literature study was performed using Web of Science and Scopus indexed journals. The main factors considered to increase the adsorption ability, including the types of lignocellulosic surface modification techniques were searched with utmost importance for quality results. Intending to summarize the literature survey and provide persuasive content, systematic review process was considered for this novel article.

RESULTS

Out of 230 valuable publications, 159 published articles were considered for the present study until March 2022. The articles surplus with factors affecting adsorption (pH, adsorption dosage, surface area, temperature, initial concentration, contact time, physical and chemical properties of pollutants) and surface modification techniques (physical, chemical, and biological) were considered for this manuscript.

CONCLUSION

Overall, the physical and chemical modification methods are widely used instead of biological methods due to various factors as discussed briefly. Furthermore, the finding of this article supports the fact that the fibrous by-product resources are wasted in various occasions due to the modern lifestyle. Even though there is evidential possibility to implement the low-cost adsorbents, the industries limit their application prospects due to existing technology and financial compromises.

Halocyclopentadienes: An Emerging Class of Toxic DBPs in Chlor(am)inated Drinking Water

Although >700 disinfection by-products (DBPs) have been identified to date, most DBPs in drinking water are still unknown. Identifying unknown DBPs is an important step for improving drinking water quality because known DBPs do not fully account for the adverse health effects noted in epidemiologic studies. Using gas chromatography high-resolution mass spectrometry, six chloro- and bromo-halocyclopentadienes (HCPDs) were identified in chlorinated and chloraminated drinking water via non-target analysis; five HCPDs are reported for the first time as new alicyclic DBPs. Formation pathways were also proposed. Simulated disinfection experiments with Suwannee River natural organic matter (NOM) confirm that NOM is a precursor for these new DBPs. Further, HCPDs are more abundant in chlorinated drinking water (real and simulated) when compared to chloraminated drinking water due to the higher reactivity of chlorine. Of these new DBPs, 1,2,3,4,5,5-hexachloro-1,3-cyclopentadiene is approximately 100,000× more toxic (in vivo) than regulated trihalomethanes (THMs) and haloacetic acids (HAAs) and 20-2000× more toxic than halobenzoquinones, halophenols, and halogenated pyridinols using the available median lethal dose (LD₅₀) and concentration for 50% of maximal effective concentration (EC₅₀) of DBPs to aquatic organisms. The predicted bioconcentration factors of these HCPDs range from 384 to 3980, which are 2-3 orders of magnitude higher than those for regulated and priority DBPs (including THMs, HAAs, halobenzoquinones, haloacetonitriles, haloacetamides, halonitromethanes, haloacetaldehydes, iodo-THMs, and iodo-HAAs). Thus, HCPDs are an important emerging class of DBPs that should be studied to better understand their impact on drinking water quality and long-term human health exposure.

Estimating National Exposures and Potential Bladder Cancer Cases Associated with Chlorination DBPs in U.S. Drinking Water

BACKGROUND

Disinfection byproducts (DBPs) in public water systems (PWS) are an unintended consequence resulting from reactions between mostly chlorine-based disinfectants and organic and inorganic compounds in source waters. Epidemiology studies have shown that exposure to DBP (specifically trihalomethanes) was associated with an increased risk of bladder cancer.

OBJECTIVE

Our goal was to characterize the relative differences in exposures and estimated potential bladder cancer risks for people served by different strata of PWS in the United States and to evaluate uncertainties associated with these estimates.

METHODS

We stratified PWS by source water type (surface vs. groundwater) and population served (large, medium, and small) and calculated population-weighted mean trihalomethane-4 (THM4) concentrations for each stratum. For each stratum, we calculated a population attributable risk (PAR) for bladder cancer using odds ratios derived from published pooled epidemiology estimates as a function of the mean THM4 concentration and the fraction of the total U.S. population served by each stratum of systems. We then applied the stratum-specific PARs to the total annual number of new bladder cancer cases in the U.S. population to estimate bladder cancer incidence in each stratum.

RESULTS

Our results show that approximately 8,000 of the 79,000 annual bladder cancer cases in the United States were potentially attributable to DBPs in drinking water systems. The estimated attributable cases vary based on source water type and system size. Approximately 74% of the estimated attributable cases were from surface water systems serving populations of > 10,000 people. We also identified several uncertainties that may affect the results from this study, primarily related to the use of THM4 as a surrogate measure for DBPs relevant to bladder cancer.

DISCUSSION

Despite significant reductions in exposure over the past several decades, our study suggests that ∼ 10 % of the bladder cancer cases in the United States may still be attributed to exposure to DBPs found in drinking water systems. https://doi.org/10.1289/EHP9985.

Critical review and analysis of literature on low dose exposure to chemical mixtures in mammalian in vivo systems

Anthropogenic chemicals are ubiquitous throughout the environment. Consequentially, humans are exposed to hundreds of anthropogenic chemicals daily. Current chemical risk assessments are primarily based on testing individual chemicals in rodents at doses that are orders of magnitude higher than that of human exposure. The potential risk from exposure to mixtures of chemicals is calculated using mathematical models of mixture toxicity based on these analyses. These calculations, however, do not account for synergistic or antagonistic interactions between co-exposed chemicals. While proven examples of chemical synergy in mixtures at low doses are rare, there is increasing evidence that, through non-conformance to current mixture toxicity models, suggests synergy. This review examined the published studies that have investigated exposure to mixtures of chemicals at low doses in mammalian in vivo systems. Only seven identified studies were sufficient in design to directly examine the appropriateness of current mixture toxicity models, of which three showed responses significantly greater than additivity model predictions. While the remaining identified studies were unable to provide evidence of synergistic toxicity, it became apparent that many results of such studies were not always explicable by current mixture toxicity models. Additionally, two data gaps were identified. Firstly, there is a lack of studies where individual chemical components of a complex mixture (>10 components) are tested in parallel to the chemical mixture. Secondly, there is a lack of dose-response data for mixtures of chemicals at low doses. Such data is essential to address the appropriateness and validity of future chemical mixture toxicity models.

Environmental Factors Involved in the High Incidence of Bladder Cancer in an Industrialized Area in North-Eastern Spain

Background

Bladder cancer (BC) is the most common of those affecting the urinary tract, and a significant proportion of the cases are attributable to tobacco use as well as occupational and environmental factors.

Objective

The aim of this study is to estimate the current incidence of BC in an industrialized area in northeastern Spain and to analyze its time trends over three decades from an ecological perspective.

Methods

Patients diagnosed with histologically confirmed primary BC, during 2018-2019, in an area in northeastern Spain (430,883 inhabitants) were included. Crude and age-standardized incidence rates were estimated per 100,000 person-years based on the number of individuals getting their first diagnosis. An exploratory time trend analysis was carried out to describe the evolution in tobacco use and occupational or environmental risk factors and the incidence of BC in the same area from the 1990s.

Results

295 patients were included (age 72.5 ± 10.3 years; 89.8% men). The crude rate was 62.6 (95% CI: 51.9-73.2) for men and 6.8 (95% CI: 3.4-10.3) for women. The annual rate adjusted to the European Standard Population was 85.3 (95% CI:75.0-95.5) for men and 7.0 (95% CI:4.5-9.5) for women. From 1994 to 2018, the prevalence of smokers decreased in men (42.3% to 30.9%) as well as in the active population working in the industry (44.36% to 22.59%). Nevertheless, the car fleet, especially diesel, has increased considerably. The annual mean concentrations of air (PM₁₀, PM_2.5, O₃, and NO₂) and water (nitrates, arsenic, trihalomethanes) pollutants were within the regulatory limit values, but not the maximum levels.

Conclusions

The incidence of BC is one of the highest in men but not in women, despite the decrease in tobacco use and industrial activity (perhaps related to high latency after carcinogen exposure cessation) and despite the control of environmental pollution (the maximum regulatory limit probably needs to be lowered). Finally, a similar exposure to the carcinogen would result in a gender-specific differential incidence.

How well does XAD resin extraction recover halogenated disinfection byproducts for comprehensive identification and toxicity testing?

Halogenated disinfection byproducts (DBPs) are an unintended consequence of drinking water disinfection, and can have significant toxicity. XAD resins are commonly used to extract and enrich trace levels of DBPs for comprehensive, nontarget identification of DBPs and also for in vitro toxicity studies. However, XAD resin recoveries for complete classes of halogenated DBPs have not been evaluated, particularly for low, environmentally relevant levels (ng/L to low µg/L). Thus, it is not known whether levels of DBPs or the toxicity of drinking water might be underestimated. In this study, DAX-8/XAD-2 layered resins were evaluated, considering both adsorption and elution from the resins, for extracting 66 DBPs from water. Results demonstrate that among the 7 classes of DBPs investigated, trihalomethanes (THMs), including iodo-THMs, were the most efficiently adsorbed, with recovery of most THMs ranging from 50%-96%, followed by halonitromethanes (40%-90%). The adsorption ability of XAD resins for haloacetonitriles, haloacetamides, and haloacetaldehydes was highly dependent on the individual species. The adsorption capacity of XAD resins for haloacetic acids was lower (5%-48%), even after adjusting to pH 1 before extraction. Recovery efficiency for most DBPs was comparable with their adsorption, as most were eluted effectively from XAD resins by ethyl acetate. DBP polarity and molecular weight were the two most important factors that determine their recovery. Recovery of trichloromethane, iodoacetic acid, chloro- and iodo-acetonitrile, and chloroacetamide were among the lowest, which could lead to underestimation of toxicity, particularly for iodoacetic acid and iodo-acetonitrile, which are highly toxic.

Evaluation of disinfection byproducts for their ability to affect mitochondrial function

In the race to deliver clean water to communities through potable water reuse, disinfection and water quality assessment are and will continue to be fundamental factors. There are over 700 disinfection byproducts (DBPs) in water; evaluating each compound is practically impossible and very time consuming. A bioanalytical approach could be an answer to this challenge. In this work, the response of four major classes of DBPs toward mitochondrial membrane potential (ΔΨm) and cytoplasmic adenosine triphosphate (C-ATP) was investigated with human carcinoma (HepG2) cells. Within 90 min of cell exposure, only the haloacetic acid (HAA) mixture caused a cytotoxic response as measured by C-ATP. All four groups (haloacetonitriles (HANs), trihalomethanes (THMs), nitrosamines (NOAs), and HAAs) responded well to ΔΨm, R² > 0.70. Based on the half-maximum concentration that evoked a 50% response in ΔΨm, the response gradient was HANs >> HAAs ∼ THM > NOAs. The inhibition of the ΔΨm by HANs is driven by dibromoacetonitrile (DBAN), while dichloroacetonitrile (DCAN) did not cause a significant change in the ΔΨm at less than 2000 µM. A mixture of HANs exhibited an antagonistic behavior on the ΔΨm compared to individual compounds. If water samples are concentrated to increase HAN concentrations, especially DBAN, then ΔΨm could be used as a biomonitoring tool for DBP toxicity.

Feel the Burn: Disinfection Byproduct Formation and Cytotoxicity during Chlorine Burn Events

Nitrification and biofilm growth within distribution systems remain major issues for drinking water treatment plants utilizing chloramine disinfection. Many chloraminated plants periodically switch to chlorine disinfection for several weeks to mitigate these issues, known as "chlorine burns". The evaluation of disinfection byproduct (DBP) formation during chlorine burns beyond regulated DBPs is scarce. Here, we quantified an extensive suite of 80 regulated and emerging, unregulated DBPs from 10 DBP classes in drinking water from two U.S. drinking water plants during chlorine burn and chloramination treatments. Total organic halogen (TOX), including total organic chlorine, total organic bromine, and total organic iodine, was also quantified, and mammalian cell cytotoxicity of whole water mixtures was assessed in chlorine burn waters for the first time. TOX and most DBPs increased in concentration during chlorine burns, and one emerging DBP, trichloroacetaldehyde, reached 99 μg/L. THMs and HAAs reached concentrations of 249 and 271 μg/L, respectively. Two highly cytotoxic nitrogenous DBP classes, haloacetamides and haloacetonitriles, increased during chlorine burns, reaching up to 14.2 and 19.3 μg/L, respectively. Cytotoxicity did not always increase from chloramine treatment to chlorine burn, but a 100% increase in cytotoxicity was observed for one plant. These data highlight that consumer DBP exposure during chlorine burns can be substantial.

Epidemiology beyond its limits

In 1995, journalist Gary Taubes published an article in Science titled "Epidemiology faces its limits," which questioned the utility of nonrandomized epidemiologic research and has since been cited more than 1000 times. He highlighted numerous examples of research topics he viewed as having questionable merit. Studies have since accumulated for these associations. We systematically evaluated current evidence of 53 example associations discussed in the article. Approximately one-quarter of those presented as doubtful are now widely viewed as causal based on current evaluations of the public health consensus. They include associations between alcohol consumption and breast cancer, residential radon exposure and lung cancer, and the use of tanning devices and melanoma. This history should inform current debates about the reproducibility of epidemiologic research results.

Microseira wollei and Phormidium algae more than doubles DBP concentrations and calculated toxicity in drinking water

Warm weather and excess nutrients from agricultural runoff trigger harmful algal blooms, which can affect drinking water safety due to the presence of algal toxins and the formation of disinfection by-products (DBPs) during drinking water treatment. In this study, 66 priority, unregulated and regulated DBPs were quantified in chlorinated controlled laboratory reactions of harmful algae Microseira wollei (formerly known as Lyngbya wollei) and Phormidium using gas chromatography (GC)-mass spectrometry (MS). Live algae samples collected from algae-impacted lakes in South Carolina were chlorinated in both ultrapure water and real source waters containing natural organic matter. DBPs were also measured in finished water from a real drinking water plant impacted by a Microseira bloom. Results show that the presence of Microseira and Phormidium more than doubles total concentrations of DBPs formed by chlorination, with levels up to 586 μg/L formed in natural lake waters. Toxic nitrogen-containing DBPs also more than doubled in concentration, with levels up to 36.1, 3.6, and 37.9 μg/L for haloacetamides, halonitromethanes, and haloacetonitriles, respectively. In ultrapure water, DBPs also formed up to 314 μg/L when algae was chlorinated, demonstrating their ability to serve as direct precursors for these DBPs. When environmentally relevant levels of bromide and iodide were added to chlorination reactions, total DBPs increased 144, 51, and 24% for drinking water reservoir, Lake Marion and Lake Wateree Microseira respectively and 29% for Phormidium. Iodo-DBPs, bromochloroiodomethane, chloroiodoacetic acid, bromoiodoacetic acid, and diiodoacetic acid were observed in finished water from a drinking water plant impacted by Microseira, and bromochloroiodomethane and dibromoiodomethane were observed in chlorinated ultrapure water containing algae, bromide, and iodide. Notably, total calculated cytotoxicity tripled in Microseira-impacted waters and doubled for Phormidium-impacted waters. Calculated genotoxicity doubled for Microseira-impacted waters and more than doubled in Phormidium-impacted waters. Haloacetonitriles were major drivers of calculated cytotoxicity in algae-impacted waters, while haloacetic acids were major drivers of calculated genotoxicity in algae-impacted waters. These results provide the most extensive assessment of DBPs formed from chlorination of algae-impacted waters and highlight potential impacts to drinking water and human health. Results from this study are particularly applicable to drinking water treatment plants that employ pre-chlorination, which can cause the release of algal organic matter (AOM) precursors to form DBPs.

Chlorination by-products in drinking water and risk of bladder cancer - A population-based cohort study

Chlorination by-products have been consistently associated with risk of bladder cancer in case-control studies, but confirmation from large-scale cohort studies is lacking. We assessed the association of drinking water trihalomethanes (THM), a proxy for chlorination by-products, with risk of bladder cancer in 58,672 men and women. Data came from two population-based cohorts, parts of the Swedish Infrastructure for Medical Population-Based Life-Course and Environmental Research (SIMPLER). Individual exposure to THM was assessed by combining residential information with tap water monitoring data. Participants were categorized into non-exposed, low (<15 µg/L) or high (≥15 µg/L) THM exposure. Incident cases were ascertained from 1998 through 2019 via register linkage. During 16 years of follow-up (965,590 person-years), 831 bladder cancer cases were ascertained. We observed no overall association of THM with risk of bladder cancer, hazard ratio for the highest exposed compared to the non-exposed 0.90 (95% confidence interval: 0.73 - 1.11). The null association remained after restricting the analysis to long-term residents and across strata of smoking status and cancer stage. Our results indicate that chlorination by-product exposure at THM concentrations representative of chlorinated drinking waters in most European countries, is not associated with an increased risk of bladder cancer.

Disinfection By-Products in Drinking Water and Bladder Cancer: Evaluation of Risk Modification by Common Genetic Polymorphisms in Two Case-Control Studies

BACKGROUND

By-products are formed when disinfectants react with organic matter in source water. The most common class of disinfection by-products, trihalomethanes (THMs), have been linked to bladder cancer. Several studies have shown exposure-response associations with THMs in drinking water and bladder cancer risk. Few epidemiologic studies have evaluated gene-environment interactions for total THMs (TTHMs) with known bladder cancer susceptibility variants.

OBJECTIVES

In this study, we investigated the combined effect on bladder cancer risk contributed by TTHMs, bladder cancer susceptibility variants identified through genome-wide association studies, and variants in several candidate genes.

METHODS

We analyzed data from two large case-control studies-the New England Bladder Cancer Study (n/n=989 cases/1,162 controls), a population-based study, and the Spanish Bladder Cancer Study (n/n=706 cases/772 controls), a hospital-based study. Because of differences in exposure distributions and metrics, we estimated effects of THMs and genetic variants within each study separately using adjusted logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals (CI) with and without interaction terms, and then combined the results using meta-analysis.

RESULTS

Of the 16 loci showing strong evidence of association with bladder cancer, rs907611 at 11p15.5 [leukocyte-specific protein 1 (LSP1 region)] showed the strongest associations in the highest exposure category in each study, with evidence of interaction in both studies and in meta-analysis. In the highest exposure category, we observed OR=1.66 (95% CI: 1.17, 2.34, p-trend=0.005) for those with the rs907611-GG genotype and p-interaction=0.02. No other genetic variants tested showed consistent evidence of interaction.

DISCUSSION

We found novel suggestive evidence for a multiplicative interaction between a putative bladder carcinogen, TTHMs, and genotypes of rs907611. Given the ubiquitous exposure to THMs, further work is needed to replicate and extend this finding and to understand potential molecular mechanisms. https://doi.org/10.1289/EHP9895.

Modeling the formation of trihalomethanes in rural and semi-urban drinking water distribution networks of Costa Rica

Chlorination is one of the most important stages in the treatment of drinking water due to its effectiveness in the inactivation of pathogenic organisms. However, the reaction between chlorine and natural organic matter (NOM) generates harmful disinfection by-products (DBPs), such as trihalomethanes (THMs). In this research, drinking water quality data was collected from the distribution networks of 19 rural and semi-urban systems that use water sources as springs, surfaces, and a mixture of both, in three provinces of Costa Rica from April 2018 to September 2019. Twelve models were developed from four data sets: all water sources, spring, surface, and a mixture of spring and surface waters. Linear, logarithmic, and exponential multivariate regression models were developed for each data set to predict the concentration of total trihalomethanes (TTHMs) in the distribution networks. Concentrations of TTHMs were found between < 0.20 and 91.31 µg/L, with chloroform being the dominant species accounting for 62% of TTHMs on average. Turbidity, free residual chlorine, total organic carbon (TOC), dissolved organic carbon (DOC), and ultraviolet absorbance at 254 nm (UV₂₅₄) showed a significant correlation with TTHMs. In all the data sets the linear models presented the best goodness-of-fit and were moderately robust. Four models, the best of each data set, were validated with data from the same systems, and, according to the criteria of R², standard error (SE), mean square error (MSE), and mean absolute error (MAE), spring water and mixed spring/surface water models showed a satisfactory level of explanation of the variability of the data. Moreover, the models seem to better predict TTHM concentrations below 30 µg/L. These models were satisfactory and could be useful for decision-making in drinking water supply systems.

Insights into metal-organic frameworks HKUST-1 adsorption performance for natural organic matter removal from aqueous solution

Natural organic matter (NOM) has rich halogenation reactive sites, therefore acts as the main precursor of disinfection byproducts (DBPs) in the chlorine disinfection process during drinking water treatment. In this research, high-quality metal-organic framework HKUST-1 is rapidly synthesized by a solvothermal method, and we are the first to report adsorption of aqueous humic acid (HA), representing NOM, and its adsorption behavior, influencing factors, and recycling capability. The crystalline HKUST-1 possessed a microporous framework with a high 1385 m²/g specific surface area, and three-dimensional structure as characterized by Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), scanning electron microscope (SEM). 99% removal of 5 mg/L HA was observed at pH 5.8, room temperature, and 0.6 g/L HKUST-1. The maximum capacity was 14.42 mg HA/g HKUST-1 at room temperature. The Langmuir adsorption isotherm, quasi-second-order kinetic model, and thermodynamic parameters accurately describe the spontaneous and disorderly endothermic adsorption of HA by HKUST-1. The desorption regeneration process was accomplished by washing HKUST-1 with NaOH and calcination; it showed that HKUST-1 was viable in three regeneration cycles. The mechanism of HA adsorption by HKUST-1 is electrostatic and synergistic interaction between π-π bonding, and hydrogen bonding. HKUST-1 is a potential treatment strategy to remove NOM.

Permanganate/Bisulfite Pre-Oxidation of Natural Organic Matter Enhances Nitrogenous Disinfection By-Products Formation during Subsequent Chlorination

The permanganate/bisulfite (PM/BS) process is a novel oxidation process, which can degrade micropollutants within several seconds. As natural organic matter (NOM) ubiquitously exists in an aquatic environment, the PM/BS process will inevitably react with NOM, which may impact the disinfection-by-products (DBPs) formation during subsequent chlorination. This study investigated the effect of PM/BS pre-oxidation of NOM on DBP formation. It was found that TOC removal reached a plateau when the molar ratio of PM to BS was 1:5. Increasing ratios of PM to BS decreased the intensity and area of fluorescence spectroscopy. PM and BS doses, pre-oxidation time, pH of solutions and concentration of Br− impacted the formation potential of various DBPs. PM/BS pre-oxidation decreased the formation of TCM while increasing the yields of N-DBPs, thus increasing the risk of water quality. Calculated toxicity analysis showed that a general increase in CTI was observed with PM/BS pre-oxidation, indicating that PM/BS pre-oxidation had a negative effect on risk control of overall cytotoxicity. Although the PM/BS process could accelerate the degradation of micropollutants, the elevated DBPs formation, especially highly toxic N-DBPs, needs enough attention to control water-quality risk.

Field Trial of an Automated Batch Chlorinator System at Two Shared Shallow Tubewells among Camps for Forcibly Displaced Myanmar Nationals (FDMN) in Cox's Bazar, Bangladesh

Chlorination of shallow tubewell water is challenging due to various iron concentrations. A mixed-method, small-scale before-and-after field trial assessed the accuracy and consistency of an automated chlorinator, Zimba, in Rohingya camp housing, Cox’s Bazar. From August–September 2018, two shallow tubewells (iron concentration = 6.5 mg/L and 1.5 mg/L) were selected and 20 households were randomly enrolled to participate in household surveys and water testing. The field-team tested pre-and post-treated tubewell and household stored water for iron, free and total chlorine, and E. coli. A sub-set of households (n = 10) also received safe storage containers (5 L jerry cans). Overall mean iron concentrations were 5.8 mg/L in Zimba water, 1.9 mg/L in household storage containers, and 2.8 mg/L in the project-provided safe storage containers. At baseline, 0% samples at source and 60% samples stored in household vessels were contaminated with E. coli (mean log₁₀ = 0.62 MPN/100 mL). After treatment, all water samples collected from source and project-provided safe storage containers were free from E. coli, but 41% of post-treated water stored in the household was contaminated with E. coli. E. coli concentrations were significantly lower in the project-provided safe storage containers (log₁₀ mean difference = 0.92 MPN, 95% CI = 0.59–1.14) compared with baseline and post-treated water stored in household vessels (difference = 0.57 MPN, 95% CI = 0.32–0.83). Zimba is a potential water treatment technology for groundwater extracted through tubewells with different iron concentrations in humanitarian settings.

Health and environmental impacts of drinking water choices in Barcelona, Spain: A modelling study

Quantitative evidence of health and environmental tradeoffs between individuals' drinking water choices is needed to inform decision-making. We evaluated health and environmental impacts of drinking water choices using health impact and life cycle assessment (HIA, LCA) methodologies applied to data from Barcelona, Spain. We estimated the health and environmental impacts of four drinking water scenarios for the Barcelona population: 1) currently observed drinking water sources; a complete shift to 2) tap water; 3) bottled water; or 4) filtered tap water. We estimated the local bladder cancer incidence attributable to trihalomethane (THM) exposure, based on survey data on drinking water sources, THM levels, published exposure-response functions, and disability-adjusted life years (DALYs) from the Global Burden of Disease 2017. We estimated the environmental impacts (species lost/year, and resources use) from waste generation and disposal, use of electricity, chemicals, and plastic to produce tap or bottled drinking water using LCA. The scenario where the entire population consumed tap water yielded the lowest environmental impact on ecosystems and resources, while the scenario where the entire population drank bottled water yielded the highest impacts (1400 and 3500 times higher for species lost and resource use, respectively). Meeting drinking water needs using bottled or filtered tap water led to the lowest bladder cancer DALYs (respectively, 140 and 9 times lower than using tap water) in the Barcelona population. Our study provides the first attempt to integrate HIA and LCA to compare health and environmental impacts of individual water consumption choices. Our results suggest that the sustainability gain from consuming water from public supply relative to bottled water may exceed the reduced risk of bladder cancer due to THM exposure from consuming bottled water in Barcelona. Our analysis highlights several critical data gaps and methodological challenges in quantifying integrated health and environmental impacts of drinking water choices.

Health effects of exposure to chlorination by-products in swimming pools

Concerns have been raised regarding the potential negative effects on human health of water disinfectants used in swimming pools. Among the disinfection options, the approaches using chlorine-based products have been typically preferred. Chlorine readily reacts with natural organic matter that are introduced in the water mainly through the bathers, leading to the formation of potentially harmful chlorination by-products (CBPs). The formation of CBPs is of particular concern since some have been epidemiologically associated with the development of various clinical manifestations. The higher the concentration of volatile CBPs in the water, the higher their concentration in the air above the pool, and different routes of exposure to chemicals in swimming pools (water ingestion, skin absorption, and inhalation) contribute to the individual exposome. Some CBPs may affect the respiratory and skin health of those who stay indoor for long periods, such as swimming instructors, pool staff, and competitive swimmers. Whether those who use chlorinated pools as customers, particularly children, may also be affected has been a matter of debate. In this article, we discuss the current evidence regarding the health effects of both acute and chronic exposures in different populations (work-related exposures, intensive sports, and recreational attendance) and identify the main recommendations and unmet needs for research in this area.

Are Disinfection Byproducts (DBPs) Formed in My Cup of Tea? Regulated, Priority, and Unknown DBPs

Globally, tea is the second most consumed nonalcoholic beverage next to drinking water and is an important pathway of disinfection byproduct (DBP) exposure. When boiled tap water is used to brew tea, residual chlorine can produce DBPs by the reaction of chlorine with tea compounds. In this study, 60 regulated and priority DBPs were measured in Twinings green tea, Earl Grey tea, and Lipton tea that was brewed using tap water or simulated tap water (nanopure water with chlorine). In many cases, measured DBP levels in tea were lower than in the tap water itself due to volatilization and sorption onto tea leaves. DBPs formed by the reaction of residual chlorine with tea precursors contributed ∼12% of total DBPs in real tap water brewed tea, with the remaining 88% introduced by the tap water itself. Of that 12%, dichloroacetic acid, trichloroacetic acid, and chloroform were the only contributing DBPs. Total organic halogen in tea nearly doubled relative to tap water, with 96% of the halogenated DBPs unknown. Much of this unknown total organic halogen (TOX) may be high-molecular-weight haloaromatic compounds, formed by the reaction of chlorine with polyphenols present in tea leaves. The identification of 15 haloaromatic DBPs using gas chromatography-high-resolution mass spectrometry indicates that this may be the case. Further studies on the identity and formation of these aromatic DBPs should be conducted since haloaromatic DBPs can have significant toxicity.

Increased disinfection byproducts in the air resulting from intensified disinfection during the COVID-19 pandemic

Intensified use of disinfectants to control COVID-19 could unintentionally increase the disinfection byproducts (DBPs) in the environment. In indoor spaces, it is critical to determine the optimal disinfection practice to prevent the spread of the virus while keeping DBPs at relatively low levels in the air. The formation of DBPs exceed 0.1 μg/mg while hypochlorite dosed at >10 mg/m³. The total DBP concentrations in highly disinfected places (100-200 mg/m³ hypochlorite) were as high as 66.8 μg/m³, and the Hazard Index (HI) was up to 0.84, and both values were much higher than those in less disinfected places (<10 mg/m³ hypochlorite). Taking into account the HI, formation yields and the origin of the DBPs, we recommended 10 mg/m³ as the suggested hypochlorite dose to minimize DBPs generation during routine disinfection for controlling the coronavirus. DBPs in indoor air could be eliminated by ventilation, reducing the usage of personal care products, and wiping the solid surface with water before or after disinfection. These results highlighted the necessity to control air-borne DBPs and their associated health risks arising from intensified disinfection, and will guide the further development of evidence-based regulation on DBP exposure during disinfection and improve public health protection.

Identification of chloramination disinfection by-products from phenylalanine in tap drinking water

Phenylalanine (Phe) is widely present in natural water and serves as a precursor of disinfection by-products (DBPs). We reported the identification of chloramination DBPs from Phe in drinking water using ultra-high performance liquid chromatography (UHPLC) coupled with complementary high-resolution quadrupole time-of-flight (QTOF) and triple quadrupole (tQ) tandem mass spectrometry (MS/MS). In the chloraminated Phe water solution, sixteen new DBPs in a total of seventeen were identified based on their accurate mass, MS/MS spectra and ³⁵Cl/³⁷Cl isotopic patterns. Three of these DBPs were verified as benzamide, phenylacetamide, and p-hydroxyphenylacetamide with their standards, while the others were chlorinated derivatives of Phe, hydrazone, amidine, amide and peroxide, in which the unique structures of these DBPs were rarely reported. Their stability and formation process were investigated as well. Furthermore, a method consisting of solid phase extraction (SPE) and UHPLC-MS/MS using dynamic multiple reaction monitoring (dMRM) was developed to investigate these DBPs in authentic waters. Phe, benzamide, phenylacetamide, and N-Cl-2-phenylacetimidamide were detected in chlorinated tap water. Compared with the other identified DBPs, these three DBPs were exceptionally stable and could be formed in wide formation conditions. Our work not only provided ideas for the identification of new chloramination DBPs, but also demonstrated that some DBPs usually generated in the chloramination disinfection process could also be found in the chlorinated drinking water.

Pathogen performance testing of a natural swimming pool using a cocktail of microbiological surrogates and QMRA-derived management goals

In recent decades, natural swimming pools (NSPs) have gained popularity in Europe, especially in Germany and Austria. NSPs differ from swimming pools in that they utilize biological treatment processes based on wetland processes with no disinfection residual. However, data are missing on the specific log-reduction performance of NSPs to address enteric virus, bacteria, and parasitic protozoa removal considered necessary to meet the North American risk-based benchmark (<35 illnesses per 1,000 swimming events) set by the USEPA for voluntary swimming. In this study, we examined Canada's first NSP at Borden Park, Edmonton, Canada, to address the following three questions: (1) Given normal faecal shedding rates by bathers, what is the total log reduction (TLR) theoretically needed to meet the EPA benchmark? (2) what is the in-situ performance of the NSP based on spiking suitable microbial surrogates (MS2 coliphage, Enterococcus faecalis, and Saccharomyces cerevisiae [Baker's yeast])? and (3) how much time is required to reach acceptable bather risk levels under different representative volume-turnover rates? A reverse-quantitative microbial risk assessment (QMRA) revealed that of the four reference pathogens selected (Norovirus, Campylobacter, Cryptosporidium, and Giardia), only Norovirus was estimated to exceed the risk benchmark at the 50th, 75th, and 95th percentiles, while Campylobacter was the only other reference pathogen to exceed at the 95th percentile. Log-reduction values (LRVs) were similar to previous reports for bacterial indicators, and novel LRVs were estimated for the other two surrogates. A key finding was that more than 24 h treatment time would be necessary to provide acceptable bather protection following heavy bather use (378 bathers/day for main pool and 26 bathers/day for children's pool), due to the mixing dynamics of the treated water diluting out possible residual pool faecal contamination. The theoretical maximum number of people in the pool per day to be below USEPA's 35 gastro cases in 1,000 swimming events was 113, 47, and 8, at the 50th, 75th, and 95th percentiles. Further, the use of ultra-violet disinfection to the pool return flow had little effect on reducing the treatment time required.