Polymorphisms in GSTT1, GSTZ1, and CYP2E1, disinfection by-products, and risk of bladder cancer in Spain

Better Together: Tandem Mass Spectrometry Achieves up to 50 Times Lower Quantification of 62 Disinfection Byproducts in Drinking Water

Disinfection byproducts (DBPs) are ubiquitous contaminants present in nearly all drinking water and are associated with adverse health effects in human epidemiologic studies. The most toxic DBPs are unregulated and often occur at concentrations well below regulated DBPs; thus, quantification at low parts-per-trillion (ng/L) levels is critical in assessing exposure. We developed a new liquid-liquid extraction-gas chromatography-tandem mass spectrometry (LLE-GC-MS/MS) method with the first analysis by tandem gas chromatography-mass spectrometry of 23 priority unregulated DBPs including 13 haloacetamides, 3 haloacetic acids, 2 haloacetonitriles, 1 haloacetaldehyde, 2 haloketones, and 2 halonitromethanes. When combined with our previous GC-MS/MS method for haloacetic acids and previously reported MS/MS transitions that we optimized for this method, the analysis of 62 regulated and priority unregulated DBPs at lower quantification limits is achieved. Limits of quantification for most DBPs were between 5 and 30 ng/L with r2 > 0.99 and an average of 9 times lower limits of quantification (LOQs) compared to LLE-GC-MS using selected ion monitoring (SIM). Relative standard deviations ranged from 0.7 to 30% for 61 DBPs in spiked samples. This new method was validated using tap waters from four US cities, where individual DBP concentrations ranged from 5 to 126,882 ng/L. This project provides the most comprehensive GC-MS/MS method for DBP analysis to date and is capable of analyzing volatile and semivolatile DBPs across nine different compound classes, including a class not previously analyzed by GC-MS/MS.

A ng/L Level LC-MS Method Using Membrane SPE as Sampling Technology: Determination of Nine Halobenzoquinones in Potable Water

A promising method was established for the determination of nine halobenzoquinones (HBQs) in potable water by membrane solid-phase extraction (MSPE) pretreatment and the liquid chromatography-mass spectrometry (LC-MS) method. A 500 mL water sample was taken for enrichment by the SDB-RPS membrane, which was previously activated by methanol and ultrapure water. The sample was eluted with methanol and re-dissolved with the initial mobile phase after nitrogen blowing. Then, it was detected in negative ion mode using the working curve, and HBQs were quantified by the external standard method. The linearity was satisfactory in the concentration range of 4-1000 ng/L, with correlation coefficients of 0.9963~0.9994. The recoveries were 73.5~126.6% at three spiked levels, with relative standard deviations (RSDs) of 6.8~15.5%. The limits of detection (LOD, S/N = 3) values were 0.1~0.7 ng/L. The results demonstrate that the MSPE-LC-MS method is reliable, rapid, and sensitive for the simultaneous analysis of nine HBPs in potable water.

Polymorphisms in drug-metabolizing genes and urinary bladder cancer susceptibility and prognosis: Possible impacts and future management

Epidemiological studies have shown the association of genetic variants with risks of occupational and environmentally induced cancers, including bladder (BC). The current review summarizes the effects of variants in genes encoding phase I and II enzymes in well-designed studies to highlight their contribution to BC susceptibility and prognosis. Polymorphisms in genes codifying drug-metabolizing proteins are of particular interest because of their involvement in the metabolism of exogenous genotoxic compounds, such as tobacco and agrochemicals. The prognosis between muscle-invasive and non-muscle-invasive diseases is very different, and it is difficult to predict which will progress worse. Web of Science, PubMed, and Medline were searched to identify studies published between January 1, 2010, and February 2023. We included 73 eligible studies, more than 300 polymorphisms, and 46 genes/loci. The most studied candidate genes/loci of phase I metabolism were CYP1B1, CYP1A1, CYP1A2, CYP3A4, CYP2D6, CYP2A6, CYP3E1, and ALDH2, and those in phase II were GSTM1, GSTT1, NAT2, GSTP1, GSTA1, GSTO1, and UGT1A1. We used the 46 genes to construct a network of proteins and to evaluate their biological functions based on the Reactome and KEGG databases. Lastly, we assessed their expression in different tissues, including normal bladder and BC samples. The drug-metabolizing pathway plays a relevant role in BC, and our review discusses a list of genes that could provide clues for further exploration of susceptibility and prognostic biomarkers.

Emerging organic contaminants in drinking water systems: Human intake, emerging health risks, and future research directions

Few earlier reviews on emerging organic contaminants (EOCs) in drinking water systems (DWS) focused on their detection, behaviour, removal and fate. Reviews on multiple exposure pathways, human intake estimates, and health risks including toxicokinetics, and toxicodynamics of EOCs in DWS are scarce. This review presents recent advances in human intake and health risks of EOCs in DWS. First, an overview of the evidence showing that DWS harbours a wide range of EOCs is presented. Multiple human exposure to EOCs occurs via ingestion of drinking water and beverages, inhalation and dermal pathways are discussed. A potential novel exposure may occur via the intravenous route in dialysis fluids. Analysis of global data on pharmaceutical pollution in rivers showed that the cumulative concentrations (μg L-1) of pharmaceuticals (mean ± standard error of the mean) were statistically more than two times significantly higher (p = 0.011) in South America (11.68 ± 5.29), Asia (9.97 ± 3.33), Africa (9.48 ± 2.81) and East Europe (8.09 ± 4.35) than in high-income regions (2.58 ± 0.48). Maximum cumulative concentrations of pharmaceuticals (μg L-1) decreased in the order; Asia (70.7) had the highest value followed by South America (68.8), Africa (51.3), East Europe (32.0) and high-income regions (17.1) had the least concentration. The corresponding human intake via ingestion of untreated river water was also significantly higher in low- and middle-income regions than in their high-income counterparts. For each region, the daily intake of pharmaceuticals was highest in infants, followed by children and then adults. A critique of the human health hazards, including toxicokinetics and toxicodynamics of EOCs is presented. Emerging health hazards of EOCs in DWS include; (1) long-term latent and intergenerational effects, (2) the interactive health effects of EOC mixtures, (3) the challenges of multifinality and equifinality, and (4) the Developmental Origins of Health and Disease hypothesis. Finally, research needs on human health hazards of EOCs in DWS are presented.

Locally enhanced mixed-order model for chloramine decay in drinking water disinfection

Chloramine is the second most popular disinfectant and is widely used in the disinfection of drinking water. For chloramine disinfection, some standards require the total chlorine concentration to be maintained in an appropriate range in the water distribution system. Therefore, exploring the mechanism of chloramine decay and deriving an accurate chloramine decay model helps to optimize the disinfection process and ensure water quality safety. This paper proposed a locally enhanced mixed-order(LEM) model consisting of the first order model and the mixed order model to describe chloramine auto-decomposition and decays caused by other reactions respectively. Via proving the parameter a and k2 related to temperatures instead of initial chloramine concentration, the model had been further simplified. Nine chloramine decay experiments with different initial chloramine concentrations and temperatures were designed and carried out to evaluate the new model performance for chloramine decay simulation. The research results showed that the simplified LEM model could simulate the whole process of chloramine decay well. Its accuracy evaluation indexes (R2 and SSE) were better than that obtained from the first order model and the mixed order model. This paper proposed a simple and accurate method to simulate the process of chloramine decay and had a guiding significance for water quality safety assurance.

A Delicate Balance: Water Disinfection and By-Product Immunotoxicity

Mouse macrophages and human blood cells exposed to very high levels of three trihalophenols showed changes in RNA methylation, pointing to one mechanism by which disinfection by-products may harm health, even as disinfection protects it in other ways.

Toxicity and underlying lipidomic alterations generated by a mixture of water disinfection byproducts in human lung cells

Complex mixtures of disinfection by-products (DBPs) are present in disinfected waters, but their mixture toxicity has been rarely described. Apart from ingestion, DBP exposure can occur through inhalation, which may lead to respiratory effects in highly exposed individuals. However, the underlying biological mechanisms have yet to be elucidated. This study aimed to investigate the toxicity of a mixture of 10 DBPs, including haloacetic acids and haloaromatics, on human alveolar A549 cells by assessing their cytotoxicity, genotoxicity, and impact on the cell lipidome. A DBP mixture up to 50 μM slightly reduced cell viability, induced the generation of reactive oxygen species (ROS) up to 3.5-fold, and increased the frequency of micronuclei formation. Exposure to 50 μM DBP mixture led to a significant accumulation of triacylglycerides and a decrease of diacylglycerides and phosphatidylcholines in A549 cells. Lipidomic profiling of extracellular vesicles (EVs) released in the culture medium revealed a marked increase in cholesterol esters, sphingomyelins, and other membrane lipids. Overall, these alterations in the lipidome of cells and EVs may indicate a disruption of lipid homeostasis, and thus, potentially contribute to the respiratory effects associated with DBP exposure.

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.

Low Parts Per Trillion Detection of Iodinated Disinfection Byproducts in Drinking Water and Urine using Vacuum-Assisted Sorbent Extraction and GC-MS/MS

Disinfection byproducts (DBPs) are ubiquitous environmental contaminants, which are present in virtually all drinking water and linked to detrimental health effects. Iodinated-DBPs are more cytotoxic and genotoxic than chloro- and bromo-DBPs and are formed during disinfection of iodide-containing source water. Liquid-liquid extraction (LLE) paired with gas chromatography (GC)-mass spectrometry (MS) has been the method of choice in the study of low molecular weight iodinated-DBPs; however, this method is laborious and time-consuming and struggles with complex matrices. We developed an environmentally friendly method utilizing headspace solid phase extraction with the application of vacuum to measure six iodinated-trihalomethanes (I-THMs) in drinking water and urine. Vacuum-assisted sorbent extraction (VASE) has the ability to exhaustively and rapidly extract volatile and semivolatile compounds from liquid matrices without the use of solvent. Using VASE with GC-MS/MS provides improved analyte recovery and reduced matrix interference compared to LLE. Additionally, VASE enables extraction of 30 samples simultaneously with minimal sample handling and improved method reproducibility. Using VASE with GC-MS/MS, we achieved quantification limits of 3-4 ng/L. This technique was demonstrated on drinking water from four cities, where five I-THMs were quantified at levels 10-33 times below comparable LLE methods with 10 times lower volumes of sample (10 mL vs 100 mL).

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.

Contributions of Pharmaceuticals to DBP Formation and Developmental Toxicity in Chlorination of NOM-containing Source Water

Pharmaceuticals have been considered a priority group of emerging micropollutants in source waters in recent years, while their role in the formation and toxicity of disinfection byproducts (DBPs) during chlorine disinfection remains largely unclear. In this study, the contributions of natural organic matter (NOM) and pharmaceuticals (a mixture of ten representative pharmaceuticals) to the overall DBP formation and toxicity during drinking water chlorination were investigated. By innovatively "normalizing" chlorine exposure and constructing a kinetic model, we were able to differentiate and evaluate the contributions of NOM and pharmaceuticals to the total organic halogen (TOX) formation for source waters that contained different levels of pharmaceuticals. It was found that at a chlorine contact time of 1.0 h, NOM (2 mg/L as C) and pharmaceuticals (total 0.0062-0.31 mg/L as C) contributed 79.8-99.5% and 0.5-20.2%, respectively, of TOX. The toxicity test results showed that the chlorination remarkably increased the toxicity of the pharmaceutical mixture by converting the parent compounds into more toxic pharmaceutical-derived DBPs, and these DBPs might contribute significantly to the overall developmental toxicity of chlorinated waters. This study highlights the non-negligible role of pharmaceuticals in the formation and toxicity of overall DBPs in chlorinated drinking water.

Clinical physiology and pharmacology of GSTZ1/MAAI

Herein I summarize the physiological chemistry and pharmacology of the bifunctional enzyme glutathione transferase zeta 1 (GSTZ1)/ maleylacetoacetate isomerase (MAAI) relevant to human physiology, drug metabolism and disease. MAAI is integral to the catabolism of the amino acids phenylalanine and tyrosine. Genetic or pharmacological inhibition of MAAI can be pathological in animals. However, to date, no clinical disease consequences are unequivocally attributable to inborn errors of this enzyme. MAAI is identical to the zeta 1 family isoform of GST, which biotransforms the investigational drug dichloroacetate (DCA) to the endogenous compound glyoxylate. DCA is a mechanism-based inhibitor of GSTZ1 that significantly reduces its rate of metabolism and increases accumulation of potentially harmful tyrosine intermediates and of the heme precursor δ-aminolevulinic acid (δ-ALA). GSTZ1 is most abundant in rodent and human liver, with its concentration several fold higher in cytoplasm than in mitochondria. Its activity and protein expression are dependent on the age of the host and the intracellular level of chloride ions. Gene association studies have linked GSTZ1 or its protein product to various physiological traits and pathologies. Haplotype variations in GSTZ1 influence the rate of DCA metabolism, enabling a genotyping strategy to allow potentially safe, precision-based drug dosing in clinical trials.

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.

Genotoxicity and endocrine disruption potential of haloacetic acids in human placental and lung cells

Chlorination of water results in the formation of haloacetic acids (HAAs) as major disinfection byproducts (DBPs). Previous studies have reported some HAAs species to act as cytotoxic, genotoxic, and carcinogenic. This work aimed at further exploring the toxicity potential of the most investigated HAAs (chloroacetic (CAA), bromoacetic (BAA), iodoacetic (IAA) acid) and HAAs species with high content of bromine (tribromoacetic acid (TBAA)), and iodine in their structures (chloroiodoacetic (CIAA) and diiodoacetic acid (DIAA)) to human cells. Novel knowledge was generated regarding cytotoxicity, oxidative stress, endocrine disrupting potential, and genotoxicity of these HAAs by using human placental and lung cells as in vitro models, not previously used for DBP assessment. IAA showed the highest cytotoxicity (EC₅₀: 7.5 μM) and ability to generate ROS (up to 3-fold) in placental cells, followed by BAA (EC₅₀: 20-25 μM and 2.1-fold). TBAA, CAA, DIAA, and CIAA showed no significant cytotoxicity (EC₅₀ > 250 μM). All tested HAAs decreased the expression of the steroidogenic gene hsd17b1 up to 40 % in placental cells, and IAA and BAA (0.01-1 μM) slightly inhibited the aromatase activity. HAAs also induced the formation of micronuclei in A549 lung cells after 48 h of exposure. IAA and BAA showed a non-significant increase in micronuclei formation at low concentrations (1 μM), while BAA, CAA, CIAA and TBAA were genotoxic at exposure concentrations above 10 μM (100 μM in the case of DIAA). These results point to genotoxic and endocrine disruption effects associated with HAA exposure at low concentrations (0.01-1 μM), and the usefulness of the selected bioassays to provide fast and sensitive responses to HAA exposure, particularly in terms of genotoxicity and endocrine disruption effects. Further studies are needed to define thresholds that better protect public health.

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.

Occurrence and multi-pathway health risk assessment of trihalomethanes in drinking water of Wuxi, China

Chlorination is widely used to disinfect drinking water to keep humans safe from microorganisms. During chlorination, chlorine and its compounds react with contaminants to form disinfection by-products (DBPs). Toxicological and epidemiological studies have demonstrated that trihalomethanes (THMs) are the most widely investigated DBPs in drinking water, and their exposure has been associated with some adverse health effects. However, studies about risk characteristics in this field are limited. We estimated the health risks of THMs exposure in drinking water through multi-pathways, and systematically analyzed the factors influencing health risks of THMs in Wuxi, China. A total of 488 drinking water samples were collected and analyzed for THMs from four water treatment utilities from 2008 to 2016 in Wuxi. And water exposure parameters were obtained from 602 participants by structured questionnaires. The median concentration of THMs ranged from 6.71 μg/L to 9.18 μg/L. The cumulative cancer risk of THMs exposure through multi-pathways was 1.26 × 10^-4, and CHBr₂Cl made the largest contribution to the total cancer risk (48.25%). The non-cancer risk of THMs exposure was 2.02 × 10^-1. Health risks of the exposure to THMs in drinking water in summer were significantly higher than that in winter (P = 0.0003 for cancer risk, and P = 5.95 × 10^-7 for non-cancer risk). In our study, the average individual disability-adjusted life years (DALYs) lost was 1.27 × 10^-4 per person-year (ppy). This study attempted to use DALYs for risk assessment of THMs, which will provide useful information for risk comparison and prioritization of hazards in drinking water. This suggested that potential higher risk might exist, and possible measures could be considered to decrease the health risks.

Impacts of disinfection byproduct exposures on male reproductive health: Current evidence, possible mechanisms and future needs

Disinfection byproducts (DBPs) are a class of ubiquitous chemicals in drinking water and inevitably result in widespread human exposures. Potentially adverse health effects of DBP exposures, including reproductive and developmental outcomes, have been increasing public concerns. Several reviews have focused on the adverse pregnancy outcomes of DBPs. This review summarized current evidence on male reproduction health upon exposure to DBPs from toxicological and epidemiological literature. Based on existing experimental studies, there are sufficient evidence showing that haloacetic acids (HAAs) are male reproductive toxicants, including reduced epididymal weight, decreased semen parameters and sperm protein 22, and declined testosterone levels. However, epidemiological evidence remains insufficient to support a link of DBP exposures with adverse male reproductive outcomes, despite that blood and urinary DBP biomarkers are associated with decreased semen quality. Eight potential mechanisms, including germ/somatic cell dysfunction, oxidative stress, genotoxicity, inflammation, endocrine hormones, folate metabolism, epigenetic alterations, and gut microbiota, are likely involved in male reproductive toxicity of DBPs. We also identified knowledge gaps in toxicological and epidemiological studies to enhance future needs.

Overlooked Iodo-Disinfection Byproduct Formation When Cooking Pasta with Iodized Table Salt

Iodized table salt provides iodide that is essential for health. However, during cooking, we found that chloramine residuals in tap water can react with iodide in table salt and organic matter in pasta to form iodinated disinfection byproducts (I-DBPs). While naturally occurring iodide in source waters is known to react with chloramine and dissolved organic carbon (e.g., humic acid) during the treatment of drinking water, this is the first study to investigate I-DBP formation from cooking real food with iodized table salt and chloraminated tap water. Matrix effects from the pasta posed an analytical challenge, necessitating the development of a new method for sensitive and reproducible measurements. The optimized method utilized sample cleanup with Captiva EMR-Lipid sorbent, extraction with ethyl acetate, standard addition calibration, and analysis using gas chromatography (GC)-mass spectrometry (MS)/MS. Using this method, seven I-DBPs, including six iodo-trihalomethanes (I-THMs) and iodoacetonitrile, were detected when iodized table salt was used to cook pasta, while no I-DBPs were formed with Kosher or Himalayan salts. Total I-THM levels of 11.1 ng/g in pasta combined with cooking water were measured, with triiodomethane and chlorodiiodomethane dominant, at 6.7 and 1.3 ng/g, respectively. Calculated cytotoxicity and genotoxicity of I-THMs for the pasta with cooking water were 126- and 18-fold, respectively, compared to the corresponding chloraminated tap water. However, when the cooked pasta was separated (strained) from the pasta water, chlorodiiodomethane was the dominant I-THM, and lower levels of total I-THMs (retaining 30% of the I-THMs) and calculated toxicity were observed. This study highlights an overlooked source of exposure to toxic I-DBPs. At the same time, the formation of I-DBPs can be avoided by boiling the pasta without a lid and adding iodized salt after cooking.

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.

Dramatically increased disinfection byproducts in swimming pool water caused by commonly used urea degradants

In China, urea degradants are often used in combination with chlorine in swimming pool water to remove urea. Here we report the first study about the impacts of urea degradants on urea degradation, disinfection byproduct (DBP) formation and estimated DBP-associated cytotoxicity and genotoxicity. Firstly, four groups of typical DBPs from six real indoor swimming pools were analyzed. The concentration of DBPs in swimming pool waters was about 1-2 orders of magnitude higher than that source tap water. Notably, a rapid increase in DBPs was observed after urea degradant treatment. Simulated processes of urea removal using three commonly used urea degradants were therefore conducted in laboratory. Neither urea degradant nor chlorine alone removed urea effectively within 48 h. When applied in combination, urea degradant with sufficient chlorine rapidly removed urea by 100% within 3 h, and anti-chlorourea oligomer in urea degradants was the main contributor. Meanwhile, a remarkable increase in DBPs, especially brominated DBPs, was observed due to bromide introduction by urea degradants. For this reason, bromine incorporation factor (BIF) of DBPs dramatically increased. For instance, the BIF of dihaloacetic acids increased by 2665%-4025% after applying three urea degradants. As the highly toxic brominated DBPs were generated, attention should be paid into the potential DBP-related health risks from the use of urea degradants together with chlorine.

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.

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.

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.

Neurotoxicity and transcriptome changes in embryonic zebrafish induced by halobenzoquinone exposure

Halobenzoquinones (HBQs) are emerging disinfection byproducts (DBPs) with a widespread presence in drinking water that exhibit much higher cytotoxicity than regulated DBPs. However, the developmental neurotoxicity of HBQs has not been studied in vivo. In this work, we studied the neurotoxicity of HBQs on zebrafish embryos, after exposure to varying concentrations (0-8 µmol/L) of three HBQs, 2,5-dichloro-1,4-benzoquinone (2,5-DCBQ), 2,6-dichloro-1,4-benzoquinone (2,6-DCBQ), and 2,5-dibromo-1,4-benzoquinone (2,5-DBBQ) for 4 to 120 hr post fertilization (hpf). HBQ exposure significantly decreased the locomotor activity of larvae, accompanied by significant reduction of neurotransmitters (dopamine and γ-aminobutyric acid) and acetylcholinesterase activity. Furthermore, the expression of genes involved in neuronal morphogenesis (gfap, α1-tubulin, mbp, and syn-2α) were downregulated by 4.4-, 5.2-, 3.0-, and 4.5-fold in the 5 µmol/L 2,5-DCBQ group and 2.0-, 1.6-, 2.1-, and 2.3-fold in the 5 µmol/L 2,5-DBBQ group, respectively. Transcriptomic analysis revealed that HBQ exposure affected the signaling pathways of neural development. This study demonstrates the significant neurotoxicity of HBQs in embryonic zebrafish and provides molecular evidence for understanding the potential mechanisms of HBQ neurotoxicity.

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.

Halonaphthoquinones: A group of emerging disinfection byproducts of high toxicity in drinking water

Aromatic halogenated disinfection byproducts (DBPs) have received particular attention in recent years due to their high toxicity. However, most relevant researches at present focused merely on halo-monocyclic DBPs, while halo-polycyclic DBPs were scarcely explored. In this study, a new group of halo-bicyclic DBPs termed as halonaphthoquinones (HNQs) was systematically studied. By coupling with vacuum centrifugal concentrator, a SPE-UPLC-MS/MS method with high accuracy and sensitivity was developed to detect five semi-volatile HNQs in drinking water, which achieved the detection limits in the range of 0.05-0.24 ng/L. Five HNQs were identified using this method with 100% detection frequency at concentrations up to 136.7 ng/L in drinking water originated from seven water treatment plants. The cytotoxicity of the five tested HNQs in CHO-K1 cells (IC₅₀ from 3.17 to 13.18 μM) was comparable to the most toxic known carbonaceous DBP in drinking water, iodoacetic acid (IC₅₀=2.95 μM). Meanwhile, the cytotoxicity of five tested HNQs were also higher than 2,6-dichloro-1,4-benzoquinone (IC₅₀=21.73 μM) which is hundreds to thousands of times more toxic than regulated DBPs, indicating the significant toxicity risk of HNQ DBPs. To the best of our knowledge, this study presents the first analytical method for analysis of HNQ DBPs, and the first set of data on the occurrence and cytotoxicity of HNQ DBPs in drinking water. These findings are meaningful for probing deeply into the presence of varied halo-polycyclic DBPs in the aqueous environment.

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.

Potential risks and approaches to reduce the toxicity of disinfection by-product - A review

Water contamination through anthropogenic and industrial activities has led to the emergence and necessity of disinfection methods. Chlorine and bromine gases, often used to disinfect water, resulted in the by-product formation by reacting with organic matter. The Disinfectant by-products (DBP) led to the formation of Trihaloaceticacid (TAA), Trihalomethane (THM), and other minor components. The release of chemicals has also led to the outbreak of diseases like infertility, asthma, stillbirth, and types of cancer. There are new approaches that are found to be useful to compensate for the generation of toxic by-products and involve membrane technologies, namely reverse osmosis, ultrafiltration, and nanofiltration. This review mainly focuses on the toxicology effects of DBPs and various approaches to mitigate the same. The health hazards caused by different DBPs and the various treatment techniques available for the removal are discussed. In addition, a critical comparison of the different removal techniques was discussed.

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.

Urinary bisphenol A and its interaction with CYP17A1 rs743572 are associated with breast cancer risk

OBJECTIVE

Bisphenol A (BPA), a common endocrine disrupter, can be activated by cytochrome P450 (CYP) metabolizing enzymes and might influence the development of breast cancer (BC). We hypothesized that BPA could interact with CYP genes, synergistically contributing to the BC risk.

METHODS

Urinary BPA was measured in a total of 302 newly diagnosed BC patients and 302 healthy controls by ultra-high performance liquid chromatography-high resolution mass spectrometry. A set of seven CYP gene polymorphisms was genotyped by using the Sequenom MassARRAY system. A multivariate logistic regression model was used to assess the associations of BPA and BPA-SNP interaction with BC risk.

RESULTS

BC patients had a higher urinary BPA concentration than healthy individuals (P < 0.001). Each 1-unit increase in log-transformed urinary BPA was associated with a 54 % increased BC risk [95 % confidence interval (CI), 1.34-1.77, P < 0.001]. Individuals with the CYP19A1 rs1902580 GA + AA genotype showed a significantly higher BC risk than those with the GG genotype (OR = 1.45, 95 % CI, 1.01-2.09, P < 0.05). A significant BPA-CYP17A1 rs743572 interaction was found to be associated with a higher risk of BC (P_interaction = 0.020). Compared with low-BPA individuals carrying CYP17A1 rs743572 GG genotypes, high-BPA individuals with the GA + AA genotype had a higher BC risk, with an odds ratio of 2.49 (95 % CI, 1.52-4.13, P < 0.05).

CONCLUSIONS

The positive association of BPA exposure with BC risk might be modified by CYP17A1 rs743572, providing evidence for the interaction effect of environment-genes on the etiology of BC.

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.

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.

Investigation into the content and formation of trihalomethanes and molecular change of dissolved organic matter from a typical water plant in south China

Trihalomethanes (THMs) are a class of disinfection by-products that were proved to have adverse effects to human health. Investigation into its content change and molecular composition variation of its main precursor, which is believed to be dissolved organic matter (DOM) during water purification process, can help understand the formation mechanism of THMs and optimize the processes in drinking water treatment plant (DWTP). This is of great significance to ensure the safety of urban water supply. In this study, detailed changes of THMs' content and formation potential were determined during the water purification process in summer and winter at a typical DWTP in south China. Specific molecular composition changes of DOM were also characterized by ultrahigh-resolution mass spectrometry, to comprehensively study its correlation with the formation of THMs in different water processing units and seasons. The result showed that chlorination will cause drastic changes of water quality and a sharp increase in the concentration of THMs (18.7 times in summer and 13.9 times in winter). Molecular-level characterization of DOM indicates that a range of lignin-like substance with lower O/C (< 0.5) and H/C (< 1.25) vanished and considerable amount of protein-like and tannins-like substance with higher H/C (> 1.25) and O/C (> 0.5) was formed after chlorination. Analysis of Cl-containing products demonstrated that a bulk of CHOCl₁ and CHOCl₂ compounds with moderate molecular weights were formed in both winter and summer. However, the newly formed CHOCl₁ molecules showed a relatively higher mass weight in summer (> 500 Da) compared to winter (300-500 Da). Seasonal differences also emerged in the result of correlation between the trihalomethanes formation potential and total organic carbon. The correlation coefficient in summer (0.500) was lower than that in winter (0.843). The results suggested that the exhaustive reaction and contribution of DOM to THMs may vary in different seasons.

How Much of the Total Organic Halogen and Developmental Toxicity of Chlorinated Drinking Water Might Be Attributed to Aromatic Halogenated DBPs?

Although >700 disinfection byproducts (DBPs) have been identified, >50% of the total organic halogen (TOX) in drinking water chlorination is unknown, and the DBPs responsible for the chlorination-associated health risks remain largely unclear. Recent studies have revealed numerous aromatic halo-DBPs, which generally present substantially higher developmental toxicity than aliphatic halo-DBPs. This raises a fascinating and important question: how much of the TOX and developmental toxicity of chlorinated drinking water can be attributed to aromatic halo-DBPs? In this study, an effective approach with ultraperformance liquid chromatography was developed to separate the DBP mixture (from chlorination of bromide-rich raw water) into aliphatic and aromatic fractions, which were then characterized for their TOX and developmental toxicity. For chlorine contact times of 0.25-72 h, aromatic fractions accounted for 49-67% of the TOX in the obtained aliphatic and aromatic fractions, which were equivalent to 26-36% of the TOX in the original chlorinated water samples. Aromatic halo-DBP fractions were more developmentally toxic than the corresponding aliphatic fractions, and the overall developmental toxicity of chlorinated water samples was dominated by aromatic halo-DBP fractions. This might be explained by the considerably higher potentials of aromatic halo-DBPs to bioconcentrate and then generate reactive oxygen species in the organism.

Hydrolysis characteristics and risk assessment of a widely detected emerging drinking water disinfection-by-product-2,6-dichloro-1,4-benzoquinone-in the water environment of Tianjin (China)

Halobenzoquinones (HBQs) are an emerging class of drinking water disinfection byproducts (DBPs) that have been frequently detected in drinking water and are highly relevant to bladder cancer. Among the studied HBQs, 2,6-dichloro-1,4-benzoquinone (DCBQ) had the highest detection frequency and concentrations in drinking water. However, compared to other countries, the studies on HBQs that are being conducted in China, especially those on HBQs in drinking water, are not sufficient. Therefore, the concentrations of DCBQ in the Tianjin drinking water supply system were investigated in two seasons (winter and summer), and the risk that is posed by DCBQ in drinking water was evaluated for the first time. In addition, since HBQs are prone to hydrolysis in neutral and alkaline environments, identification of the hydrolytic characteristics of DCBQ at various pH values and in the real water environment is essential for better describing the environmental behavior of DCBQ; hence, the hydrolysis characteristics of DCBQ in phosphate buffers with various pH values and in four water samples were also examined in our study. The results demonstrated that DCBQ was widely detected in the drinking water treatment process and distribution systems, and the average concentration in our study (12.0 ng/L) was at a moderately high level compared with the reported concentration of DCBQ in the drinking water distribution networks. The risk quotient (RQ) of DCBQ is equivalent to that of trihalomethanes (THMs); thus, the relatively low concentrations of DCBQ should also be considered. Furthermore, the results demonstrated that the hydrolysis of DCBQ follows first-order reaction kinetics, the reaction rate accelerates as the pH of the phosphate buffer system increases, and the rate of hydrolysis of DCBQ in drinking water is affected not only by the pH but also by other environmental factors, such as the organic matter concentration. Therefore, further investigation is necessary to identify the main factor of DCBQ hydrolysis in real water environments.

Formation and control of C- and N-DBPs during disinfection of filter backwash and sedimentation sludge water in drinking water treatment

Drinking water treatment plants (DWTPs) produce filter backwash water (FBW) and sedimentation sludge water (SSW) that may be partially recycled to the head of DWTPs. The impacts of key disinfection conditions, water quality parameters (e.g., disinfection times, disinfectant types and doses, and pH values), and bromide concentration on controlling the formation of trihalomethanes (THMs), haloacetic acids (HAAs), haloacetonitriles (HANs), and haloacetamides (HAMs) during disinfection of FBW and SSW were investigated. Concentrations of most disinfection byproducts (DBPs) and associated calculated toxicity increased with extended chlorination for both FBW and SSW. During chlorination of both FBW and SSW, elevated chlorine doses significantly increased THM yields per unit dissolved organic carbon (DOC), but decreased HAN and HAM yields, with minimum effect on HAA yields. Chloramine disinfection effectively inhibited C-DBP formation but promoted N-DBPs yields, which increased with chloramine dose. Calculated toxicities after chloramination increased with chloramine dose, which was opposite to the trend found after free chlorine addition. An examination of pH effects demonstrated that C-DBPs were more readily generated at alkaline pH (pH=8), while acidic conditions (pH=6) favored N-DBP formation. Total DBP concentrations increased at higher pH levels, but calculated DBP toxicity deceased due to lower HAN and HAM concentrations. Addition of bromide markedly increased bromo-THM and bromo-HAN formation, which are more cytotoxic than chlorinated analogues, but had little impact on the formation of HAAs and HAMs. Bromide incorporation factors (BIFs) for THMs and HANs from both water samples all significantly increased as bromide concentrations increased. Overall, high bromide concentrations increased the calculated toxicity values in FBW and SSW after chlorination. Therefore, while currently challenging, technologies capable of removing bromide should be explored as part of a strategy towards controlling cumulative toxicity burden (i.e., hazard) while simultaneously lowering individual DBP concentrations (i.e., exposure) to manage DBP risks in drinking water.

Water Safety Plans and HACCP implementation in water utilities around the world: benefits, drawbacks and critical success factors

Drinking water is of paramount importance for people's health. Many outbreaks due to poor water quality are being recorded even nowadays. Although the institutional framework exists at global (e.g., WHO guidelines) and national level, there are still many factors contributing to water contamination. Risk assessment tools, such as HACCP and Water Safety Plans, are being elaborated all over the world to act proactively referring to drinking water quality. The present paper aims at reviewing the implementation status of risk assessment tools around the world and presenting the benefits and the difficulties recorded during the implementation process. The benefits include improved water quality, improved operational efficiency, reduced consumers' complaints, reduced production cost, and reduced potential hazardous incidents. Studying the difficulties, the identification of critical success factors for the implementation of such tools is feasible. Some of the critical success factors include the financial and human resources, staff training, effective identification of critical control points, correct estimation of the occurrence and the severity of the hazards, effective coordination, and efficient monitoring.

Disinfection by-products in drinking water: Occurrence, toxicity and abatement

Disinfection means the killing of pathogenic organisms (e.g. bacteria and its spores, viruses, protozoa and their cysts, worms, and larvae) present in water to make it potable for other domestic works. The substances used in the disinfection of water are known as disinfectants. At municipal level, chlorine (Cl₂), chloramines (NH₂Cl, NHCl₂), chlorine dioxide (ClO₂), ozone (O₃) and ultraviolet (UV) radiations, are the most commonly used disinfectants. Chlorination, because of its removal efficiency and cost effectiveness, has been widely used as method of disinfection of water. But, disinfection process may add several kinds of disinfection by-products (DBPs) (∼600-700 in numbers) in the treated water such as Trihalomethanes (THM), Haloacetic acids (HAA) etc. which are detrimental to the human beings in terms of cytotoxicity, mutagenicity, teratogenicity and carcinogenicity. In water, THMs and HAAs were observed in the range from 0.138 to 458 μg/L and 0.16-136 μg/L, respectively. Thus, several regulations have been specified by world authorities like WHO, USEPA and Bureau of Indian Standard to protect human health. Some techniques have also been developed to remove the DBPs as well as their precursors from the water. The popular techniques of DBPs removals are adsorption, advance oxidation process, coagulation, membrane based filtration, combined approaches etc. The efficiency of adsorption technique was found up to 90% for DBP removal from the water.

Effects of Arsenic (+3 Oxidation State) Methyltransferase Gene Polymorphisms and Expression on Bladder Cancer: Evidence from a Systematic Review, Meta-analysis and TCGA Dataset

Inorganic arsenic (iAs) is a recognized environment-related factor for bladder cancer (BCa). Arsenic (+3 oxidation state) methyltransferase (AS3MT) gene might influence BCa by regulating iAs metabolism. The aim of the present study was to explore whether AS3MT polymorphisms could affect BCa susceptibility. We systematically reviewed eligible case-control studies about AS3MT polymorphisms and BCa and to further compare the genotype distribution and allele distribution between BCa patients and controls by meta-analysis for humans. Besides, to clarify the effects of AS3MT expression on BCa clinical outcomes and survival time, we also conducted a series of analyses based on The Cancer Genome Atlas dataset. Databases were systematically retrieved and we applied Stata software to perform meta-analysis. The registration of this study protocol is at PROSPERO and ID is CRD42019133947. Five articles were recruited and pooled results demonstrated that rs3740393 and rs11191438 polymorphisms were related to BCa risk in overall population (p < .05) in the overall population. In addition, GG and GC genotypes in rs3740393 and GG genotype in rs11191438 might be the susceptibility genotypes for BCa. Results based on 168 BCa samples from TGCA indicated that patients with higher expression of AS3MT had poor overall survival time and AS3MT expression is an independent indicator for BCa survival. This study identified that AS3MT polymorphisms could affect BCa risk and AS3MT expression was pivotal in prognosis of BCa.

N-acetyltransferase 2 polymorphism is associated with bladder cancer risk: An updated meta-analysis based on 54 case-control studies

OBJECTIVE

N-acetyltransferase 2 (NAT2) polymorphism could participate in the metabolism of carcinogens through regulating the activity of a series of critical enzymes. However, the effects of NAT2 polymorphism on bladder cancer (BCa) risk were still inconclusive. In order to illustrate whether NAT2 polymorphism may influence the susceptibility to BCa, we conducted this updated meta-analysis.

MATERIALS AND METHODS

Databases including PubMed, Medline, Embase, Web of Science, Cochrane Library, and China National Knowledge Infrastructure(CNKI) were systematically retrieved and we applied MetaGenyo to perform final meta-analysis. Odds ratios (ORs) as well as 95% confidence intervals (CIs) were calculated and Bonferroni method was applied to correct the P-value for multiple comparisons. The registration of this study protocol is at PROSPERO and ID is CRD42019133957.

RESULTS

Ultimately, 54 case-control studies were identified for final meta-analysis (13343 BCa cases and 18,586 controls). Overall analysis indicated that the slow genotype in NAT2 polymorphism was obviously associated with BCa risk (P_Bonferroni < 0.001). Subgroup analyses demonstrated that significant risk with the slow genotype was observed in Caucasians, Asians, smokers, non-exposed individuals, high grade bladder cancer (HGBC) patients and muscle-invasive bladder cancer (MIBC) patients. In addition, the intermediate NAT2 genotype was revealed to increase the BCa risk of Asians and transitional cell carcinoma (TCC) patients. However, no correlation was identified in Africans with the NAT2 polymorphism.

CONCLUSIONS

The slow NAT2 genotype was identified to be the risk genotype for BCa. The intermediate genotype could serve as the candidate risk genotype. The gene-smoking interaction with NAT2 polymorphism might accelerate the tumor progression.

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.

Unveiling prognostics biomarkers of tyrosine metabolism reprogramming in liver cancer by cross-platform gene expression analyses

Tyrosine is mainly degraded in the liver by a series of enzymatic reactions. Abnormal expression of the tyrosine catabolic enzyme tyrosine aminotransferase (TAT) has been reported in patients with hepatocellular carcinoma (HCC). Despite this, aberration in tyrosine metabolism has not been investigated in cancer development. In this work, we conduct comprehensive cross-platform study to obtain foundation for discoveries of potential therapeutics and preventative biomarkers of HCC. We explore data from The Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO), Gene Expression Profiling Interactive Analysis (GEPIA), Oncomine and Kaplan Meier plotter (KM plotter) and performed integrated analyses to evaluate the clinical significance and prognostic values of the tyrosine catabolic genes in HCC. We find that five tyrosine catabolic enzymes are downregulated in HCC compared to normal liver at mRNA and protein level. Moreover, low expression of these enzymes correlates with poorer survival in patients with HCC. Notably, we identify pathways and upstream regulators that might involve in tyrosine catabolic reprogramming and further drive HCC development. In total, our results underscore tyrosine metabolism alteration in HCC and lay foundation for incorporating these pathway components in therapeutics and preventative strategies.

Precise exposure assessment revealed the cancer risk and disease burden caused by trihalomethanes and haloacetic acids in Shanghai indoor swimming pool water

Swimming pool disinfection byproducts (DBPs) are becoming increasingly common worldwide. Precise exposure and health risk assessment for DBPs in swimming pool water with optimized parameters for local and specific population is more urgently needed. This study aimed to determine the levels of trihalomethanes (THMs) and haloacetic acids (HAAs) in 16 public indoor swimming pools in Shanghai, China. Swimming habits were also investigated to obtain more accurate exposure assessment parameters. Precise exposure assessment through multiple pathways, resulting cancer risk, and disability-adjusted life years (DALYs) were assessed. Results indicated that the highest total level of THMs and HAAs occurred in autumn. The surveyed swimmers 9-17 years of age had higher average daily dose (ADD) of DBPs than swimmers ≥18 years of age. The total lifetime cancer risk (LCR) attributable to THMs and HAAs exceeded 10^-6, which represents a negligible risk level (NRL). The cancer risk from inhalation exposure predominantly by THMs contributed more than 99% of the total risk. Annual disease burden was 19.0 person-years attributed to exposure of DBPs in swimming pool water in Shanghai. This study provides a paradigm and strategic reference of precise exposure assessments, risk assessments, and disease burden estimation of hazards in swimming pool water for other regions.

GAC to BAC: Does it make chloraminated drinking water safer?

Biological activated carbon (BAC) is widely used as a polishing step at full-scale drinking water plants to remove taste and odor compounds and assimilable organic carbon. BAC, especially with pre-ozonation, has been previously studied to control regulated disinfection by-products (DBPs) and DBP precursors. However, most previous studies only include regulated or a limited number of unregulated DBPs. This study explored two full-scale drinking water plants that use pre-chloramination followed by BAC and chloramine as the final disinfectant. While chloramine generally produces lower concentrations of regulated DBPs, it may form increased levels of unregulated nitrogenous and iodinated DBPs. We evaluated 71 DBPs from ten DBP classes including haloacetonitriles, haloacetamides, halonitromethanes, haloacetaldehydes, haloketones, iodinated acetic acids, iodinated trihalomethanes, nitrosamines, trihalomethanes, and haloacetic acids, along with speciated total organic halogen (total organic chlorine, bromine and iodine) across six different BAC filters of increasing age. Most preformed DBPs were well removed by BAC with different ages (i.e., operation times). However, some preformed DBPs were poorly removed or increased following treatment with BAC, including chloroacetaldehyde, dichloronitromethane, bromodichloronitromethane, N-nitrosodimethylamine, dibromochloromethane, tribromomethane, dibromochloroacetic acid, and tribromoacetic acid. Some compounds, including dibromoacetaldehyde, bromochloroacetamide, and dibromoacetamide, were formed only after treatment with BAC. Total organic halogen removal was variable in both plants and increases in TOCl or TOI were observable on one occasion at each plant. While calculated genotoxicity decreased in all filters, decreases in overall DBP formation did not correlate with decreases in calculated cytotoxicity. In three of the six filters, calculated toxicity increased by 4-27%. These results highlight that DBP concentration alone may not always provide an adequate basis for risk assessment.

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.

Tracking and analysis of DBP precursors' properties by fluorescence spectrometry of dissolved organic matter

Disinfection by-products (DBPs) play a significant role in human health. Identification of the precursor of DBPs, which constitutes dissolved organic matter (DOM), can help optimize the processes in a drinking water treatment plant (DWTP). This is very important for obtaining more safe water. In this context, a one-year study was performed in a DWTP. Fluorescence spectra of DOM were quantified for determining DOM composition and properties, and the corresponding DBPs formation was analyzed. Hydrophobic neutral and acidic compounds were found to be the two predominant substances forming DBPs, which also were dominant in the DOM. Coagulation and sedimentation were not effective in DOM elimination. Besides, sand filtration caused organic compounds to increase by 14.8% on average, especially 28.59% for aromatic protein II and 18.7% for soluble microbial product-like compounds, which was due to metabolism by microorganisms present in the filter. Carbonaceous DBPs were elevated from 34.8 μg/L in source water to 42.5 μg/L in effluent, along with organic compounds increasing in filtration, and nitrogenous DBPs were under detection in winter. All DBPs appeared at a high level in summer. Accordingly, enhanced coagulation process and measures that can avoid the release of organic compounds during filtration have been suggested. As the source water was rarely affected by human activities in the study area and owing to the wide use of traditional treatment process, the data of this research can be regarded as environmental background values and the results are considered as a significant reference.