1
|
DiSalvo RW, Hill EL. Drinking Water Contaminant Concentrations and Birth Outcomes. JOURNAL OF POLICY ANALYSIS AND MANAGEMENT : [THE JOURNAL OF THE ASSOCIATION FOR PUBLIC POLICY ANALYSIS AND MANAGEMENT] 2023; 43:368-399. [PMID: 38983462 PMCID: PMC11230651 DOI: 10.1002/pam.22558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
Previous research in the US has found negative health effects of contamination when it triggers regulatory violations. An important question is whether levels of contamination that do not trigger a health-based violation impact health. We study the impact of drinking water contamination in community water systems on birth outcomes using drinking water sampling results data in Pennsylvania. We focus on the effects of water contamination for births not exposed to regulatory violations. Our most rigorous specification employs mother fixed effects and finds changing from the 10th to the 90th percentile of water contamination (among births not exposed to regulatory violations) increases low birth weight by 12% and preterm birth by 17%.
Collapse
Affiliation(s)
- Richard W DiSalvo
- Princeton School of Public and International Affairs, Princeton University
| | - Elaine L Hill
- Department of Public Health Sciences and Department of Economics, University of Rochester & NBER, 265 Crittenden Blvd., Box 420644, Rochester, NY
| |
Collapse
|
2
|
Tafesse N, Porcelli M, Hirpessa BB, Gasana J, Padhi R, Robele S, Ambelu A. Trihalomethanes and physicochemical quality of drinking water in Addis Ababa, Ethiopia. Heliyon 2023; 9:e19446. [PMID: 37809755 PMCID: PMC10558591 DOI: 10.1016/j.heliyon.2023.e19446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 08/04/2023] [Accepted: 08/23/2023] [Indexed: 10/10/2023] Open
Abstract
Background Trihalomethanes (THMs) are the most dominant fraction of all the byproducts formed during chlorination of water. Disinfection by product (DBP) formation in water is a function of numerous factors, including pH, temperature, residual chlorine, source water characteristics, and organic matter. No study has determined the THM level in the drinking water supply of Addis Ababa, Ethiopia. Methods A cross-sectional design was conducted to collect water samples in the water supply distribution networks of Addis Ababa, Ethiopia. Twenty-one (21) sampling stations yielded a total of one hundred twenty (120) samples of drinking water. The sample handling and collection procedures were carried out in accordance with USEPA guidelines. A DB-5 capillary column was used to separate the THMs, which were detected using GC-ECD (gas chromatography-electron capture detector). Spectrophotometric and in situ methods were used for physicochemical parameters. Redundancy analysis (RDA) was used for data analysis of trihalomethanes and environmental variables using CANOCO 4.5. Results The mean concentration of total trihalomethanes in drinking water in Addis Ababa was 76.3 μg/L. The concentration of chloroform in the drinking water supply in Addis Ababa, Ethiopia, ranged between 4.03 and 79.4 μg/L. The mean total THMs in the Legedadi and Gefersa water supply systems were 77.4 μg/L and 69.66 μg/L, respectively. The residual chlorine, phosphates, UV absorbance at 254 nm, and combined chlorine had positive correlations with THM formation. However, electron conductivity had a negative correlation with THM formation. Conclusions Chloroform contributed the most to TTHMs in nearly all samples. The residual chlorine, UV absorbance, phosphate and hardness as calcium, and electron conductivity were found to be the main predictors determining the abundance and distribution of trihalomethanes. The monitoring and regulation of the THMs is required on a regular basis to analyse trends and guide the water treatment and distribution system.
Collapse
Affiliation(s)
- Nebiyou Tafesse
- Department of Water and Public Health, Ethiopian Institute of Water Resources, Addis Ababa University, P.O. Box: 56402, Addis Ababa, Ethiopia
- Menelik II Medical and Health Sciences College, Addis Ababa Health Bureau, Addis Ababa, Ethiopia
| | - Massimiliano Porcelli
- Kuwait Institute for Scientific Research Quality, Health, Safety & Work Environment Department P.O. Box: 2622, Safat, 13136 Kuwait City, Kuwait
| | - Belachew Bacha Hirpessa
- Belachew Bacha Hirpessa, Ethiopian Agriculture Authority (EAA), Quality and Safety Assessment Centre, Physicochemical Lab. Services Division, P.O. Box: 31303 Addis Ababa, Ethiopia
| | - Janvier Gasana
- Past Inaugural Head of the Dept. of Environmental & Occupational Health (EOH), Director of Postgraduate Programme & MPH-EOH Advisor, College of Public Health Sciences Centre, Kuwait University, Shadadiya, Kuwait
| | - R.K. Padhi
- Materials Chemistry and Metal Fuel Cycle Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, 603102 India
| | - Sirak Robele
- Department of Water and Public Health, Ethiopian Institute of Water Resources, Addis Ababa University, P.O. Box: 56402, Addis Ababa, Ethiopia
| | - Argaw Ambelu
- Department of Water and Public Health, Ethiopian Institute of Water Resources, Addis Ababa University, P.O. Box: 56402, Addis Ababa, Ethiopia
| |
Collapse
|
3
|
Pérez-Albaladejo E, Pinteño R, Aznar-Luque MDC, Casado M, Postigo C, Porte C. Genotoxicity and endocrine disruption potential of haloacetic acids in human placental and lung cells. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 879:162981. [PMID: 36963690 DOI: 10.1016/j.scitotenv.2023.162981] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 05/17/2023]
Abstract
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.
Collapse
Affiliation(s)
| | - Raquel Pinteño
- Environmental Chemistry Department, IDAEA -CSIC-, C/ Jordi Girona 18-26, 08034 Barcelona, Spain
| | | | - Marta Casado
- Environmental Chemistry Department, IDAEA -CSIC-, C/ Jordi Girona 18-26, 08034 Barcelona, Spain
| | - Cristina Postigo
- Technologies for Water Management and Treatment Research Group, Department of Civil Engineering, University of Granada, Campus de Fuentenueva s/n, Granada 18071, Spain; Environmental Chemistry Department, IDAEA -CSIC-, C/ Jordi Girona 18-26, 08034 Barcelona, Spain; Institute for Water Research, University of Granada, C/ Ramón y Cajal 4, Granada, 18071, Spain.
| | - Cinta Porte
- Environmental Chemistry Department, IDAEA -CSIC-, C/ Jordi Girona 18-26, 08034 Barcelona, Spain
| |
Collapse
|
4
|
Abd-Allah ER, Fouad NY, Ghareeb AEWE, Eldebss TMA. Chloroacetonitrile reduces rat prenatal bone length and induces oxidative stress, apoptosis, and DNA damage in rat fetal liver. Birth Defects Res 2023; 115:614-632. [PMID: 36751045 DOI: 10.1002/bdr2.2155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 01/15/2023] [Accepted: 01/24/2023] [Indexed: 02/09/2023]
Abstract
One of the disinfection byproducts of chlorinating drinking water is chloroacetonitrile (CAN). Thirty-six female rats were used and distributed equally into four groups. The low dose treated group received CAN at a dose of 5.5 mg/kg body weight/day (1/40 LD50 ) orally from the 6th to 12th day of gestation. The high dose treated group received 11 mg/kg body weight/day (1/20 LD50 ) of CAN orally for the same period, the vehicle control group received 1 mL of corn oil, and the water control group received 1 mL of distilled water orally for the same period. High dose exposure to CAN significantly reduced gravid uterine weight, fetal body weights, and length, and caused obvious skeletal deformities, weak mineralization. Fetal tibial growth plates displayed histopathologic changes. Induced oxidative stress and redox imbalance in fetal liver tissues was evidenced by significantly decreased in catalase and superoxide dismutase activity, and elevated malondialdehyde levels. Histopathological, glycogen content changes, and DNA damage were observed in the fetal liver of high dose treated group. Additionally, administration of high dose of CAN induced apoptosis, evidenced by increased caspase-3 concentration in fetal liver. Thus, extensive exposure to CAN induces poor pregnancy outcomes. CAN levels in water should be monitored regularly.
Collapse
Affiliation(s)
- Entsar R Abd-Allah
- Department of Zoology, Faculty of Science, Al-Azhar University, Nasr City, Egypt
| | - Nourhan Y Fouad
- Department of Biotechnology, Faculty of Science, Cairo University, Giza, Egypt
| | | | - Taha M A Eldebss
- Department of Chemistry, Faculty of Science, Cairo University, Giza, Egypt
| |
Collapse
|
5
|
Luo Q, Miao Y, Liu C, Bei E, Zhang JF, Zhang LH, Deng YL, Qiu Y, Lu WQ, Wright JM, Chen C, Zeng Q. Maternal exposure to nitrosamines in drinking water during pregnancy and birth outcomes in a Chinese cohort. CHEMOSPHERE 2023; 315:137776. [PMID: 36623593 DOI: 10.1016/j.chemosphere.2023.137776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Maternal exposure to regulated disinfection by-products (DBPs) during pregnancy has been linked with adverse birth outcomes. However, no human studies have focused on drinking water nitrosamines, a group of emerging unregulated nitrogenous DBPs that exhibits genotoxicity and developmental toxicity in experimental studies. This cohort study included 2457 mother-infant pairs from a single drinking water supply system in central China, and maternal trimester-specific and entire pregnancy exposure of drinking water nitrosamines were evaluated. Multivariable linear and Poisson regression models were used to estimate the associations between maternal exposure to nitrosamines in drinking water and birth outcomes [birth weight (BW), low birth weight (LBW), small for gestational age (SGA) and preterm delivery (PTD)]. Elevated maternal N-nitrosodimethylamine (NDMA) exposure in the second trimester and N-nitrosopiperidine (NPIP) exposure during the entire pregnancy were associated with decreased BW (e.g., β = -88.6 g; 95% CI: -151.0, -26.1 for the highest vs. lowest tertile of NDMA; p for trend = 0.01) and increased risks of PTD [e.g., risk ratio (RR) = 2.16; 95% CI: 1.23, 3.79 for the highest vs. lowest tertile of NDMA; p for trend = 0.002]. Elevated maternal exposure of N-nitrosodiethylamine (NDEA) in the second trimester was associated with increased risk of SGA (RR = 1.80; 95% CI: 1.09, 2.98 for the highest vs. lowest tertile; p for trend = 0.01). Our study detected associations of maternal exposure to drinking water nitrosamines during pregnancy with decreased BW and increased risks of SGA and PTD. These findings are novel but require replication in other study populations.
Collapse
Affiliation(s)
- Qiong Luo
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yu Miao
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Chong Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Er Bei
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, PR China
| | - Jin-Feng Zhang
- Maternal and Child Health Care Service Centre of Xiaonan District, Xiaogan City, Hubei, PR China
| | - Ling-Hua Zhang
- Maternal and Child Health Care Service Centre of Xiaonan District, Xiaogan City, Hubei, PR China
| | - Yan-Ling Deng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yu Qiu
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, PR China
| | - Wen-Qing Lu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - J Michael Wright
- Office of Research and Development, U.S. Environmental Protection Agency, Center for Public Health and Environmental Assessment, Cincinnati, OH, USA
| | - Chao Chen
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing, PR China.
| | - Qiang Zeng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
| |
Collapse
|
6
|
Stanhope J, Maric F, Rothmore P, Weinstein P. Physiotherapy and ecosystem services: improving the health of our patients, the population, and the environment. Physiother Theory Pract 2023; 39:227-240. [PMID: 34904927 DOI: 10.1080/09593985.2021.2015814] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION The relevance of ecosystems to physiotherapy has traditionally been overlooked, despite its potential for health impacts relevant to conditions often managed by physiotherapists. PURPOSE The purpose of this article is to introduce the concept of ecosystem services to physiotherapists, and to discuss how understanding ecosystem services may improve patient care, and population and planetary health. DISCUSSION AND CONCLUSION Physiotherapists with an understanding of ecosystem services may improve patient care by value-adding to management through patient education, empathy, advocacy, and broader population health approaches. Physiotherapists are also well placed to promote the conservation and restoration of ecosystem through participation, advocacy, and the development of public health measures, to the benefit of global sustainability and population health. Further research is required into how physiotherapists currently use nature-based interventions, and the barriers and enablers to their use. To be adequately prepared to meet the challenges that climate change and environmental degradation pose to patient care, population health and health systems, both current and future physiotherapists need to take a broader view of their practice. By including consideration of the potential role of the environment and green space exposure in particular on their patient's health, physiotherapists can ultimately contribute more to population and planetary health.
Collapse
Affiliation(s)
- Jessica Stanhope
- School of Allied Health Science and Practice, University of Adelaide, Adelaide, Australia
| | - Filip Maric
- Department of Health and Care Sciences, UiT the Arctic University of Norway (Tromsø), Tromsø, Norway
| | - Paul Rothmore
- School of Allied Health Science and Practice, University of Adelaide, Adelaide, Australia
| | - Philip Weinstein
- School of Public Health, University of Adelaide, Adelaide, Australia
| |
Collapse
|
7
|
Abstract
Purpose of Review Climate change is the biggest public health threat of the twenty-first century but its impact on the perinatal period has only recently received attention. This review summarizes recent literature regarding the impacts of climate change and related environmental disasters on pregnancy health and provides recommendations to inform future adaptation and mitigation efforts. Recent Findings Accumulating evidence suggests that the changing climate affects pregnancy health directly via discrete environmental disasters (i.e., wildfire, extreme heat, hurricane, flood, and drought), and indirectly through changes in the natural and social environment. Although studies vary greatly in design, analytic methods, and assessment strategies, they generally converge to suggest that climate-related disasters are associated with increased risk of gestational complication, pregnancy loss, restricted fetal growth, low birthweight, preterm birth, and selected delivery/newborn complications. Window(s) of exposure with the highest sensitivity are not clear, but both acute and chronic exposures appear important. Furthermore, socioeconomically disadvantaged populations may be more vulnerable. Summary Policy, clinical, and research strategies for adaptation and mitigation should be continued, strengthened, and expanded with cross-disciplinary efforts. Top priorities should include (a) reinforcing and expanding policies to further reduce emission, (b) increasing awareness and education resources for healthcare providers and the public, (c) facilitating access to quality population-based data in low-resource areas, and (d) research efforts to better understand mechanisms of effects, identify susceptible populations and windows of exposure, explore interactive impacts of multiple exposures, and develop novel methods to better quantify pregnancy health impacts.
Collapse
|
8
|
Associations between drinking water disinfection byproducts and menstrual cycle characteristics: A cross-sectional study among women attending an infertility clinic. Int J Hyg Environ Health 2022; 241:113931. [PMID: 35114412 DOI: 10.1016/j.ijheh.2022.113931] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/24/2022] [Accepted: 01/24/2022] [Indexed: 12/22/2022]
Abstract
Disinfection byproducts (DBPs) have been shown to alter ovarian steroidogenesis and cause estrous cyclicity disturbance and prolongation in experimental studies, however human studies are lacking. We aimed to evaluate the cross-sectional associations between drinking water DBPs and menstrual cycle characteristics. A total of 1078 women attending an infertility clinic in Wuhan, China were included between December 2018 and January 2020. Characteristics of menstrual cycle were collected by questionnaires. Concentrations of dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA) were measured in urine as biomarkers of drinking water DBPs. Multivariate logistic and linear regression models were used to evaluate the associations between urinary DCAA and TCAA concentrations and menstrual cycle characteristics. Higher urinary DCAA concentrations were associated with increased odds ratios (ORs) of irregular menstrual cycle (OR = 1.80; 95% CI: 0.97, 3.33 for the highest vs. lowest quartile; P for trend = 0.05) and long menstrual cycle (OR = 1.62; 95% CI: 0.97, 2.70 for the highest vs. lowest quartile; P for trend = 0.06), as well as prolonged variation in cycle length (β = 1.27 days; 95% CI: -0.11, 2.66 for the highest vs. lowest quartile; P for trend = 0.04). Higher urinary TCAA concentrations were associated with prolonged bleeding duration (β = 0.23 days; 95% CI: -0.06, 0.51 for the highest vs. lowest quartile; P for trend = 0.07). These results suggest that exposure to drinking water DBPs is associated with menstrual cycle disturbances. These findings are warranted to confirm in other studies.
Collapse
|
9
|
Liu C, Sun Y, Mustieles V, Chen YJ, Huang LL, Deng YL, Wang YX, Lu WQ, Messerlian C. Prenatal Exposure to Disinfection Byproducts and Intrauterine Growth in a Chinese Cohort. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:16011-16022. [PMID: 34813313 DOI: 10.1021/acs.est.1c04926] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Disinfection byproduct (DBP) exposure has been associated with birth size, pregnancy oxidative stress, and other adverse perinatal outcomes. However, little is known about the potential effect of prenatal DBP exposure on intrauterine growth. The present study included 1516 pregnant women from the Xiaogan Disinfection By-Products (XGDBP) birth cohort who were measured for four blood trihalomethanes [i.e., chloroform (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform (TBM)] and two urinary haloacetic acids [i.e., dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA)] across pregnancy trimesters. Second- and third-trimester fetal ultrasound measures of the abdominal circumference (AC), head circumference, biparietal diameter, femur length, and estimated fetal weight and birth weight were converted into z-scores. After adjusting for potential confounders, linear mixed models showed a decreasing AC z-score across tertiles of blood brominated THM (Br-THMs, the sum of BDCM, DBCM, and TBM) and total THM (THM4, the sum of Br-THMs and TCM) concentrations (both p for trend <0.01). We also observed a decreasing AC z-score across categories of blood TBM during pregnancy trimesters (p for trend = 0.03). Urinary haloacetic acids were unrelated to fetal growth parameters. In summary, prenatal exposure to THMs, particularly during the first trimester, was associated with reduced fetal abdominal circumference.
Collapse
Affiliation(s)
- Chong Liu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Yang Sun
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Vicente Mustieles
- Center for Biomedical Research (CIBM), University of Granada, Granada 18016, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Madrid 28029, Spain
| | - Ying-Jun Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Li-Li Huang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yan-Ling Deng
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Yi-Xin Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Wen-Qing Lu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Carmen Messerlian
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| |
Collapse
|
10
|
Craven CB, Blackstock LKJ, Xie J, Li J, Yuan CG, Li XF. Analytical discovery of water disinfection byproducts of toxicological relevance: highlighting halobenzoquinones. CAN J CHEM 2021. [DOI: 10.1139/cjc-2021-0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Analytical advancement enables discoveries in water research, and challenges in the identification and determination of a wide range of trace level toxic compounds in water drives the development of new analytical platforms and tools. The identification of toxic disinfection byproducts (DBPs) in disinfected drinking water is an excellent example. Water disinfection is necessary to protect the public from waterborne disease. However, an unintentional consequence is the formation of DBPs resulting from reactions of disinfectants with natural organic matter in source water. To date, regulated DBPs do not account for the increased bladder cancer risk estimated in epidemiological studies. The majority of halogenated DBPs remain unidentified and the discovery of unknown DBPs of toxicological relevance continues to be a major focus of current water research. This review will highlight halobenzoquinones as a class of DBPs that serves as an example of analytical development and toxicological studies. We will feature recent trends and gaps in analytical technologies for identification of unknown DBPs and bioassays for evaluation of the toxicological effects of specific DBPs and their mixtures.
Collapse
Affiliation(s)
- Caley B. Craven
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2G3, Canada
- Department of Chemistry, Faculty of Science, University of Alberta, Edmonton, AB T6G 2G3, Canada
| | - Lindsay K. Jmaiff Blackstock
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2G3, Canada
| | - Jiaojiao Xie
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2G3, Canada
- Department of Environmental Science and Engineering, North China Electric Power University, Baoding, 071000, PR China
| | - Jinhua Li
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2G3, Canada
| | - Chun-Gang Yuan
- Department of Environmental Science and Engineering, North China Electric Power University, Baoding, 071000, PR China
| | - Xing-Fang Li
- Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2G3, Canada
| |
Collapse
|
11
|
Lewis A, McKeon TP, De Roos AJ, Ravel J, Elovitz MA, Burris HH. Associations of public water system trihalomethane exposure during pregnancy with spontaneous preterm birth and the cervicovaginal microbial-immune state. ENVIRONMENTAL RESEARCH 2021; 199:111288. [PMID: 33965388 PMCID: PMC8195861 DOI: 10.1016/j.envres.2021.111288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Water total trihalomethanes (TTHMs) are disinfectant byproducts found in municipal water supplies. TTHM exposure has been linked to cancer and may be associated with adverse reproductive outcomes. A non-optimal cervicovaginal microbiota and low cervicovaginal beta-defensin-2 levels are associated with increased risk of spontaneous preterm birth. Whether TTHM exposure increases the risk of spontaneous preterm birth or alters the cervicovaginal microbial or immune state is unknown. OBJECTIVE Investigate associations of water TTHM levels with spontaneous preterm birth, a non-optimal cervicovaginal microbiota, and beta-defensin-2 levels in a completed, diverse, urban pregnancy cohort. We hypothesized that higher TTHM levels would be associated with spontaneous preterm birth, a non-optimal cervicovaginal microbiota, and lower beta-defensin-2 levels. DESIGN Methods: This was a secondary analysis of participants (n = 474) in the Motherhood & Microbiome (M&M) study (n = 2000), who lived in Philadelphia and had cervicovaginal samples analyzed for cervicovaginal microbiota composition and beta-defensin-2 levels. The microbiota was classified into community state types (CSTs). CST IV (non-optimal microbiota) is characterized by a paucity of Lactobacillus species and wide array of anaerobes. Municipal water TTHM levels were obtained from 16 sites monthly across the city of Philadelphia to establish mean residential water supply levels for each participant for the first four months of pregnancy (prior to vaginal swab collection at 16-20 weeks' gestation). Associations of water TTHM levels with spontaneous preterm birth and a non-optimal cervicovaginal microbiota birth were analyzed using multivariable logistic regression. Multivariable linear regression was used to model associations of water TTHM levels with log-transformed cervicovaginal beta-defensin-2 levels. Since water TTHM levels vary by season and beta-defensin-2 levels have been shown to differ by race, stratified models by warm (April-September) and cold (October-March) seasons as well as by self-identified race were utilized. RESULTS Participants' water supply TTHM levels (mean μg/L [SD]) were higher in the warm (53.5 [9.4]) than cold (33.4 [7.5]) season (p < 0.0001). TTHM levels were non-significantly higher among Black participants than non-Black participants (44.8 [13.5] vs. 41.8 [11.8], p = 0.07). No associations were detected between TTHM with spontaneous preterm birth (per SD increment of TTHM, aOR 0.94, 95%CI: 0.66, 1.34) or with CST IV (aOR 0.94, 95%CI: 0.86, 1.16). Counter to our hypothesis, we observed positive associations of water TTHM with log-transformed cervicovaginal beta-defensin-2 levels in unadjusted models (β 0.20 [95%CI: 0.02, 0.39]) per SD increment of TTHM), but the association was null after adjustment for season. However, in models adjusted for covariates including season and stratified by race, TTHM was significantly associated with lower beta-defensin-2 levels among non-Black participants (β -0.75 [95%CI: -1.43, -0.08]) but not among Black participants (β 0.17 [95%CI: -0.15, 0.49]), interaction p = 0.013). CONCLUSION We did not detect associations of water TTHM levels with spontaneous preterm birth or the structure of the cervicovaginal microbiota. However, the finding of a significant interaction between TTHM and race on beta-defensin-2 levels suggest that environmental exposures may contribute to differences in reproductive tract innate immune function by race. Future studies to delineate environmental contributions to the cervicovaginal microbial-immune state, a potentially important biologic underpinning for preterm birth, are warranted.
Collapse
Affiliation(s)
- Andrea Lewis
- Center of Excellence in Environmental Toxicology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas P McKeon
- Center of Excellence in Environmental Toxicology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Anneclaire J De Roos
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Jacques Ravel
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Michal A Elovitz
- Maternal and Child Health Research Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Heather H Burris
- Maternal and Child Health Research Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Department of Pediatrics, The Children's Hospital of Philadelphia and University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
| |
Collapse
|
12
|
Badaró JPM, Campos VP, da Rocha FOC, Santos CL. Multivariate analysis of the distribution and formation of trihalomethanes in treated water for human consumption. Food Chem 2021; 365:130469. [PMID: 34243123 DOI: 10.1016/j.foodchem.2021.130469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 06/03/2021] [Accepted: 06/24/2021] [Indexed: 11/18/2022]
Abstract
The disinfection of water for human consumption with chlorine or other compounds produces secondary reactions with the organic matter, generating undesirable disinfection by-products (DBPs). Among these are trihalomethanes (THMs), identified as carcinogenic compounds. This work determined the trihalomethanes concentration, both speciated and total, in treated water distributed and stored in tanks of residential condominiums of different social classes. THMs were quantified using static manual Headspace as preconcentration technique, injecting the vapor phase collected in a GC/FID. The results show that the water distributed to the homes already contains THMs, trichloromethane being the major compound. The Principal Components Analysis (PCA) and Hierarchical Cluster Analysis (HCA) with 60 water samples showed that there is no significant distinction among samples of treated water distributed water and water stored in tanks. This study warns to the importance of controlling the formation of trihalomethanes in water throughout treatment and distribution for users.
Collapse
Affiliation(s)
| | - Vânia Palmeira Campos
- Departamento de Química Analítica, Instituto de Química, Universidade Federal da Bahia, 40170-270 Salvador, Bahia, Brazil
| | | | - Camila Lima Santos
- Departamento de Química Analítica, Instituto de Química, Universidade Federal da Bahia, 40170-270 Salvador, Bahia, Brazil
| |
Collapse
|
13
|
Zhou W, Fu L, Zhao L, Xu X, Li W, Wen M, Wu Q. Novel Core-Sheath Cu/Cu 2O-ZnO-Fe 3O 4 Nanocomposites with High-Efficiency Chlorine-Resistant Bacteria Sterilization and Trichloroacetic Acid Degradation Performance. ACS APPLIED MATERIALS & INTERFACES 2021; 13:10878-10890. [PMID: 33635062 DOI: 10.1021/acsami.0c21336] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In order to solve two issues of chlorine-resistant bacteria (CRB) and disinfection byproducts (DBPs) in tap water after the chlorine-containing treatment process, an innovative core-sheath nanostructured Cu/Cu2O-ZnO-Fe3O4 was designed and synthesized. The fabrication mechanism of the materials was then systematically analyzed to determine the component and valence state. The properties of CRB inactivation together with trichloroacetic acid (TCAA) photodegradation by Cu/Cu2O-ZnO-Fe3O4 were investigated in detail. It was found that Cu/Cu2O-ZnO-Fe3O4 displayed excellent antibacterial activity with a relatively low cytotoxicity concentration due to its synergism of nanowire structure, ion release, and reactive oxygen species generation. Furthermore, the Cu/Cu2O-ZnO-Fe3O4 nanocomposite also exhibited outstanding photocatalytic degradation activity on TCAA under simulated sunlight irradiation, which was verified to be dominated by the surface reaction through kinetic analysis. More interestingly, the cell growth rate of Cu/Cu2O-ZnO-Fe3O4 was determined to be 50% and 10% higher than those of Cu/Cu2O and Cu/Cu2O-ZnO after 10 h incubation, respectively, manifesting a weaker cytotoxicity. Therefore, the designed Cu/Cu2O-ZnO-Fe3O4 could be a promising agent for tap water treatment.
Collapse
Affiliation(s)
- Wei Zhou
- College of Environmental Science and Engineering, School of Chemical Science and Engineering, State Key Laboratory of Pollution Control and Resource Reuse, Shanghai Key Laboratory of Chemical Assessment and Sustainability, Tongji University, Shanghai 200092, PR China
| | - Lin Fu
- College of Environmental Science and Engineering, School of Chemical Science and Engineering, State Key Laboratory of Pollution Control and Resource Reuse, Shanghai Key Laboratory of Chemical Assessment and Sustainability, Tongji University, Shanghai 200092, PR China
| | - Long Zhao
- College of Environmental Science and Engineering, School of Chemical Science and Engineering, State Key Laboratory of Pollution Control and Resource Reuse, Shanghai Key Laboratory of Chemical Assessment and Sustainability, Tongji University, Shanghai 200092, PR China
| | - Xiaojuan Xu
- Department of Pathology and Pathophysiology, School of Medicine, Tongji University, Shanghai 200092, PR China
| | - Weiying Li
- College of Environmental Science and Engineering, School of Chemical Science and Engineering, State Key Laboratory of Pollution Control and Resource Reuse, Shanghai Key Laboratory of Chemical Assessment and Sustainability, Tongji University, Shanghai 200092, PR China
| | - Ming Wen
- College of Environmental Science and Engineering, School of Chemical Science and Engineering, State Key Laboratory of Pollution Control and Resource Reuse, Shanghai Key Laboratory of Chemical Assessment and Sustainability, Tongji University, Shanghai 200092, PR China
| | - Qingsheng Wu
- College of Environmental Science and Engineering, School of Chemical Science and Engineering, State Key Laboratory of Pollution Control and Resource Reuse, Shanghai Key Laboratory of Chemical Assessment and Sustainability, Tongji University, Shanghai 200092, PR China
| |
Collapse
|
14
|
Stanhope J, Davidson G, McAuley K, Cook A, Weinstein P. Spatial and Temporal Variability in Trihalomethane Concentrations in the Bromine-Rich Public Waters of Perth, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7280. [PMID: 33028020 PMCID: PMC7579358 DOI: 10.3390/ijerph17197280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/20/2020] [Accepted: 09/23/2020] [Indexed: 12/03/2022]
Abstract
High concentrations of trihalomethanes (THMs) in public water supplies potentially pose a health hazard, but exposure assessment remains a complex task. To interpret research findings and monitoring data for THMs, it is important to evaluate spatial and temporal variations in both total THM and the individual constituent compounds (including brominated species). We therefore aimed to determine the concentrations, and spatial and temporal variability of concentrations, of THMs public water supplies in Perth, Western Australia, which is known historically to have high brominated THM concentrations. We analysed water samples from 21 water distribution zones around Perth (including Busselton and Bunbury) across different seasons over a period of two years. A total of 250 samples provided a median total THM of 72 µg/L (range of 0-157 µg/L), which falls well within Australia's National Health and Medical Research Council guidelines. The concentration of all species, including brominated forms, also fell the World Health Organization's guidelines. Total THM concentrations were typically higher in spring and summer. A high degree of spatial variability was detected and appears to relate to the source water. Both the temporal and spatial variability in THM concentrations have implications for epidemiological studies, and monitoring.
Collapse
Affiliation(s)
- Jessica Stanhope
- School of Biological Sciences, The University of Adelaide, Adelaide, SA 5005, Australia;
- School of Allied Health Science and Practice, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Gael Davidson
- School of Population and Global Health, The University of Western Australia, Perth, WA 6009, Australia; (G.D.); (K.M.); (A.C.)
| | - Kimberley McAuley
- School of Population and Global Health, The University of Western Australia, Perth, WA 6009, Australia; (G.D.); (K.M.); (A.C.)
- Discipline of Paediatrics, The University of Western Australia, Perth, WA 6009, Australia
| | - Angus Cook
- School of Population and Global Health, The University of Western Australia, Perth, WA 6009, Australia; (G.D.); (K.M.); (A.C.)
| | - Philip Weinstein
- School of Biological Sciences, The University of Adelaide, Adelaide, SA 5005, Australia;
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| |
Collapse
|
15
|
Shi Y, Ma W, Han F, Geng Y, Yu X, Wang H, Kimura SY, Wei X, Kauffman A, Xiao S, Zheng W, Jia X. Precise exposure assessment revealed the cancer risk and disease burden caused by trihalomethanes and haloacetic acids in Shanghai indoor swimming pool water. JOURNAL OF HAZARDOUS MATERIALS 2020; 388:121810. [PMID: 31831286 DOI: 10.1016/j.jhazmat.2019.121810] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/26/2019] [Accepted: 12/01/2019] [Indexed: 06/10/2023]
Abstract
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.
Collapse
Affiliation(s)
- Yewen Shi
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Wuren Ma
- Key Laboratory of the Public Health Safety, Ministry of Education, Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China; Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China
| | - Fengchan Han
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Yan Geng
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Xia Yu
- Department of Dermatology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China
| | - Haiyin Wang
- Department of Health Technology Assessment, Shanghai Health Development Research Center, Shanghai 200032, China
| | - Susana Y Kimura
- Department of Chemistry, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Xiao Wei
- Department of Occupational and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Alexandra Kauffman
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Shuo Xiao
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Weiwei Zheng
- Key Laboratory of the Public Health Safety, Ministry of Education, Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China; Center for Water and Health, School of Public Health, Fudan University, Shanghai, 200032, China.
| | - Xiaodong Jia
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China.
| |
Collapse
|
16
|
Monti MM, David F, Shin M, Vaidyanathan A. Community drinking water data on the National Environmental Public Health Tracking Network: a surveillance summary of data from 2000 to 2010. ENVIRONMENTAL MONITORING AND ASSESSMENT 2019; 191:557. [PMID: 31402397 PMCID: PMC6689568 DOI: 10.1007/s10661-019-7710-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 07/24/2019] [Indexed: 05/04/2023]
Abstract
This report describes the available drinking water quality monitoring data on the Centers for Disease Control and Prevention (CDC) National Environmental Public Health Tracking Network (Tracking Network). This surveillance summary serves to identify the degree to which ten drinking water contaminants are present in finished water delivered to populations served by community water systems (CWS) in 24 states from 2000 to 2010. For each state, data were collected from every CWS. CWS are sampled on a monitoring schedule established by the Environmental Protection Agency (EPA) for each contaminant monitored. Annual mean and maximum concentrations by CWS for ten water contaminants were summarized from 2000 to 2010 for 24 states. For each contaminant, we calculated the number and percent of CWS with mean and maximum concentrations above the maximum contaminant level (MCL) and the number and percent of population served by CWS with mean and maximum concentrations above the MCL by year and then calculated the median number of those exceedances for the 11-year period. We also summarized these measures by CWS size and by state and identified the source water used by those CWS with exceedances of the MCL. The contaminants that occur more frequently in CWS with annual mean and annual maximum concentrations greater than the MCL include the disinfection byproducts, total trihalomethanes (TTHM), and haloacetic acids (HAA5); arsenic; nitrate; radium and uranium. A very high proportion of exceedances based on MCLs occurred mostly in very small and small CWS, which serve a year-round population of 3,300 or less. Arsenic in New Mexico and disinfection byproducts HAA5 and TTHM, represent the greatest health risk in terms of exposure to regulated drinking water contaminants. Very small and small CWS are the systems' greatest difficulty in achieving compliance.
Collapse
Affiliation(s)
- Michele M Monti
- Environmental Health Tracking Section, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Felicita David
- Health Systems and Trauma Systems Branch, Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mikyong Shin
- Environmental Health Tracking Section, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ambarish Vaidyanathan
- Environmental Health Tracking Section, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|