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

Trihalomethanes in developed and developing countries

The reactions between natural organic matter, anthropogenic contaminants, ions, and disinfectants lead to the formation of disinfection by-products (DBPs) such as trihalomethanes (THMs) in drinking water. The formation of THMs is strongly related to the chlorination of water. The study's central objective was to compare the concentration of THMs in twenty developed and developing countries and their disinfection techniques. The THM concentration in 11 developed and 9 developing countries ranged from 0.5 µg/L (Germany) to 215 µg/L (Russia) and 3 µg/L (China) to 439.2 µg/L (Bangladesh), respectively. The developed country has partially succeeded in reducing THM concentration in drinking water, whereas significant steps are needed in developing countries to reduce the existing high THM concentration. The concentration of THMs in water varies among these countries because of the different water sources, water quality, environmental conditions, and efficiency of water treatment technologies. A meaningful relationship has been observed between the properties of water and the THM formation. The use of chemical disinfectants will result in new forms of DBPs that are undesirable due to their carcinogenic and mutagenic effects on human health. The DBP guidelines by various national and international agencies have helped to control and manage the THM concentration in drinking water. However, these regulatory standards are not continuously monitored. Therefore, the formation of these compounds should be prevented either by removing THMs forming precursors or by using an integrated approach for controlling THM formation by implementing advanced water treatment technology. Extensive research is desirable in domains like THM minimization strategies which are easy to deploy, scalable, and cost-effective.

Association between type of drinking water and upper gastrointestinal cancer incidence in the Linxian General Population

BACKGROUND

This study aimed to explore the association between drinking water source and risk of upper gastrointestinal (UGI) cancer, including esophageal cancer (EC) and gastric cancer (GC), in the Linxian General Population Nutrition Intervention Trial (NIT) cohort.

METHODS

In this study, we used data from the Linxian NIT cohort, which included 29,584 healthy adults aged 40 to 69 years. Subjects were enrolled in April 1986 and followed up until March 2016. Tap water drinking status and demographic characteristics were collected at baseline. Subjects who drank tap water were treated as the exposed group. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using the Cox proportional hazard model.

RESULTS

A total of 5,463 cases of UGI cancer were identified during the 30-year follow-up period. After adjusting for multiple factors, the incidence rate of UGI cancer in participants who drank tap water was significantly lower compared with individuals in the control (HR = 0.91, 95% CI: 0.86-0.97). A similar association was observed between tap water drinking and EC incidence (HR = 0.89, 95% CI: 0.82-0.97). The association between drinking tap water and risk of UGI cancer and EC incidence did not vary across the subgroup by age and gender (All P_interaction > 0.05). For EC incidence, an interaction effect was observed for riboflavin/niacin supplements and drinking water source (P_interaction = 0.03). No association was observed between drinking water source and GC incidence.

CONCLUSIONS

In this prospective cohort study in Linxian, participants who drank tap water had a lower risk of EC incidence. As a source of drinking water, use of tap water may reduce the risk of EC by avoiding exposure to nitrate/nitrite. Measures should be taken to improve the quality of drinking water in high-incidence areas of EC.

TRIAL REGISTRATION

The trial is registered with ClinicalTrials.gov (NCT00342654, 21/06/2006), and the trial name is Nutrition Intervention Trials in Linxian Follow-up Study.

Formation characteristics of disinfection byproducts from four different algal organic matter during chlorination and chloramination

Algal organic matter (AOM) has become an important precursor of disinfection byproducts (DBPs) in multiple drinking water sources. In this study, the formation of DBPs during chlorination and chloramination of AOMs from four algal species (Microcystis aeruginosa, Chlorella vulgaris, Scenedesmus obliquus, and Cyclotella sp.) under different conditions (disinfectant doses 4.0-8.0 mg/L as Cl₂, pH 6.0-8.0, and bromide 0-1.0 mg/L) were simultaneously investigated. Some common and specific characteristics of DBP formation have also been identified. The yields of total DBPs from the four AOMs were 3.28 × 10²-6.00 × 10² and 1.97 × 10²-3.70 × 10² nmol/mg C during chlorination and chloramination, respectively. The proportions of haloacetic acids (HAAs) in total DBPs were approximately ≥50%. Increasing disinfectant doses or pH only enhanced the yields of trihalomethanes (THMs) during chlorination but enhanced the yields of THMs, HAAs and dihaloacetonitriles (DHANs) during chloramination. Increasing bromide concentrations enhanced THM yields but decreased HAA yields during chlorination and chloramination, in addition to the shift from chlorinated DBPs to brominated DBPs. The DHAN yields of the four AOMs slightly decreased with bromide levels during chlorination, whereas different AOMs showed different trends with bromide levels during chloramination. During chlorination, C. vulgaris and S. obliquus AOMs generated higher THM and DHAN yields (at 4.0-5.0 mg/L as Cl₂) than the other AOMs. During chloramination, M. aeruginosa AOM generated higher THM and HAA yields than the other AOMs (at 0.1 mg/L bromide). Cyclotella sp. AOM had the highest THM-bromine substitution factors during chlorination and the highest DHAN-bromine substitution factors during both chlorination and chloramination (at 0.1 mg/L bromide).

Sono-Enzymatically Embedded Antibacterial Silver-Lignin Nanoparticles on Cork Filter Material for Water Disinfection

Providing clean drinking water is a great challenge worldwide, especially for low-income countries where the access to safe water is limited. During the last decade, new biotechnological approaches have been explored to improve water management. Among them, the use of antimicrobial nanoparticles for designing innovative centralized and decentralized (point-of-use) water treatment systems for microbial decontamination has received considerable attention. Herein, antimicrobial lignin capped silver nanoparticles (AgLNP) were embedded on residual cork pieces using high-intensity ultrasound coupled with laccase-mediated grafting to obtain biofunctionalized nanomaterial. The developed AgLNP-coated cork proved to be highly efficient to drastically reduce the number of viable Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus in liquid medium. Additionally, the coated-cork was characterized using FTIR-ATR spectroscopy and SEM imaging, and further used as a filter bed in a point-of-use device for water disinfection. The constructed water filtering system significantly reduced the amount of viable E. coli and resistant Bacillus cereus spores from filtered water operating at increasing residence times of 1, 4, 6, 16, 24, and 48 h. Therefore, the presented results prove that the obtained cork-based antimicrobial nanocomposite material could be used as a filtering medium for the development of water filtration system to control pathogen dissemination.

Prevalence and Trends of Drinking Water Disinfection Byproducts-Related Cancers in Addis Ababa, Ethiopia

BACKGROUND

Disinfection byproducts (DBPs) from chlorinated drinking water have been linked to an increased risk of cancer in the bladder, stomach, colon, and rectum. No studies showed the independent trends and prevalence of these cancers in Ethiopia. Therefore, this study aimed to determine the prevalence and trends of disinfection byproducts-related cancers in Addis Ababa, Ethiopia.

METHODS

Data were collected from the Addis Ababa Cancer Registry. Spatial data sets were produced and classified into households receiving chlorinated surface water and less chlorinated groundwater. The Cochran-Armitage trend test was used to evaluate whether there was a disinfection byproducts-related cancers (DBRCs) trend among communities receiving chlorinated water. Negative binomial regression was used to analyze the incidence rate.

RESULTS

A total of 11, 438 cancer cases were registered between 2012 and 2016, and DBRCs accounted for approximately 17%. The majority of the total cancer cases were female; 7,706 (67%). The prevalence of DBRCs was found to be higher in communities supplied with chlorinated water. From 2012 to 2016, the trend of colon cancer increased (β = 10.3, P value = .034); however, esophageal cancer decreased (β = -6.5, P value = .018). Approximately 56% of colorectal cancer patients and 53% of stomach cancer patients are known to be using chlorinated surface water for drinking regularly. In addition, approximately 57.1% and 54% of kidney and bladder cancer patients, respectively, used chlorinated surface water.

CONCLUSION

The prevalence of DBRCs in this study was found to be high. The colon cancer trend increased substantially from 2012 to 2016. The prevalence of DBRCs was higher in communities supplied with chlorinated surface water. Similarly, the prevalence of DBRCs was higher among males than females. Further study is required to validate the association between DBRCs and water chlorination.

Response surface methodological (RSM) approach for optimizing the removal of trihalomethanes (THMs) and its precursor's by surfactant modified magnetic nanoadsorbents (sMNP) - An endeavor to diminish probable cancer risk

Response surface methodology (RSM) approach was used for optimization of the process parameters and identifying the optimal conditions for the removal of both trihalomethanes (THMs) and natural organic matter (NOM) in drinking water supplies. Co-precipitation process was employed for the synthesis of magnetic nano-adsorbent (sMNP), and were characterized by field emission scanning electron microscopy (SEM), trans-emission electron microscopy (TEM), BET (Brunauer-Emmett-Teller), energy dispersive X-ray (EDX) and zeta potential. Box-Behnken experimental design combined with response surface and optimization was used to predict THM and NOM in drinking water supplies. Variables were concentration of sMNP (0.1 g to 5 g), pH (4–10) and reaction time (5 min to 90 min). Statistical analysis of variance (ANOVA) was carried out to identify the adequacy of the developed model, and revealed good agreement between the experimental data and proposed model. The experimentally derived RSM model was validated using t-test and a range of statistical parameters. The observed R² value, adj. R², pred. R² and “F-values” indicates that the developed THM and NOM models are significant. Risk analysis study revealed that under the RSM optimized conditions, a marked reduction in the cancer risk of THMs was observed for both the groups studied. Therefore, the study observed that the developed process and models can be efficiently applied for the removal of both THM and NOM from drinking water supplies.