Assessing exposure in epidemiologic studies to disinfection by-products in drinking water: report from an international workshop.
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.
Arbuckle
Tye E
TE
Bureau of Reproductive and Child Health, Health Canada, Ottawa, Ontario, Canada. tye_arbuckle@hc-sc.gc.ca
Hrudey
Steve E
SE
Krasner
Stuart W
SW
Nuckols
Jay R
JR
Richardson
Susan D
SD
Singer
Philip
P
Mendola
Pauline
P
Dodds
Linda
L
Weisel
Clifford
C
Ashley
David L
DL
Froese
Kenneth L
KL
Pegram
Rex A
RA
Schultz
Irvin R
IR
Reif
John
J
Bachand
Annette M
AM
Benoit
Frank M
FM
Lynberg
Michele
M
Poole
Charles
C
Waller
Kirsten
K
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
D000085:Acetates; D004202:Disinfectants; D022882:Trihalomethanes