Estimating Potential Increased Bladder Cancer Risk Due to Increased Bromide Concentrations in Sources of Disinfected Drinking Waters

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.

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.

Risks of obstructive genitourinary birth defects in relation to trihalomethane and haloacetic acid exposures: expanding disinfection byproduct mixtures analyses using relative potency factors

BACKGROUND

Some disinfection byproducts (DBPs) are teratogens based on toxicological evidence. Conventional use of predominant DBPs as proxies for complex mixtures may result in decreased ability to detect associations in epidemiological studies.

OBJECTIVE

We assessed risks of obstructive genitourinary birth defects (OGDs) in relation to 12 DBP mixtures and 13 individual component DBPs.

METHODS

We designed a nested registry-based case-control study (210 OGD cases; 2100 controls) in Massachusetts towns with complete quarterly 1999-2004 data on four trihalomethanes (THMs) and five haloacetic acids (HAAs). We estimated temporally-weighted average DBP exposures for the first trimester of pregnancy. We estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for OGD in relation to individual DBPs, unweighted mixtures, and weighted mixtures based on THM/HAA relative potency factors (RPF) from animal toxicology data for full-litter resorption, eye defects, and neural tube defects.

RESULTS

We detected elevated aORs for OGDs for the highest of bromodichloromethane (aOR = 1.75; 95% CI: 1.15-2.65), dibromochloromethane (aOR = 1.71; 95% CI: 1.15-2.54), bromodichloroacetic acid (aOR = 1.56; 95%CI: 0.97-2.51), chlorodibromoacetic acid (aOR = 1.97, 95% CI: 1.23-3.15), and tribromoacetic acid (aOR = 1.90; 95%CI: 1.20-3.03). Across unweighted mixture sums, the highest aORs were for the sum of three brominated THMs (aOR = 1.74; 95% CI: 1.15-2.64), the sum of six brominated HAAs (aOR = 1.43; 95% CI: 0.89-2.31), and the sum of nine brominated DBPs (aOR = 1.80; 95% CI: 1.05-3.10). Comparing eight RPF-weighted to unweighted mixtures, the largest aOR differences were for two HAA metrics, which both were higher with RPF weighting; other metrics had reduced or minimally changed ORs in RPF-weighted models.

Co-Occurrence of Bromine and Iodine Species in US Drinking Water Sources That Can Impact Disinfection Byproduct Formation

Bromine and iodine species are precursors for forming disinfection byproducts in finished drinking waters. Our study incorporates spatial and temporal data to quantify concentrations of inorganic (bromide (Br-), iodide (I-), and iodate (IO3-)), organic, and total bromine (BrT) and iodine (IT) species from 286 drinking water sources and 7 wastewater effluents across the United States. Br- ranged from <5-7800 μg/L (median of 62 μg/L in surface water (SW) and 95 μg/L in groundwater (GW)). I- was detected in 41% of SW (1-72 μg/L, median = <1 μg/L) and 62% of GW (<1-250 μg/L, median = 3 μg/L) samples. The median Br-/I- ratio in SW and GW was 22 μg/μg and 16 μg/μg, respectively, in paired samples with detect Br- and I-. BrT existed primarily as Br-, while IT was present as I-, IO3-, and/or total organic iodine (TOI). Inorganic iodine species (I- and IO3-) were predominant in GW samples, accounting for 60-100% of IT; however, they contributed to only 20-50% of IT in SW samples. The unknown fraction of IT was attributed to TOI. In lakes, seasonal cycling of I-species was observed and was presumably due to algal productivity. Finally, Spearman Rank Correlation tests revealed a strong correlation between Br- and IT in SW (RBr-,IT = 0.83) following the log10 (Br-, μg/L) = 0.65 × log10 (IT, μg/L) - 0.17 relationship. Br- and I- in treated wastewater effluents (median Br- = 234 μg/L, median I- = 5 μg/L) were higher than drinking water sources.

Critical Review on Bromate Formation during Ozonation and Control Options for Its Minimization

Ozone is a commonly applied disinfectant and oxidant in drinking water and has more recently been implemented for enhanced municipal wastewater treatment for potable reuse and ecosystem protection. One drawback is the potential formation of bromate, a possible human carcinogen with a strict drinking water standard of 10 μg/L. The formation of bromate from bromide during ozonation is complex and involves reactions with both ozone and secondary oxidants formed from ozone decomposition, i.e., hydroxyl radical. The underlying mechanism has been elucidated over the past several decades, and the extent of many parallel reactions occurring with either ozone or hydroxyl radicals depends strongly on the concentration, type of dissolved organic matter (DOM), and carbonate. On the basis of mechanistic considerations, several approaches minimizing bromate formation during ozonation can be applied. Removal of bromate after ozonation is less feasible. We recommend that bromate control strategies be prioritized in the following order: (1) control bromide discharge at the source and ensure optimal ozone mass-transfer design to minimize bromate formation, (2) minimize bromate formation during ozonation by chemical control strategies, such as ammonium with or without chlorine addition or hydrogen peroxide addition, which interfere with specific bromate formation steps and/or mask bromide, (3) implement a pretreatment strategy to reduce bromide and/or DOM prior to ozonation, and (4) assess the suitability of ozonation altogether or utilize a downstream treatment process that may already be in place, such as reverse osmosis, for post-ozone bromate abatement. A one-size-fits-all approach to bromate control does not exist, and treatment objectives, such as disinfection and micropollutant abatement, must also be considered.

Alkaline chlorination of drinking water: A trade-off between genotoxicity control and trihalomethane formation

The pH of chlorination is an important factor affecting the formation of disinfection byproducts (DBPs). In this study, we discovered that the genotoxicity induced by chlorination can be effectively reduced under alkaline conditions. As the pH of chlorination increased from 6.5 to 8.5, the genotoxicity of investigated waters reduced by ∼30-90 %. By assessing the genotoxicity of the mixture of measured DBPs, it was found that the contribution of measured DBPs to the overall genotoxicity was lower than 5 %, and the significant reduction of genotoxicity was largely associated with unknown DBPs. The result of Pearson's correlation analysis indicated that humified organics and soluble microbial byproducts were likely responsible for the genotoxicity, and their derived genotoxic compounds (i.e., unknown DBPs) tended to decompose during alkaline chlorination. However, the control of genotoxicity by alkaline chlorination was achieved at the expense of promoting trihalomethane (THM) formation. The highest genotoxicity reduction (93 %) was observed for chlorinated granular activated carbon-treated waters, but the formation of THMs was promoted to a level approaching that in untreated waters. The inconsistent trend of overall genotoxicity and THM concentration during alkaline chlorination suggested the inadequacy of THMs as metric for DBP exposure, and considerations should also be given to the toxicity of bulk water in addition to regulated DBPs.

Formation, toxicity, and mechanisms of halonitromethanes from poly(diallyl dimethyl ammonium chloride) during UV/monochloramine disinfection in the absence and presence of bromide ion

Bromide ion (Br^-) is known as a prevalent component in water environments, which exhibits significant impacts on halonitromethanes (HNMs) formation. This study was performed to explore and compare the formation, toxicity, and mechanisms of HNMs from poly(diallyl dimethyl ammonium chloride) (PDDACl) in the absence and presence of Br^- in the UV/monochloramine (UV/NH₂Cl) disinfection process. The results showed that chlorinated HNMs were found in the absence of Br^-, while brominated (chlorinated) HNMs and brominated HNMs were found in the presence of Br^-. Furthermore, the peaks of total HNMs were promoted by 2.0 and 2.4 times, respectively when 1.0 and 2.0 mg L^-1 Br^- were added. Also, the peaks of total HNMs were enhanced with the increase of the NH₂Cl dosage, which were reduced with the increase of pH. It should be noted that Br^- induced higher toxicity of HNMs, and the cytotoxicity and genotoxicity of HNMs with the addition of 2.0 mg L^-1 Br^- were 78.0 and 3.7 times those without the addition of Br^-, respectively. Meanwhile, both the reaction mechanisms of HNMs produced from PDDACl were speculated in the absence and presence of Br^-. Finally, different HNMs species and yields were discovered in these two real water samples compared to those in simulated waters. These findings of this work will be conducive to understanding the significance of Br^- affecting HNMs formation and toxicity in the disinfection process.

Decomposition of Total Organic Halogen Formed during Chlorination: The Iceberg of Halogenated Disinfection Byproducts Was Previously Underestimated

Total organic halogen (TOX) is widely used as a surrogate bulk parameter to measure the overall exposure of halogenated disinfection byproducts (DBPs) in drinking water. In this study, we surprisingly found that the level of TOX in chlorinated waters had been significantly underestimated under common analytical conditions. After the addition of quenching agent sodium thiosulfate, total organic chlorine and total organic bromine exhibited a two-phase decomposition pattern with increasing contact time, and a significant decomposition was observed for different types of quenching agents, quenching doses, and pH conditions. More importantly, the decomposed TOX closely correlated with the acute toxicity of quenched water against luminous bacteria, implying that the DBPs responsible for TOX decomposition could be of important toxicological significance. Based on nontarget analysis by using high-resolution mass spectrometry, molecular formulas for the decomposed TOX were determined. After re-examining the mass balance of TOX in the context of unintentional decomposition, it was found that both the level and percentage of unknown TOX in chlorinated waters were considerably higher than historically thought. Overall, this study brings new insights into the knowledge of TOX formed during chlorination, providing important clues on the identification of toxicity driver in drinking water.

The convergence of 2,6-dichloro-1,4-benzoquinone in the whole process of lignin phenol precursor chlorination

The formation and decomposition of 2,6-dichloro-1,4-benzoquinone, an emerging disinfection byproduct (DBP), was studied in the chlorination of lignin phenol precursors. The results show that DCBQ and the related hydroxyl DCBQ (DCBQ-OH) acts as the intermediate products of the chlorination process of the three typical lignin phenol precursors (p-hydroxybenzoic acid, protocatechuic acid, and gallic acid). The contributions of lignin phenol precursors to the overall formation of the targeted DBPs were determined based on the observed abundances of individual lignin phenols and their DBP yields. DCBQ and DCBQ-OH were generated within 2-6 h, the relative abundance of the yields of mol carbon atoms in DCBQ corresponding to the mol carbon atoms in the three model precursors (DCBQ-C) was about 0.01%-14.37% under different pH conditions. With the chlorination reaction time increased (after two or four h), the concentrations of DCBQ and DCBQ-OH entirely decreased, and the decomposition of DCBQ do not follow a pseudo-first-order kinetics during chlorination. Conversely, the decomposition of DCBQ generated from p-hydroxybenzoic acid followed a pseudo-second-order kinetics. Moreover, the formation of trichloromethane (TCM), dichloroacetic acid (DCAA), and trichloroacetic acid (TCAA) was also detected during the chlorination. The contribution of the decomposed DCBQ was mainly to TCAA and the unknown DBPs within 2-12 h, and DCBQ decomposition pathway was affected by pH. Moreover, except for DCBQ/DCBQ-OH and TCM/HAAs, there were still 73.6%-92.41% unknown products (including non-halogenated aromatic DBPs and chlorine-substituted DBPs) needing to identify during the chlorination process for lignin phenols. Overall, revealing the formation and decomposition of DCBQ during the chlorination of lignin phenol precursors would contribute to the effective development of drinking water treatment processes for the removal of highly toxic intermediates generated during disinfection.

Cancer and Ongoing Climate Change: Who Are the Most Affected?

Cancer has become the leading cause of premature death in many counties in recent decades. Previous studies showed plenty of evidence that control of modifiable risk factors would reduce the cancer burden. Since modifiable risk factors could be eliminated by changing the lifestyles of individuals, a greater uptake of modifiable risk factors is critical to reducing cancer burden and inequality in cancer survival. However, climate change will widen cancer inequities through its complex connections with modifiable risk factors. In this perspective, complex connections between climate change and cancer risks via modifiable risk factors, including abnormal temperature, UV, air pollution, natural disasters, food (diet), water, infections, and inefficient physical activities, have been summarized. The associations between climate change and modifiable risk factors have no doubt expanded the inequities. People who face overlapping modifiable risk factors, but who are unable to change or adapt, are at the highest risk in the climate change-cancer linkage. Though individual actions to avoid exposure to modifiable risk factors have been recommended, limited benefits would be achieved unless the nations strive to ensure the basic needs of the people. No choice makes avoiding exposure to risk factors an empty phrase. Thus, government actions should be taken to reduce the expanded inequities in cancer risks.

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.

Tradeoff between micropollutant abatement and bromate formation during ozonation of concentrates from nanofiltration and reverse osmosis processes

Water treatment with nanofiltration (NF) or reverse osmosis (RO) membranes results in a purified permeate and a retentate, where solutes are concentrated and have to be properly managed and discharged. To date, little is known on how the selection of a semi-permeable dense membrane impacts the dissolved organic matter in the concentrate and what the consequences are for micropollutant (MP) abatement and bromate formation during concentrate treatment with ozone. Laboratory ozonation experiments were performed with standardized concentrates produced by three membranes (two NFs and one low-pressure reverse osmosis (LPRO) membrane) from three water sources (two river waters and one lake water). The concentrates were standardized by adjustment of pH and concentrations of dissolved organic carbon, total inorganic carbon, selected micropollutants (MP) with a low to high ozone reactivity and bromide to exclude factors which are known to impact ozonation. NF membranes had a lower retention of bromide and MPs than the LPRO membrane, and if the permeate quality of the NF membrane meets the requirements, the selection of this membrane type is beneficial due to the lower bromate formation risks upon concentrate ozonation. The bromate formation was typically higher in standardized concentrates of LPRO than of NF membranes, but the tradeoff between MP abatement and bromate formation upon ozonation of the standardized concentrates was not affected by the membrane type. Furthermore, there was no difference for the different source waters. Overall, ozonation of concentrates is only feasible for abatement of MPs with a high to moderate ozone reactivity with limited bromate formation. Differences in the DOM composition between NF and LPRO membrane concentrates are less relevant than retention of MPs and bromide by the membrane and the required ozone dose to meet a treatment target.

Disinfection byproducts in chlorinated or brominated swimming pools and spas: Role of brominated DBPs and association with mutagenicity

Although the health benefits of swimming are well-documented, health effects such as asthma and bladder cancer are linked to disinfection by-products (DBPs) in pool water. DBPs are formed from the reaction of disinfectants such as chlorine (Cl) or bromine (Br) with organics in the water. Our previous study (Daiber et al., Environ. Sci. Technol. 50, 6652; 2016) found correlations between the concentrations of classes of DBPs and the mutagenic potencies of waters from chlorinated or brominated swimming pools and spas. We extended this study by identifying significantly different concentrations of 21 individual DBPs in brominated or chlorinated pool and spa waters as well as identifying which DBPs and additional DBP classes were most associated with the mutagenicity of these waters. Using data from our previous study, we found that among 21 DBPs analyzed in 21 pool and spa waters, the concentration of bromoacetic acid was significantly higher in Br-waters versus Cl-waters, whereas the concentration of trichloroacetic acid was significantly higher in Cl-waters. Five Br-DBPs (tribromomethane, dibromochloroacetic acid, dibromoacetonitrile, bromoacetic acid, and tribromoacetic acid) had significantly higher concentrations in Br-spa versus Cl-spa waters. Cl-pools had significantly higher concentrations of Cl-DBPs (trichloroacetaldehyde, trichloromethane, dichloroacetic acid, and chloroacetic acid), whereas Br-pools had significantly higher concentrations of Br-DBPs (tribromomethane, dibromoacetic acid, dibromoacetonitrile, and tribromoacetic acid). The concentrations of the sum of all 4 trihalomethanes, all 11 Br-DBPs, and all 5 nitrogen-containing DBPs were each significantly higher in brominated than in chlorinated pools and spas. The 8 Br-DBPs were the only DBPs whose individual concentrations were significantly correlated with the mutagenic potencies of the pool and spa waters. These results, along with those from our earlier study, highlight the importance of Br-DBPs in the mutagenicity of these recreational waters.

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.

Bromine and iodine species in drinking water supply system along the Changjiang River in China: Occurrence and transformation

Bromine (Br) and iodine (I) in source water can form highly toxic brominated or iodinated disinfection byproducts in treatment plants. For the first time, the occurrence of Br and I speciation and their proportion, transformation in the drinking water supply system along the Changjiang River were investigated. 96 water samples were collected from eight drinking water treatment plants under conditions of low, normal, and flood water regimes. Total Br (TBr) and total I (TI) concentrations were quantified by inductively coupled plasma mass spectrometry (ICPMS) and inorganic Br/I forms (bromide, bromate, iodide, and iodate) were determined by high-performance liquid chromatography coupled with ICPMS. Concentrations of organic Br/I were calculated as the difference between total Br/I and inorganic Br/I. Water regimes had different effect on Br and I species, and there were different rules in untreated and treated water samples. Apparent increase of TBr and TI concentrations after water treatment were observed, which indicated the possibility of Br/I introduction by chlorine-containing disinfectant. The occurrence of TBr, TI, bromide, and total organic I in the river were investigated to increase with the direction of flow. In addition, TBr and TI concentrations correlated with the concentrations of artificial sweeteners (e.g., acesulfame and sucralose, a kind of wastewater indicator), suggesting the influence of domestic sewage on Br and I in the river. In untreated water, bromide was the main Br species, and after treatment more than 50% was transformed into organic Br. Iodoorganics were the majority of I species in raw water and were partly transformed into iodate after treatment. Overall, the Br/I species have accumulation potential in the Changjiang River and organic forms occupy high proportion in treated water samples, which should be paid more attention.

Endocrine-Disrupting Compounds: An Overview on Their Occurrence in the Aquatic Environment and Human Exposure

Endocrine-disrupting compounds (EDCs) as emerging contaminants have accumulated in the aquatic environment at concentration levels that have been determined to be significant to humans and animals. Several compounds belong to this family, from natural substances (hormones such as estrone, 17-estradiol, and estriol) to synthetic chemicals, especially pesticides, pharmaceuticals, and plastic-derived compounds (phthalates, bisphenol A). In this review, we discuss recent works regarding EDC occurrence in the aquatic compartment, strengths and limitations of current analytical methods used for their detection, treatment technologies for their removal from water, and the health issues that they can trigger in humans. Nowadays, many EDCs have been identified in significant amounts in different water matrices including drinking water, thus increasing the possibility of entering the food chain. Several studies correlate human exposure to high concentrations of EDCs with serious effects such as infertility, thyroid dysfunction, early puberty, endometriosis, diabetes, and obesity. Although our intention is not to explain all disorders related to EDCs exposure, this review aims to guide future research towards a deeper knowledge of EDCs’ contamination and accumulation in water, highlighting their toxicity and exposure risks to humans.

Spatial/temporal distribution and multi-pathway cancer risk assessment of trihalomethanes in low TOC and high bromide groundwater

This study aims (1) to determine the seasonal and spatial distribution of THMs formed in chlorinated groundwater containing low levels of organic matter (0.4-0.8 mg L^-1) and low to high levels of bromine (40-380 μg L^-1), and (2) to evaluate the multi-route cancer risks associated with them. The study was conducted in Kayseri (Turkey), where drinking water is supplied from groundwater after chlorination only. THM formation in 50 water samples from 18 storage tanks and 32 distribution points was investigated to evaluate the spatial and temporal changes in THM concentrations for 12 months. The lifetime cancer risk associated with exposure to THMs through multiple pathways (i.e., oral ingestion, dermal absorption, and inhalation) was estimated for males and females. For a 12 month sampling period, the minimum and maximum THM concentrations varied from 2 μg L^-1 to 17 μg L^-1 and from 2 μg L^-1 to 29 μg L^-1 in storage tanks and distribution points, respectively. The ranges of median concentrations of THM were 5 μg L^-1 to 9 μg L^-1 in storage tanks and 5 μg L^-1 to 12 μg L^-1 in distribution points. In all samples dibromochloromethane was the dominant species, followed by bromoform, chloroform, and bromodichloromethane. The average values of total cancer risk associated with exposure to THMs via oral ingestion, dermal absorption, and inhalation for females and males were 1.31 × 10^-5 and 1.25 × 10^-5 in storage tanks, and 1.46 × 10^-5 and 1.39 × 10^-5 in distribution points, respectively. Although THM concentrations were very low, cancer risk values are 1.0 × 10^-6 < CR < 1.0 × 10^-4, which are higher than the negligible risk level (1.0 × 10^-6).

Cancer and climate change

The acute impact of climate change on human health is receiving increased attention, but little is known or appreciated about the effect of climate change on chronic diseases, particularly cancer. This Review provides a synopsis of what is known about climate change and the exposures it generates relevant to cancer. In the context of the world's cancer burden and the probable direction we could expect to follow in the absence of climate change, this scoping review of the literature summarises the effects that climate change is having on major cancers, from environmental exposures to ultraviolet radiation, air pollution, disruptions in the food and water supply, environmental toxicants, and infectious agents. Finally, we explore the effect of climate change on the possible disruption of health systems that have been essential to cancer control practice. We conclude with potential responses and opportunities for intervention.

Study of the occurrence and multi-pathway health risk assessment of regulated and unregulated disinfection by-products in drinking and swimming pool waters of Mediterranean cities

The occurrence of a wide variety of regulated (four trihalomethanes (THM(4)), five haloacetic acids (HAA(5))) and unregulated (haloacetonitriles (HANs), halogenated ketones, chloropicrin, carbon tetrachloride, and other haloacetic acids) disinfection by-products (DBPs) was studied, in two hundred twenty-six finished drinking water samples collected in Barcelona (Spain, between 2008 and 2009), Athens (Greece, 2009-2010), Heraklion (Greece, 2009-2010), Nicosia (Cyprus, 2012-2013), and Limassol (Cyprus, 2011). The samples were analyzed by using liquid-liquid extraction, gas chromatography coupled with an electron capture detector or negative chemical ionization mass spectrometry. In addition, fourteen swimming pool water samples (from Heraklion and Athens) were also investigated regarding their DBPs content. The studied DBPs were determined concurrently with pH, total organic carbon (TOC), and bromide. Spearman's statistical analysis has shown statistically significant (p < 0.001) weak correlations between TOC, THM(4), HANs and HAA(5) but a strong correlation between THM(4) and HANs. Principal component analysis (PCA) on THM(4), HANs and HAA(5) provided a clear differentiation between the examined drinking waters, on the basis of their DBPs content. In the drinking water of coastal cities, the brominated DBPs dominated over the chlorinated ones, due to the higher bromide concentrations occurring in the corresponding raw waters. Lifetime cancer risk and hazard quotient by exposure to four THMs, dichlorocetic acid and trichloroacetic acid in drinking water and indoor swimming pools through multiple pathways were estimated. Total cancer unit risks in drinking water for Nicosia, Barcelona, Limassol and Athens exceeded in most cases the US EPA's regulatory threshold (1.0E-06). The total lifetime cancer risk evaluated for the studied indoor swimming pools was above the US EPA's negligible level for male, female, and junior swimmers.

Comparative Quantitative Toxicology and QSAR Modeling of the Haloacetonitriles: Forcing Agents of Water Disinfection Byproduct Toxicity

The haloacetonitriles (HANs) is an emerging class of nitrogenous-disinfection byproducts (N-DBPs) present in disinfected drinking, recycled, processed wastewaters, and reuse waters. HANs were identified as primary forcing agents that accounted for DBP-associated toxicity. We evaluated the toxic characteristics of iodoacetonitrile (IAN), bromoacetonitrile (BAN), dibromoacetonitrile (DBAN), bromochloroacetonitrile (BCAN), tribromoacetonitrile (TBAN), chloroacetonitrile (CAN), dichloroacetonitrile (DCAN), trichloroacetonitrile (TCAN), bromodichloroacetonitrile (BDCAN), and chlorodibromoacetonitrile (CDBAN). This research generated the first quantitative, comparative analyses on the mammalian cell cytotoxicity, genotoxicity and thiol reactivity of these HANs. The descending rank order for HAN cytotoxicity was TBAN ≈ DBAN > BAN ≈ IAN > BCAN ≈ CDBAN > BDCAN > DCAN ≈ CAN ≈ TCAN. The rank order for genotoxicity was IAN ≈ TBAN ≈ DBAN > BAN > CDBAN ≈ BDCAN ≈ BCAN ≈ CAN ≈ TCAN ≈ DCAN. The rank order for thiol reactivity was TBAN > BDCAN ≈ CDBAN > DBAN > BCAN > BAN ≈ IAN > TCAN. These toxicity metrics were associated with membrane permeability and chemical reactivity. Based on their physiochemical parameters and toxicity metrics, we developed optimized, robust quantitative structure activity relationship (QSAR) models for cytotoxicity and for genotoxicity. These models can predict cytotoxicity and genotoxicity of novel HANs prior to analytical biological evaluation.

A review on the 40th anniversary of the first regulation of drinking water disinfection by-products

Water disinfection, primarily by chlorination, is one of the greatest achievements of public health. However, more than half a century after its introduction, studies in the 1970s reported that (a) chlorine interacted with organic matter in the water to form disinfection by-products (DBPs); (b) two DBPs, chloroform and bromoform, both trihalomethanes (THMs), were rodent carcinogens; (c) three brominated THMs were mutagenic; in six studies chlorinated drinking waters in the United States and Canada were mutagenic; and (d) in one epidemiological study there was an association between bladder cancer mortality and THM exposure. This led the U.S. Environmental Protection Agency to issue its first DBP regulation in 1979. Forty years later, >600 DBPs have been characterized, 20/22 have been shown to be rodent carcinogens, >100 have been shown to be genotoxic, and 1000s of water samples have been found to be mutagenic. Data support a hypothesis that long-term dermal/inhalation exposure to certain levels of the three brominated THMs, as well as oral exposure to the haloacetic acids, combined with a specific genotype may increase the risk for bladder cancer for a small but significant population group. Improved water-treatment methods and stricter regulations have likely reduced such risks over the years, and further reductions in potential risk are anticipated with the application of advanced water-treatment methods and wider application of drinking water regulations. This 40-year research effort is a remarkable example of sustained cooperation between academic and government scientists, along with public/private water companies, to find answers to a pressing public health question.

Radial basis function artificial neural network able to accurately predict disinfection by-product levels in tap water: Taking haloacetic acids as a case study

Control of risks caused by disinfection by-products (DBPs) requires pre-knowledge of their levels in drinking water. In this study, a radial basis function (RBF) artificial neural network (ANN) was proposed to predict the concentrations of haloacetic acids (HAAs, one dominant class of DBPs) in actual distribution systems. To train and verify the RBF ANN, a total of 64 samples taken from a typical region (Jinhua region) in China were characterized in terms of water characteristics (dissolved organic carbon (DOC), ultraviolet absorbance at 254 nm (UVA₂₅₄), NO₂^--N level, NH₄⁺-N level, Br^- and pH), temperature and the prevalent HAAs concentrations. Compared with multiple linear/log linear regression (MLR) models, predictions done by RBF ANNs showed rather higher regression coefficients and accuracies, indicating the high capability of RBF ANNs to depict complicated and non-linear relationships between HAAs formation and various factors. Meanwhile, it was found that, predictions of HAAs formation done by RBF ANNs were efficient and allowed to further improve the prediction accuracy. This is the first study to systematically explore feasibility of RBF ANNs in prediction of DBPs. Accurate predictions by RBF ANNs provided great potential application of DBPs monitoring in actual distribution system.

Transcriptome analyses unravel CYP1A1 and CYP1B1 as novel biomarkers for disinfection by-products (DBPs) derived from chlorinated algal organic matter

Disinfection by-products (DBPs) are generated during chlorination of drinking water. Previous studies demonstrate that DBPs are cytotoxic, genotoxic and associated with an increased risk of human cancer. However, the molecular basis of DBPs-induced toxic effects remains unclear. Here, we chlorinated samples of algal-derived organic matter (AOM) and sediment organic matter (SOM) from a local drinking water reservoir. Chemical properties, toxicities and transcriptomic profiles of human Caco-2 cell exposed to AOM and SOM were compared before and after chlorination. We analyzed chlorination-caused distinct gene expression patterns between AOM and SOM, and identified a set of 22 differentially expressed genes under chlorination of AOM that are different from chlorinated SOM. Consequent network analysis indicates that differential CYP1A1, CYP1B1, ID1 and ID2 are common targets of the upstream regulators predicted in the AOM group, but not the SOM group. Through experimental validation and data integration from previous reports related to DBPs or environmental stressors, we found that CYP1A1 and CYP1B1 are specifically up-regulated after chlorinating AOM. Our study demonstrates that the two CYP1 genes likely act as novel biomarkers of AOM derived DBPs, and this would be helpful for testing drinking water DBPs toxicity and further monitoring drinking water safety.

Analysis of Cumulative Cancer Risk Associated with Disinfection Byproducts in United States Drinking Water

Hundreds of different disinfection byproducts form in drinking water following necessary treatment with chlorine and other disinfectants, and many of those byproducts can damage DNA and increase the risk of cancer. This study offers the first side-by-side comparison of cancer risk assessments based on toxicological and epidemiological studies of disinfection byproducts using a comprehensive contaminant occurrence dataset for haloacetic acids and trihalomethanes, two groups of disinfection byproducts that are regulated in drinking water. We also provide the first analysis of a new occurrence dataset for unregulated haloacetic acids that became available from the latest, fourth round of the U.S. EPA-mandated unregulated contaminant monitoring program (UCMR4). A toxicological assessment indicated that haloacetic acids, and in particular brominated haloacetic acids, are more carcinogenic and are associated with a greater number of attributable cancer cases than trihalomethanes. Based on the toxicological analysis, cumulative lifetime cancer risk due to exposure to trihalomethanes and haloacetic acids for community water systems monitored under UCMR4, estimated with standard default parameters for body weight and water intake, corresponds to 7.0 × 10-5 (3.5 × 10-5-1.3 × 10-4). The same analysis conducted with age sensitivity factors to account for elevated risk in infants and children yielded a cumulative risk estimate of 2.9 × 10-4 (1.7 × 10-4-6.2 × 10-4). Epidemiological data suggest that lifetime cancer risk from disinfection byproducts for the U.S. population served by community water systems is approximately 3.0 × 10-3 (2.1 × 10-4-5.7 × 10-3), or a lifetime cancer risk of three cases per thousand people. Overall, this analysis highlights the value of using human data in health risk assessments to the greatest extent possible.

Endocrine Disruptors in Water and Their Effects on the Reproductive System

Anthropogenic contaminants in water can impose risks to reproductive health. Most of these compounds are known to be endocrine disrupting chemicals (EDCs). EDCs can impact the endocrine system and subsequently impair the development and fertility of non-human animals and humans. The source of chemical contamination in water is diverse, originating from byproducts formed during water disinfection processes, release from industry and livestock activity, or therapeutic drugs released into sewage. This review discusses the occurrence of EDCs in water such as disinfection byproducts, fluorinated compounds, bisphenol A, phthalates, pesticides, and estrogens, and it outlines their adverse reproductive effects in non-human animals and humans.

Modeling Trihalomethane Increases Associated with Source Water Bromide Contributed by Coal-Fired Power Plants in the Monongahela River Basin

Increases in source water bromide concentrations are challenging for drinking water utilities since bromide contributes to the formation of disinfection byproducts (DBPs) that have negative human-health effects. The present work evaluates the role of coal-fired power plant wet flue gas desulfurization (FGD)-associated bromide loads on in-stream bromide concentrations in the Monongahela River Basin in the water year (WY) 1998 (during a nationwide study) and over a five-year period from WYs 2013 through 2017. Under mean flow conditions in the lower Monongahela River for the WYs of interest, the median-estimated wet FGD bromide discharges are modeled to represent a significant fraction (27-57%) of observed bromide concentrations with the range representing the change in load conditions across WYs. Seasonal effects are predicted due to changes in the dilution capacity of the river with elevated concentrations under lower flows in the third and fourth quarters (July through December). The effect of these bromide concentration contributions, which range from 6.8 to 23 μg/L under median load estimates and median flow conditions, on trihalomethane (THM) formation and associated risk were assessed. A simple model was applied to demonstrate an analytical approach for evaluating the power plant total THM (TTHM) and risk contributions. Utilizing this model, the power plant TTHM contribution was estimated to range from 7.6 to 27 μg/L with a median risk contribution of 0.0014.

Factors Associated with Exposure to Trihalomethanes, NHANES 2001-2012

Disinfection is critical for maintaining a safe water supply, but the use of chlorine or chloramine leads to exposure to disinfection byproducts (DBPs), including trihalomethanes (THMs), which have been associated with adverse reproductive outcomes and bladder cancer. The U.S. Environmental Protection Agency revised the DBP regulations starting in 1998 to further limit levels of THMs in household water. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) collected between 2001 and 2012 (with 2 years per cycle) using models with and without water-related predictors to examine the utility of including these measures. Median blood chloroform levels (25th-75th percentiles) were 16.2 (9.13-31.2) ng/L in 2001-2002 and 5.97 (2.92-12.3) ng/L in 2011-2012. Median blood bromodichloromethane (BDCM) levels (25th-75th percentiles) were 2.22 (1.06-4.61) ng/L in 2001-2002 and 1.18 (<limit of detection-2.92) ng/L in 2011-2012. THM water concentrations and measures of the recency since time spent in water use activities were associated with blood THM levels. Being in a pool/hot tub/sauna within 24 h or taking a shower/bath within 6 h of blood collection was associated with elevated blood levels of chloroform and BDCM. When possible, it is important to include recency and external dose when assessing associations to internal dose levels for nonpersistent compounds.

Trihalomethanes in Drinking Water and Bladder Cancer Burden in the European Union

BACKGROUND

Trihalomethanes (THMs) are widespread disinfection by-products (DBPs) in drinking water, and long-term exposure has been consistently associated with increased bladder cancer risk.

OBJECTIVE

We assessed THM levels in drinking water in the European Union as a marker of DBP exposure and estimated the attributable burden of bladder cancer.

METHODS

We collected recent annual mean THM levels in municipal drinking water in 28 European countries (EU28) from routine monitoring records. We estimated a linear exposure-response function for average residential THM levels and bladder cancer by pooling data from studies included in the largest international pooled analysis published to date in order to estimate odds ratios (ORs) for bladder cancer associated with the mean THM level in each country (relative to no exposure), population-attributable fraction (PAF), and number of attributable bladder cancer cases in different scenarios using incidence rates and population from the Global Burden of Disease study of 2016.

RESULTS

We obtained 2005-2018 THM data from EU26, covering 75% of the population. Data coverage and accuracy were heterogeneous among countries. The estimated population-weighted mean THM level was 11.7μg/L [standard deviation (SD) of 11.2]. The estimated bladder cancer PAF was 4.9% [95% confidence interval (CI): 2.5, 7.1] overall (range: 0-23%), accounting for 6,561 (95% CI: 3,389, 9,537) bladder cancer cases per year. Denmark and the Netherlands had the lowest PAF (0.0% each), while Cyprus (23.2%), Malta (17.9%), and Ireland (17.2%) had the highest among EU26. In the scenario where no country would exceed the current EU mean, 2,868 (95% CI: 1,522, 4,060; 43%) annual attributable bladder cancer cases could potentially be avoided.

DISCUSSION

Efforts have been made to reduce THM levels in the European Union. However, assuming a causal association, current levels in certain countries still could lead to a considerable burden of bladder cancer that could potentially be avoided by optimizing water treatment, disinfection, and distribution practices, among other possible measures. https://doi.org/10.1289/EHP4495.

Risk associated with increasing bromide in drinking water sources in Yancheng City, China

The bromide concentration in water source (WS) of Yancheng City in China increased unexpectedly due to industrial discharge and saltwater intrusion, which leads to the formation of trihalomethane (THMs) in finished water of water treatment plants (WTP), especially brominated THMs. In Yancheng City, drinking water is supplied by WTP1 and WTP2, primarily sourced by WS1 and WS2, respectively. In this paper, the seasonal variations of bromide in WS1 and WS2 and THMs species in WTP1 and WTP2 were analyzed and compared. The effects of bromide in WS on THMs formation in finished water of WTP in terms of bromine substitution factor (BSF) were simulated by statistical linear model. Although the THMs concentrations in WTP1 were approximate to that in WTP2, the brominated THMs concentrations in WTP1 were higher than that in WTP2 due to higher bromide concentration in WS1 than WS2. The cancer risk analysis indicated that THMs' species of DBCM is the dominant THMs for WTP1 as well as WTP2, which can provide more information for WTPs with higher bromide concentration in water source.

Non-targeted screening and analysis of volatile organic compounds in drinking water by DLLME with GC-MS

Volatile organic compounds (VOCs) in drinking water may potentially be hazardous. We developed a novel non-targeted analysis method of VOCs in drinking water that uses dispersive liquid-liquid microextraction coupled with gas chromatography-mass spectrometry. Analysis parameters were selected from range-finding tests on the peak number and average area of the extracted compounds. The optimized method was applied to analyze VOCs in tap water samples collected from Wuhan City, China. Twenty-seven compounds with high match degrees and a high prevalence were selected for quantification and evaluation. We used structure-activity relationships to predict the carcinogenicity of these compounds. Although most of the compounds were non-toxic, compounds such as dibutyl phthalate and diacetone alcohol should be investigated further. Untargeted analysis of the tap water samples identified 75-200 VOCs, including 67 highly prevalent compounds. Industrial and pharmaceutical chemicals accounted for approximately 70% of the VOCs in the samples. This method of non-targeted analysis and in silico toxicity prediction is simple and economic, and could be used in screening VOCs in drinking water.

Hydrophobic organic compounds in drinking water reservoirs: Toxic effects of chlorination and protective effects of dietary antioxidants against disinfection by-products

This study investigated formation and genotoxicities of disinfection by-products (DBPs) during chlorination of hydrophobic organic compounds (HOCs) extracted from six drinking water reservoirs around the Pearl River Delta region, China. Chemical analyses firstly showed that after chlorination aromatic HOCs (including polycyclic aromatic hydrocarbons, PAHs) decreased but DBPs (including chlorinated PAHs) increased, while genotoxicity assays revealed that the chlorination increased DNA damage in human Caco-2 cells. Although the link between DBPs and the genotoxicity was weak (insignificant correlations, p ≥ 0.05), we observed that chlorination of HOCs from more contaminated reservoirs in general resulted in higher genotoxicity. Secondly, remedial effects of catalase and dietary antioxidants (i.e. vitamin C and epigallocatechin gallate) in protecting cells against DBPs genotoxicity were detected. After 1 h treatment by the antioxidants, the DNA damage in Caco-2 cells (due to previous exposure to DBPs) significantly decreased (p < 0.05) in 7 out of a total of 18 treatments (38.9%). This is the first study demonstrating that catalase, vitamin C and epigallocatechin gallate protected human cells in vitro against DNA damage upon exposure to chlorinated genotoxic DBPs.

Disinfection Byproducts in Rajasthan, India: Are Trihalomethanes a Sufficient Indicator of Disinfection Byproduct Exposure in Low-Income Countries?

The implementation of chlorine disinfection in low-income countries reduces the risk of waterborne illness but initiates exposure to disinfection byproducts (DBPs). Like high-income countries, low-income countries typically are adopting regulations focusing on trihalomethanes (THM4) as an indicator of overall DBP exposure. However, the use of impaired water sources can decouple the formation of THM4 from other DBP classes that are more potent toxins. The documentation of DBP species other than THM4 is rare in low-income countries, where water sources may be degraded by inadequate sanitation infrastructure and other uncontrolled wastewater discharges. We measured THM4 and 21 unregulated DBPs in tap waters and laboratory-treated source waters from two cities in northwestern India. The contribution of each DBP class to the cumulative toxicity was estimated by weighting each species by metrics of toxic potency; haloacetonitriles typically were the dominant contributor, while the contribution of THM4 was negligible. THM4 concentrations did not correlate with the total toxic potency-weighted DBP concentrations. Although THM4 rarely exceeded international guidelines, DBPs of greater toxicological concern were observed in high concentrations. The total toxic potency-weighted DBP concentrations in some waters were elevated compared to conventional drinking waters in high-income countries and more closely resembled chlorine-disinfected wastewater effluents. Artificial sweeteners confirmed widespread contamination of both surface and groundwaters by domestic sewage. The results suggest that THM4 may not be an adequate indicator of overall DBP exposure in impaired water supplies prevalent in some low-income nations.

Disinfection byproducts potentially responsible for the association between chlorinated drinking water and bladder cancer: A review

Epidemiological studies have consistently associated the consumption of chlorinated drinking water with an enhanced risk of bladder cancer. While this suggests that some disinfection byproducts (DBPs) are bladder carcinogens, causal agents are unknown. This study aims to highlight likely candidates. To achieve this, structures of known and hypothesised DBPs were compared with 76 known bladder carcinogens. The latter are dominated by nitrogenous and aromatic compounds; only 10 are halogenated. Under 10% of the chlorine applied during drinking water treatment is converted into identified halogenated byproducts; most of the chlorine is likely to be consumed during the generation of unidentified non-halogenated oxidation products. Six nitrosamines are among the nine most potent bladder carcinogens, and two of them are known to be DBPs: N-nitrosodiphenylamine and nitrosodibutylamine. However, these and other nitrosamines are formed in insufficiently low concentrations in chlorinated drinking water to account for the observed bladder cancer risk. Furthermore, although not proven bladder carcinogens, certain amines, haloamides, halocyclopentenoic acids, furans and haloquinones are potential candidates. At present, most identified bladder carcinogens are nitrogenous, whereas >90% of natural organic matter is not. Therefore, non-nitrogenous DBPs are likely to contribute to the bladder cancer risk. Given the high proportion of DBPs that remains uncharacterised, it is important that future research prioritises compounds believed to be potent toxicants.

Halomethanesulfonic Acids-A New Class of Polar Disinfection Byproducts: Standard Synthesis, Occurrence, and Indirect Assessment of Mitigation Options

Halomethanesulfonic acids (HMSAs) are recently discovered polar disinfection byproducts without commercially available reference materials. To allow for their accurate quantification, we successfully synthesized standards for the four presumably most prevalent HMSA congeners: chloromethanesulfonic acid, bromomethanesulfonic acid, dichloromethanesulfonic acid, and bromochloromethanesulfonic acid. After structure confirmation and quantification with high-resolution mass spectrometry and nuclear magnetic resonance spectroscopy, we integrated them into a multilayer solid phase extraction and hydrophilic interaction liquid chromatography-tandem mass spectrometry method dedicated to the analysis of polar water contaminants. With this method we monitored HMSAs in drinking water production plants from four European countries and tap water samples taken in six countries. HMSAs were detected in the low μg/L range after the chlorination step during drinking water production, all tap waters samples, and two surface waters used for drinking water production. Concentrations in tap water samples ranged from 0.07 μg/L to 11.5 μg/L while the HMSA concentrations in surface waters were in the range of 100 ng/L. We utilized the HMSA formation potential to indirectly assess the behavior of hitherto unknown HMSA precursors, consequently identifying ozonation, filtration through activated carbon, and reverse osmosis as efficient removal tools for HMSA precursors, thus limiting their formation during subsequent water disinfection.

Re-assessing ICR GAC Treatment Study Database: Effect of Bromide on DBP Formation

While granular active carbon (GAC) can effectively remove disinfection byproduct (DBP) precursors, its use has raised concerns over increased formation of some brominated DBP species in treated water following postchlorination, especially for waters with high bromide concentrations. The Information Collection Rule Treatment Study Database contains results of the most extensive GAC studies ever conducted nationwide. Data were analyzed to assess the extent of DBP speciation changes and overall reduction of brominated DBPs by GAC to gain new insights of the bromide effect. Results showed that formation of three brominated trihalomethanes (collectively, Br-THM3) varied greatly depending on TOC removal and bromide concentrations. Low TOC concentrations in GAC effluents resulted in greatly reduced Br-THM3 formation, except for a few cases where Br-THM3 formation increased. GAC followed by chloramination were likely to better control Br-THM3 formation for waters with high TOC and high bromide. Lastly, the chlorine demand reduction by GAC was quantified.

Factors influencing DBPs occurrence in tap water of Jinhua Region in Zhejiang Province, China

Investigating the occurrence of disinfection by-products (DBPs) and identify the related influencing factors in drinking water is essentially important to control DBPs risk. In this study, 64 tap water samples were collected from 8 counties (or county level cities) in Jinhua Region of Zhejiang Province, China. Results showed that the median (range) of trihalomethane (THMs), haloacetic acids (HAAs), haloacetonitriles (HANs), haloketones (HKs) and halonitromethanes (HNMs) were 23.2 (9.1-40.9), 15.3 (5.8-38.6), 2.2 (0.7-7.6), 2.1 (0.2-6.4) and 0.7 (0.2-2.9) µg/L, respectively. HAAs, HANs, HKs and HNMs levels were generally higher in summer than in winter or spring, while for THMs in most counties, higher levels occurred in winter than in summer or spring. Spatially, Yongkang, Yiwu and Dongyang had higher DBPs levels than Pujiang, Pan'an, Lanxi, Wuyi and Jinhua, which was generally consistent with their economy development (GDP). Correlation analysis showed that DBPs occurrence in tap water was significantly related with physicochemical parameters. Principle component analysis further suggested that organic matter (DOC and UVA₂₅₄) are the major factors influencing the occurrence of THMs, HAAs, HANs and HKs in tap water, while for HNMs, both the organic (DOC and UVA₂₅₄) and inorganic factors (e.g. Temp, NO₂^--N, pH, Br^- and NH₄⁺-N) played important role in its formation.

Impact of chlorine exposure time on disinfection byproduct formation in the presence of iopamidol and natural organic matter during chloramination

Chloramines, in practice, are formed onsite by adding ammonia to chlorinated drinking water to achieve the required disinfection. While regulated disinfection byproducts (DBPs) are reduced during chloramine disinfection, other DBPs such as iodinated (iodo-) DBPs, that elicit greater toxicity are formed. The objective of this study was to investigate the impact of prechlorination time on the formation of both halogen-specific total organic halogen (TOX) and iodo/chlorinated (chloro-) DBPs during prechlorination/chloramination in source waters (SWs) containing iopamidol, an X-ray contrast medium. Barberton SW (BSW) and Cleveland SW (CSW) containing iopamidol were prechlorinated for 5-60 min and afterwards chloraminated for 72 hr with ammonium chloride. Chlorine contact time (CCT) did not significantly impact total organic iodine (TOI) concentrations after prechlorination or chloramination. Concentrations of total organic chlorine (TOCl) formed during prechlorination did not significantly change regardless of pH and prechlorination time, while TOCl appeared to decrease after 72 hr chloramination period. Dichloroiodomethane (CHCl₂I) formation during prechlorination did not exhibit any significant trends as a function of pH or CCT, but after chloramination, significant increases were observed at pHs 6.5 and 7.5 with respect to CCT. Iodo-HAAs were not formed during prechlorination but were detected after chloramination. Significant quantities of chloroform (CHCl₃) and trichloroacetic acid (TCAA) were formed during prechlorination but formation ceased upon ammonia addition. Therefore, prechlorination studies should measure TOX and DBP concentrations prior to ammonia addition to obtain data regarding the initial conditions.

Formation, distribution, and speciation of DBPs (THMs, HAAs, ClO2-,andClO3-) during treatment of different source water with chlorine and chlorine dioxide

Formation potential and speciation characteristics of two important groups of disinfection byproducts (DBPs), namely, trihalomethanes (THMs) and haloacetic acids (HAA_S), during Cl₂ and ClO₂ treatment of water samples collected from three different sources, namely, sea, river, and reservoir, were investigated with reference to key controlling parameters. Formation of inorganic DBPs such as chlorate and chlorite was evaluated. Dissolved organic carbon (DOC) and UV absorbance (UV₂₅₄) of the sea, river, and reservoir samples were 3.35 ± 0.05, 3.12 ± 0.05, and 3.23 ± 0.05 mg/L and 0.062 ± 0.01, 0.074 ± 0.01, and 0.055 ± 0.01 cm^-1, respectively. For Cl₂ and ClO₂ treatments, the respective formation potential of THMs and HAAs from the three water sources studied exhibited unidentical trend suggesting that higher THM formation was not necessarily associated with higher HAA formation. On chlorination, the concentrations of total HAAs formed were 9.8 μg/L (sea), 12.8 μg/L (river), and 20.6 μg/L (reservoir) and total THM yields were 38.3 μg/L (sea), 18.8 μg/L (river), and 21.5 μg/L (reservoir) for a Cl₂ dose of 1 mg/L and 30 min reaction time. The trend of formation of THMs and HAAs for Cl₂ treatment was similar to that for ClO₂ treatment. However, the amount of HAAs (3.5 μg/L (sea), 1.8 μg/L (river), and 1.9 μg/L (reservoir)) and THMs (not detected) formed was much lower than that formed during chlorination. Regardless of source water type, di-HAAs were the most favored HAAs, followed by tri-HAAs with a small amount of mono-HAAs formed for both Cl₂ and ClO₂ treatment. Chlorination yielded more THMs than HAAs, whereas it was reverse for chlorine dioxide treatment. Irrespective of treatment with ClO₂ or Cl₂, seawater samples showed the highest bromine incorporation percentage (BIP) in both THMs and HAAs followed by that for river and reservoir water samples. HAAs were found to be always associated with lower amount of BIP than THMs.

National Trends of Bladder Cancer and Trihalomethanes in Drinking Water: A Review and Multicountry Ecological Study

We examined trends in incidence of bladder cancer in 8 countries in the 45+ years since trihalomethanes (THMs) were detected in chlorinated drinking water. Total trihalomethanes (TTHMs) are the principal regulated disinfection by-products (DBPs) along with halogenated acetic acids (HAAs). Numerous epidemiological studies have examined exposure to TTHMs and associations with bladder cancer. Concentrations of TTHM have declined in most of the 8 countries that were studied as has smoking prevalence. Incidences of bladder cancer have usually stayed relatively flat, especially for females, with some variations. Since THMs are not carcinogens in whole animal tests, they may not be appropriate surrogates for studying potential cancer risks in drinking water. Etiology of bladder cancer is complex; incidence correlates with age. Previously identified risk factors include smoking, type 2 diabetes, sex, ethnicity, arsenic, aromatic amines, and occupations. As a predominant risk factor, smoking trends may dominate incidence rates, but additional time might be required to determine whether a DBP risk exists due to long latency periods. Causal drinking water-related bladder cancer risks remain questionable and likely small compared to other factors, although surrogate-based DBP management is an appropriate strategy for maintaining drinking water quality as long as it does not compromise microbial disinfection.

Coal-Fired Power Plant Wet Flue Gas Desulfurization Bromide Discharges to U.S. Watersheds and Their Contributions to Drinking Water Sources

Wet flue gas desulfurization (FGD) wastewater discharges from coal-fired power plants may increase bromide concentrations at downstream drinking water intakes, leading to increased formation of toxic disinfection byproducts (DBPs). Despite this, bromide was not regulated in FGD wastewater in the 2015 Effluent Limitations Guidelines and Standards for the Steam Electric Power Generating Point Source Category (ELGs). Case-by-case management was recommended instead, depending on downstream drinking water effects. The present work seeks to identify U.S. regions where power plant discharges could affect drinking water. Bromide loads were evaluated for all coal-fired power plants operating wet FGD, and flow paths were used to identify downstream surface water sources. A population-concentration metric was used to evaluate the effect of wet FGD on downstream drinking water and the vulnerability of drinking water to upstream discharges. On a hydrologic region level, results indicate the Ohio, South Atlantic Gulf, and Missouri Regions are the most likely to see effects of power plant bromide discharges on populations served by surface water. Increased refined coal use, which may be treated with bromide, contributes to uncertainty in potential bromide effects on drinking water. Measurement of bromide concentrations in wet FGD discharges would reduce this uncertainty, and control of bromide discharges may be needed in some watersheds.

Chlorination of Source Water Containing Iodinated X-ray Contrast Media: Mutagenicity and Identification of New Iodinated Disinfection Byproducts

Iodinated contrast media (ICM) are nonmutagenic agents administered for X-ray imaging of soft tissues. ICM can reach μg/L levels in surface waters because they are administered in high doses, excreted largely unmetabolized, and poorly removed by wastewater treatment. Iodinated disinfection byproducts (I-DBPs) are highly genotoxic and have been reported in disinfected waters containing ICM. We assessed the mutagenicity in Salmonella of extracts of chlorinated source water containing one of four ICM (iopamidol, iopromide, iohexol, and diatrizoate). We quantified 21 regulated and nonregulated DBPs and 11 target I-DBPs and conducted a nontarget, comprehensive broad-screen identification of I-DBPs. We detected one new iodomethane (trichloroiodomethane), three new iodoacids (dichloroiodoacetic acid, chlorodiiodoacetic acid, bromochloroiodoacetic acid), and two new nitrogenous I-DBPs (iodoacetonitrile and chloroiodoacetonitrile). Their formation depended on the presence of iopamidol as the iodine source; identities were confirmed with authentic standards when available. This is the first identification in simulated drinking water of chloroiodoacetonitrile and iodoacetonitrile, the latter of which is highly cytotoxic and genotoxic in mammalian cells. Iopamidol (5 μM) altered the concentrations and relative distribution of several DBP classes, increasing total haloacetonitriles by >10-fold. Chlorination of ICM-containing source water increased I-DBP concentrations but not mutagenicity, indicating that such I-DBPs were either not mutagenic or at concentrations too low to affect mutagenicity.

Molybdenum sulfide Co-catalytic Fenton reaction for rapid and efficient inactivation of Escherichia coli

As a typical advanced oxidation technology, the Fenton reaction has been employed for the disinfection, owing to the strong oxidizability of hydroxyl radicals (·OH). However, the conventional Fenton system always exhibits a low H₂O₂ decomposition efficiency, leading to a low production yield of ·OH, which makes the disinfection effect unsatisfactory. Herein, we develop a molybdenum sulfide (MoS₂) co-catalytic Fenton reaction for rapid and highly efficient inactivation of Escherichia coli K-12 (E. coli) and Staphylococcus aureus (S. aureus). As a co-catalyst in the Fe(II)/H₂O₂ Fenton system, MoS₂ can greatly facilitate the Fe(III)/Fe(II) cycle reaction by the exposed Mo⁴⁺ active sites, which significantly improves the H₂O₂ decomposition efficiency for the ·OH production. As a result, the MoS₂ co-catalytic Fenton system can reach up to 83.37% of inactivation rate of E. coli just in 1 min and 100% of inactivation rate within 30 min, which increased by 2.5 times than that of the conventional Fenton reaction. Furthermore, the ·OH as the primary reactive oxygen species (ROS) in MoS₂ co-catalytic Fenton reaction was measured and verified by electron paramagnetic resonance (EPR) and photoluminescence (PL). It is demonstrated an increased amount of ·OH generated from the decomposition of H₂O₂ in the presence of MoS₂, which is responsible for the rapid and efficient inactivation of E. coli and S. aureus. This study provides a new perspective for rapid and highly efficient inactivation of bacteria in environmental remediation.

A community-based evaluation of proximity to unconventional oil and gas wells, drinking water contaminants, and health symptoms in Ohio

Over 4 million Americans live within 1.6 km of an unconventional oil and gas (UO&G) well, potentially placing them in the path of toxic releases. We evaluated relationships between residential proximity to UO&G wells and (1) water contamination and (2) health symptoms in an exploratory study. We analyzed drinking water samples from 66 Ohio households for 13 UO&G-related volatile organic compounds (VOCs) (e.g., benzene, disinfection byproducts [DBPs]), gasoline-range organics (GRO), and diesel-range organics. We interviewed participants about health symptoms and calculated metrics capturing proximity to UO&G wells. Based on multivariable logistic regression, odds of detection of bromoform and dibromochloromethane in surface water decreased significantly as distance to nearest UO&G well increased (odds ratios [OR]: 0.28-0.29 per km). Similarly, distance to nearest well was significantly negatively correlated with concentrations of GRO and toluene in ground water (r_Spearman: -0.40 to -0.44) and with concentrations of bromoform and dibromochloromethane in surface water (r_Spearman: -0.48 to -0.50). In our study population, those with higher inverse-distance-squared-weighted UO&G well counts within 5 km around the home were more likely to report experiencing general health symptoms (e.g. stress, fatigue) (OR: 1.52, 95%CI: 1.02-2.26). This exploratory study, though limited by small sample size and self-reported health symptoms, suggests that those in closer proximity to multiple UO&G wells may be more likely to experience environmental health impacts. Further, presence of brominated DBPs (linked to UO&G wastewater) raises the question of whether UO&G activities are impacting drinking water sources in the region. The findings from this study support expanded studies to advance knowledge of the potential for water quality and human health impacts; such studies could include a greater number of sampling sites, more detailed chemical analyses to examine source attribution, and objective health assessments.

Web-based applications to simulate drinking water inorganic chloramine chemistry

Two web-based applications (WBAs) relevant to drinking water practice are presented to simulate (1) inorganic chloramine formation and stability, including an example inorganic chloramine demand reaction for organic matter and (2) breakpoint curves. The model underlying both WBAs is a well-established inorganic chloramine formation and decay model. The WBAs were developed to be freely accessible over the Internet as web pages (https://usepaord.shinyapps.io/Unified-Combo/ and https://usepaord.shinyapps.io/Breakpoint-Curve/), providing drinking water practitioners (e.g., operators, regulators, engineers, professors, and students) learning tools to explore inorganic chloramine chemistry in an interactive manner without requiring proprietary software or user modeling expertise. The WBAs allow the user to specify two side-by-side simulations, providing a direct comparison of impacts associated with changing simulation conditions (e.g., free chlorine, free ammonia, and total organic carbon concentrations; pH; total alkalinity; and temperature). Once completed, the user may download simulation data to use offline. The WBAs' implementation, validation, and example simulations are described.

Thiol Reactivity Analyses To Predict Mammalian Cell Cytotoxicity of Water Samples

An in chemico high throughput assay based on N-acetylcysteine was developed and used in conjunction with previous and new mammalian cell cytotoxicity data. Our objective was to derive an empirical equation with confidence levels for mammalian cell cytotoxicity prediction. Modeling data included 16 unique sources of waters and wastewaters of distinct water qualities to encompass a wide range of real environmental samples. This approach provides a quick screen to identify those water and wastewaters that could be prioritized for in depth analytical biological analyses and toxicity. The resulting model can serve as a preliminary convenient tool to screen for potential mammalian cell cytotoxicity in organic extracts of a wide variety of water samples.

Synchronous, efficient and fast removal of phosphate and organic matter by carbon-coated lanthanum nanorods

Both phosphate and organic carbon can serve as nutrients for microorganism growth. Simultaneous removal of both nutrients would realize the antibacterial strategy of nutrient starvation better to ensure water quality safety. In addition, a short treatment time is the premise for the application of a material in water treatment. Herein, carbon-coated lanthanum nanorods with a uniform distribution of La and C (C–La-MOF) were rationally prepared through glucose and La-MOF hydrothermal treatment and further carbonization to synchronously and rapidly remove phosphate and organic matter. The carbon layer thickness was tuned by varying the hydrothermal time to find the optimal balance between excellent phosphate intake and low lanthanum leakage. C–La-MOF had a strong anti-interference ability and high phosphate capture capacity over a wide pH range of 2–12. Impressively, when phosphate and organic carbon coexisted in solution, their removal performances remained relatively unchanged compared with that when the two nutrients existed independently, and their adsorption equilibriums could be easily reached within 10 min. All of the above results prove that C–La-MOF is a promising material for practical drinking water treatment.

The carbon-coated lanthanum nanorods with uniform distribution of La and C can synchronously remove phosphate and organic matter, efficiently and rapidly.

Power Plant Bromide Discharges and Downstream Drinking Water Systems in Pennsylvania

Coal-fired power plants equipped with wet flue gas desulfurization (FGD) systems have been implicated in increasing bromide levels and subsequent increases in disinfection byproducts at downstream drinking water plants. Bromide was not included as a regulated constituent in the recent steam electric effluent limitations guidelines and standards (ELGs) since the U.S. EPA analysis suggested few drinking water facilities would be affected by bromide discharges from power plants. The present analysis uses a watershed approach to identify Pennsylvania drinking water intakes downstream of wet FGD discharges and to assess the potential for bromide discharge effects. Twenty-two (22) public drinking water systems serving 2.5 million people were identified as being downstream of at least one wet FGD discharge. During mean August conditions (generally low-flow, minimal dilution) in receiving rivers, the median predicted bromide concentrations contributed by wet FGD at Pennsylvania intake locations ranged from 5.2 to 62 μg/L for the Base scenario (including only natural bromide in coal) and from 16 to 190 μg/L for the Bromide Addition scenario (natural plus added bromide for mercury control); ranges depend on bromide loads and receiving stream dilution capacity.

Disinfection byproduct regulatory compliance surrogates and bromide-associated risk

Natural and anthropogenic factors can alter bromide concentrations in drinking water sources. Increasing source water bromide concentrations increases the formation and alters the speciation of disinfection byproducts (DBPs) formed during drinking water treatment. Brominated DBPs are more toxic than their chlorinated analogs, and thus have a greater impact on human health. However, DBPs are regulated based on the mass sum of DBPs within a given class (e.g., trihalomethanes and haloacetic acids), not based on species-specific risk or extent of bromine incorporation. The regulated surrogate measures are intended to protect against not only the species they directly represent, but also against unregulated DBPs that are not routinely measured. Surrogates that do not incorporate effects of increasing bromide may not adequately capture human health risk associated with drinking water when source water bromide is elevated. The present study analyzes trihalomethanes (THMs), measured as TTHM, with varying source water bromide concentrations, and assesses its correlation with brominated THM, TTHM risk and species-specific THM concentrations and associated risk. Alternative potential surrogates are evaluated to assess their ability to capture THM risk under different source water bromide concentration conditions. The results of the present study indicate that TTHM does not adequately capture risk of the regulated species when source water bromide concentrations are elevated, and thus would also likely be an inadequate surrogate for many unregulated brominated species. Alternative surrogate measures, including THM₃ and the bromodichloromethane concentration, are more robust surrogates for species-specific THM risk at varying source water bromide concentrations.