Health impacts of long-term exposure to disinfection by-products in drinking water in Europe: HIWATE.

TitleHealth impacts of long-term exposure to disinfection by-products in drinking water in Europe: HIWATE.
Publication TypeJournal Article
Year of Publication2009
AuthorsNieuwenhuijsen MJ, Smith R, Golfinopoulos S, Best N, Bennett J, Aggazzotti G, Righi E, Fantuzzi G, Bucchini L, Cordier S, Villanueva CM, Moreno V, La Vecchia C, Bosetti C, Vartiainen T, Rautiu R, Toledano M, Iszatt N, Grazuleviciene R, Kogevinas M
JournalJ Water Health
Volume7
Issue2
Pagination185-207
Date Published06/2009
ISSN1477-8920
KeywordsCausality, Chlorine, Congenital Abnormalities, Disinfectants, Environmental Exposure, Environmental Monitoring, Epidemiologic Studies, Epidemiological Monitoring, Europe, Female, Humans, Male, Neoplasms, Pregnancy, Pregnancy Complications, Premature Birth, Research Design, Risk Assessment, Semen Analysis, Trihalomethanes, Water Pollutants, Chemical, Water Purification, Water Supply
Abstract

There appears to be very good epidemiological evidence for a relationship between chlorination by-products, as measured by trihalomethanes (THMs), in drinking water and bladder cancer, but the evidence for other cancers, including colorectal cancer appears to be inconclusive and inconsistent. There appears to be some evidence for a relationship between chlorination by-products, as measured by THMs, and small for gestational age (SGA)/intrauterine growth retardation (IUGR) and preterm delivery, but evidence for other outcomes such as low birth weight (LBW), stillbirth, congenital anomalies and semen quality appears to be inconclusive and inconsistent.The overall aim of the HIWATE study is to investigate potential human health risks (e.g. bladder and colorectal cancer, premature births, SGA, semen quality, stillbirth, congenital anomalies) associated with long-term exposure to low levels of disinfectants (such as chlorine) and DBPs occurring in water for human consumption and use in the food industry. The study will comprise risk-benefit analyses including quantitative assessments of risk associated with microbial contamination of drinking water versus chemical risk and will compare alternative treatment options. The outcome will be improved risk assessment and better information for risk management. The work is divided into different topics (exposure assessment, epidemiology, risk assessment and management) and studies.

DOI10.2166/wh.2009.073
Alternate JournalJ Water Health
PubMed ID19240347