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. 2002 Feb;110(Suppl 1):53–60. doi: 10.1289/ehp.02110s153

Assessing exposure in epidemiologic studies to disinfection by-products in drinking water: report from an international workshop.

Tye E Arbuckle 1, Steve E Hrudey 1, Stuart W Krasner 1, Jay R Nuckols 1, Susan D Richardson 1, Philip Singer 1, Pauline Mendola 1, Linda Dodds 1, Clifford Weisel 1, David L Ashley 1, Kenneth L Froese 1, Rex A Pegram 1, Irvin R Schultz 1, John Reif 1, Annette M Bachand 1, Frank M Benoit 1, Michele Lynberg 1, Charles Poole 1, Kirsten Waller 1
PMCID: PMC1241147  PMID: 11834463

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.

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Selected References

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  1. Aggazzotti G., Fantuzzi G., Righi E., Predieri G. Blood and breath analyses as biological indicators of exposure to trihalomethanes in indoor swimming pools. Sci Total Environ. 1998 Jun 30;217(1-2):155–163. doi: 10.1016/s0048-9697(98)00174-0. [DOI] [PubMed] [Google Scholar]
  2. Ashley D. L., Bonin M. A., Cardinali F. L., McCraw J. M., Holler J. S., Needham L. L., Patterson D. G., Jr Determining volatile organic compounds in human blood from a large sample population by using purge and trap gas chromatography/mass spectrometry. Anal Chem. 1992 May 1;64(9):1021–1029. doi: 10.1021/ac00033a011. [DOI] [PubMed] [Google Scholar]
  3. Backer L. C., Ashley D. L., Bonin M. A., Cardinali F. L., Kieszak S. M., Wooten J. V. Household exposures to drinking water disinfection by-products: whole blood trihalomethane levels. J Expo Anal Environ Epidemiol. 2000 Jul-Aug;10(4):321–326. doi: 10.1038/sj.jea.7500098. [DOI] [PubMed] [Google Scholar]
  4. Cantor K. P., Lynch C. F., Hildesheim M. E., Dosemeci M., Lubin J., Alavanja M., Craun G. Drinking water source and chlorination byproducts. I. Risk of bladder cancer. Epidemiology. 1998 Jan;9(1):21–28. [PubMed] [Google Scholar]
  5. Cardinali F. L., McCraw J. M., Ashley D. L., Bonin M., Wooten J. Treatment of vacutainers for use in the analysis of volatile organic compounds in human blood at the low parts-per-trillion level. J Chromatogr Sci. 1995 Oct;33(10):557–560. doi: 10.1093/chromsci/33.10.557. [DOI] [PubMed] [Google Scholar]
  6. DeMarini D. M., Shelton M. L., Warren S. H., Ross T. M., Shim J. Y., Richard A. M., Pegram R. A. Glutathione S-transferase-mediated induction of GC-->AT transitions by halomethanes in Salmonella. Environ Mol Mutagen. 1997;30(4):440–447. [PubMed] [Google Scholar]
  7. Dodds L., King W., Woolcott C., Pole J. Trihalomethanes in public water supplies and adverse birth outcomes. Epidemiology. 1999 May;10(3):233–237. [PubMed] [Google Scholar]
  8. Doyle T. J., Zheng W., Cerhan J. R., Hong C. P., Sellers T. A., Kushi L. H., Folsom A. R. The association of drinking water source and chlorination by-products with cancer incidence among postmenopausal women in Iowa: a prospective cohort study. Am J Public Health. 1997 Jul;87(7):1168–1176. doi: 10.2105/ajph.87.7.1168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Ells B., Barnett D. A., Froese K., Purves R. W., Hrudey S., Guevremont R. Detection of chlorinated and brominated byproducts of drinking water disinfection using electrospray ionization-high-field asymmetric waveform ion mobility spectrometry-mass spectrometry. Anal Chem. 1999 Oct 15;71(20):4747–4752. doi: 10.1021/ac990343j. [DOI] [PubMed] [Google Scholar]
  10. Ells B, Barnett DA, Purves RW, Guevremont R. Detection of nine chlorinated and brominated haloacetic acids at part-per-trillion levels using ESI-FAIMS-MS. Anal Chem. 2000 Oct 1;72(19):4555–4559. doi: 10.1021/ac000341v. [DOI] [PubMed] [Google Scholar]
  11. Kim H., Haltmeier P., Klotz J. B., Weisel C. P. Evaluation of biomarkers of environmental exposures: urinary haloacetic acids associated with ingestion of chlorinated drinking water. Environ Res. 1999 Feb;80(2 Pt 1):187–195. doi: 10.1006/enrs.1998.3896. [DOI] [PubMed] [Google Scholar]
  12. King W. D., Dodds L., Allen A. C. Relation between stillbirth and specific chlorination by-products in public water supplies. Environ Health Perspect. 2000 Sep;108(9):883–886. doi: 10.1289/ehp.00108883. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. King W. D., Marrett L. D. Case-control study of bladder cancer and chlorination by-products in treated water (Ontario, Canada). Cancer Causes Control. 1996 Nov;7(6):596–604. doi: 10.1007/BF00051702. [DOI] [PubMed] [Google Scholar]
  14. King W. D., Marrett L. D., Woolcott C. G. Case-control study of colon and rectal cancers and chlorination by-products in treated water. Cancer Epidemiol Biomarkers Prev. 2000 Aug;9(8):813–818. [PubMed] [Google Scholar]
  15. Klotz J. B., Pyrch L. A. Neural tube defects and drinking water disinfection by-products. Epidemiology. 1999 Jul;10(4):383–390. doi: 10.1097/00001648-199907000-00005. [DOI] [PubMed] [Google Scholar]
  16. Koivusalo M., Pukkala E., Vartiainen T., Jaakkola J. J., Hakulinen T. Drinking water chlorination and cancer-a historical cohort study in Finland. Cancer Causes Control. 1997 Mar;8(2):192–200. doi: 10.1023/a:1018420229802. [DOI] [PubMed] [Google Scholar]
  17. Lilly P. D., Andersen M. E., Ross T. M., Pegram R. A. A physiologically based pharmacokinetic description of the oral uptake, tissue dosimetry, and rates of metabolism of bromodichloromethane in the male rat. Toxicol Appl Pharmacol. 1998 Jun;150(2):205–217. doi: 10.1006/taap.1998.8405. [DOI] [PubMed] [Google Scholar]
  18. Lindstrom A. B., Pleil J. D., Berkoff D. C. Alveolar breath sampling and analysis to assess trihalomethane exposures during competitive swimming training. Environ Health Perspect. 1997 Jun;105(6):636–642. doi: 10.1289/ehp.97105636. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Lynberg M., Nuckols J. R., Langlois P., Ashley D., Singer P., Mendola P., Wilkes C., Krapfl H., Miles E., Speight V. Assessing exposure to disinfection by-products in women of reproductive age living in Corpus Christi, Texas, and Cobb county, Georgia: descriptive results and methods. Environ Health Perspect. 2001 Jun;109(6):597–604. doi: 10.1289/ehp.01109597. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Lévesque B., Ayotte P., LeBlanc A., Dewailly E., Prud'Homme D., Lavoie R., Allaire S., Levallois P. Evaluation of dermal and respiratory chloroform exposure in humans. Environ Health Perspect. 1994 Dec;102(12):1082–1087. doi: 10.1289/ehp.102-1567469. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Magnuson ML, Kelty CA. Microextraction of nine haloacetic acids in drinking water at microgram per liter levels with electrospray-mass spectrometry of stable association complexes. Anal Chem. 2000 May 15;72(10):2308–2312. doi: 10.1021/ac991469j. [DOI] [PubMed] [Google Scholar]
  22. Pegram R. A., Andersen M. E., Warren S. H., Ross T. M., Claxton L. D. Glutathione S-transferase-mediated mutagenicity of trihalomethanes in Salmonella typhimurium: contrasting results with bromodichloromethane off chloroform. Toxicol Appl Pharmacol. 1997 May;144(1):183–188. doi: 10.1006/taap.1997.8123. [DOI] [PubMed] [Google Scholar]
  23. Reif J. S., Hatch M. C., Bracken M., Holmes L. B., Schwetz B. A., Singer P. C. Reproductive and developmental effects of disinfection by-products in drinking water. Environ Health Perspect. 1996 Oct;104(10):1056–1061. doi: 10.1289/ehp.961041056. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Rossman L. A., Brown R. A., Singer P. C., Nuckols J. R. DBP formation kinetics in a simulated distribution system. Water Res. 2001 Oct;35(14):3483–3489. doi: 10.1016/s0043-1354(01)00059-8. [DOI] [PubMed] [Google Scholar]
  25. Schultz I. R., Merdink J. L., Gonzalez-Leon A., Bull R. J. Comparative toxicokinetics of chlorinated and brominated haloacetates in F344 rats. Toxicol Appl Pharmacol. 1999 Jul 15;158(2):103–114. doi: 10.1006/taap.1999.8698. [DOI] [PubMed] [Google Scholar]
  26. Selevan S. G., Kimmel C. A., Mendola P. Identifying critical windows of exposure for children's health. Environ Health Perspect. 2000 Jun;108 (Suppl 3):451–455. doi: 10.1289/ehp.00108s3451. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Waller K., Swan S. H., DeLorenze G., Hopkins B. Trihalomethanes in drinking water and spontaneous abortion. Epidemiology. 1998 Mar;9(2):134–140. [PubMed] [Google Scholar]
  28. Weisel C. P., Jo W. K. Ingestion, inhalation, and dermal exposures to chloroform and trichloroethene from tap water. Environ Health Perspect. 1996 Jan;104(1):48–51. doi: 10.1289/ehp.9610448. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Weisel C. P., Kim H., Haltmeier P., Klotz J. B. Exposure estimates to disinfection by-products of chlorinated drinking water. Environ Health Perspect. 1999 Feb;107(2):103–110. doi: 10.1289/ehp.99107103. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Yang C. Y., Chiu H. F., Cheng M. F., Tsai S. S. Chlorination of drinking water and cancer mortality in Taiwan. Environ Res. 1998 Jul;78(1):1–6. doi: 10.1006/enrs.1997.3823. [DOI] [PubMed] [Google Scholar]
  31. Zender R., Bachand A. M., Reif J. S. Exposure to tap water during pregnancy. J Expo Anal Environ Epidemiol. 2001 May-Jun;11(3):224–230. doi: 10.1038/sj.jea.7500163. [DOI] [PubMed] [Google Scholar]

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