Health impacts of long-term exposure to disinfection by-products in drinking water in Europe: HIWATE.
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.
Nieuwenhuijsen
Mark J
MJ
Centre for research in Environmental, Epidemiology (CREAL), Parc de Recerca Biomédical de Barcelona-PRBB, Barcelona, Spain. mnieuwenhuijsen@imim.es
Smith
Rachel
R
Golfinopoulos
Spyros
S
Best
Nicky
N
Bennett
James
J
Aggazzotti
Gabriella
G
Righi
Elena
E
Fantuzzi
Guglielmina
G
Bucchini
Luca
L
Cordier
Sylvaine
S
Villanueva
Cristina M
CM
Moreno
Victor
V
La Vecchia
Carlo
C
Bosetti
Cristina
C
Vartiainen
Terttu
T
Rautiu
Radu
R
Toledano
Mireille
M
Iszatt
Nina
N
Grazuleviciene
Regina
R
Kogevinas
Manolis
M
D015984:Causality; D002713:Chlorine / Q000009:adverse effects*; D000013:Congenital Abnormalities / Q000453:epidemiology / Q000209:etiology; D004202:Disinfectants / Q000009:adverse effects*; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D004784:Environmental Monitoring / Q000379:methods; D016021:Epidemiologic Studies; D062665:Epidemiological Monitoring; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000139:chemically induced / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced / Q000453:epidemiology; D047928:Premature Birth / Q000139:chemically induced / Q000453:epidemiology; D012107:Research Design; D018570:Risk Assessment; D055101:Semen Analysis; D022882:Trihalomethanes / Q000009:adverse effects*; D014874:Water Pollutants, Chemical / Q000009:adverse effects* / Q000032:analysis; D018508:Water Purification / Q000379:methods*; D014881:Water Supply / Q000032:analysis
D004202:Disinfectants; D022882:Trihalomethanes; D014874:Water Pollutants, Chemical; D002713:Chlorine