title: Assessing exposure in epidemiologic studies to disinfection by-products in drinking water: report from an international workshop.
abstract: The inability to accurately assess exposure has been one of the major shortcomings of epidemiologic studies of disinfection by-products (DBPs) in drinking water. A number of contributing factors include a) limited information on the identity, occurrence, toxicity, and pharmacokinetics of the many DBPs that can be formed from chlorine, chloramine, ozone, and chlorine dioxide disinfection; b) the complex chemical interrelationships between DBPs and other parameters within a municipal water distribution system; and c) difficulties obtaining accurate and reliable information on personal activity and water consumption patterns. In May 2000, an international workshop was held to bring together various disciplines to develop better approaches for measuring DBP exposure for epidemiologic studies. The workshop reached consensus about the clear need to involve relevant disciplines (e.g., chemists, engineers, toxicologists, biostatisticians and epidemiologists) as partners in developing epidemiologic studies of DBPs in drinking water. The workshop concluded that greater collaboration of epidemiologists with water utilities and regulators should be encouraged in order to make regulatory monitoring data more useful for epidemiologic studies. Similarly, exposure classification categories in epidemiologic studies should be chosen to make results useful for regulatory or policy decision making.
authors.affiliation: Bureau of Reproductive and Child Health, Health Canada, Ottawa, Ontario, Canada. tye_arbuckle@hc-sc.gc.ca
authors.forename: Tye E
authors.initials: TE
authors.lastname: Arbuckle
authors.forename: Steve E
authors.initials: SE
authors.lastname: Hrudey
authors.forename: Stuart W
authors.initials: SW
authors.lastname: Krasner
authors.forename: Jay R
authors.initials: JR
authors.lastname: Nuckols
authors.forename: Susan D
authors.initials: SD
authors.lastname: Richardson
authors.forename: Philip
authors.initials: P
authors.lastname: Singer
authors.forename: Pauline
authors.initials: P
authors.lastname: Mendola
authors.forename: Linda
authors.initials: L
authors.lastname: Dodds
authors.forename: Clifford
authors.initials: C
authors.lastname: Weisel
authors.forename: David L
authors.initials: DL
authors.lastname: Ashley
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Froese
authors.forename: Rex A
authors.initials: RA
authors.lastname: Pegram
authors.forename: Irvin R
authors.initials: IR
authors.lastname: Schultz
authors.forename: John
authors.initials: J
authors.lastname: Reif
authors.forename: Annette M
authors.initials: AM
authors.lastname: Bachand
authors.forename: Frank M
authors.initials: FM
authors.lastname: Benoit
authors.forename: Michele
authors.initials: M
authors.lastname: Lynberg
authors.forename: Charles
authors.initials: C
authors.lastname: Poole
authors.forename: Kirsten
authors.initials: K
authors.lastname: Waller
mesh_terms: D000085:Acetates / Q000009:adverse effects / Q000032:analysis; D004202:Disinfectants / Q000009:adverse effects*; D004781:Environmental Exposure; D004784:Environmental Monitoring; D016021:Epidemiologic Studies; D006801:Humans; D007391:International Cooperation; D008962:Models, Theoretical; D011050:Policy Making; D011640:Public Policy; D012107:Research Design; D022882:Trihalomethanes / Q000009:adverse effects / Q000032:analysis*; D014881:Water Supply
chemical_list: D000085:Acetates; D004202:Disinfectants; D022882:Trihalomethanes