Chlorination by-products in drinking water and risk of bladder cancer – A population-based cohort study

Helte, Emilie; Säve‐Söderbergh, Melle; Ugge, Henrik; Fall, Katja; Larsson, Susanna C.; Åkesson, Agneta

doi:10.1016/j.watres.2022.118202

Cited by 21 publications

(6 citation statements)

References 23 publications

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“…Similar observations were reported in different parts of the world 58,61 ; however, contradictory findings were reported in other studies. 56,[62][63][64] In general, the prevalence of DBRCs is higher in communities supplied with chlorinated surface water than in those supplied with less chlorinated groundwater. Another study conducted in Norway showed that chlorination was associated with a 20 to 40% increase in colorectal cancer rates, 65 and other related studies are also in line with this study.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Trends of Drinking Water Disinfection Byproducts-Related Cancers in Addis Ababa, Ethiopia

Tafesse

Porcelli

Gari

et al. 2022

Environ�Health�Insights

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Background: Disinfection byproducts (DBPs) from chlorinated drinking water have been linked to an increased risk of cancer in the bladder, stomach, colon, and rectum. No studies showed the independent trends and prevalence of these cancers in Ethiopia. Therefore, this study aimed to determine the prevalence and trends of disinfection byproducts-related cancers in Addis Ababa, Ethiopia. Methods: Data were collected from the Addis Ababa Cancer Registry. Spatial data sets were produced and classified into households receiving chlorinated surface water and less chlorinated groundwater. The Cochran-Armitage trend test was used to evaluate whether there was a disinfection byproducts-related cancers (DBRCs) trend among communities receiving chlorinated water. Negative binomial regression was used to analyze the incidence rate. Results: A total of 11, 438 cancer cases were registered between 2012 and 2016, and DBRCs accounted for approximately 17%. The majority of the total cancer cases were female; 7,706 (67%). The prevalence of DBRCs was found to be higher in communities supplied with chlorinated water. From 2012 to 2016, the trend of colon cancer increased (β = 10.3, P value = .034); however, esophageal cancer decreased (β = −6.5, P value = .018). Approximately 56% of colorectal cancer patients and 53% of stomach cancer patients are known to be using chlorinated surface water for drinking regularly. In addition, approximately 57.1% and 54% of kidney and bladder cancer patients, respectively, used chlorinated surface water. Conclusion: The prevalence of DBRCs in this study was found to be high. The colon cancer trend increased substantially from 2012 to 2016. The prevalence of DBRCs was higher in communities supplied with chlorinated surface water. Similarly, the prevalence of DBRCs was higher among males than females. Further study is required to validate the association between DBRCs and water chlorination.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Trends of Drinking Water Disinfection Byproducts-Related Cancers in Addis Ababa, Ethiopia

Tafesse

Porcelli

Gari

et al. 2022

Environ�Health�Insights

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“…Hadi Sadeghi et al, [ 26 ] showed in their results that the concentrations of THMs were higher in summer than in other seasons as well as the mean values of lifetime cancer risks for residents through ingestion, inhalation, and dermal contact. Emilie Helte et al, [ 27 ] reported that there is no overall association of THM with the risk of bladder cancer, hazard ratio for the highest exposed compared to the non-exposed 0.90 (95% confidence interval: 0.73–1.11).…”

Section: Resultsmentioning

confidence: 99%

Quality and risk assessment of lead and cadmium in drinking water for child development centres use in Phatthalung province, Thailand

Decharat,

Phethuayluk

2023

Environ Anal Health Toxicol

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The purpose of this cross-sectional study and research was to evaluate the health risks to children in relation to the concentration of lead and cadmium in drinking water. Samples were collected between 1 May 2020 and 15 October 2020. Thirty-three child development centres, Phatthalung province, Thailand. Two hundred and ten drinking water samples were taken, consisting of 66 bottled water samples, 66 tap water samples, 66 filtered tap water samples and 12 raw water samples for using in the child development centres. Concentrations of lead and cadmium were identified by graphite furnace atomic absorption spectrometry. The concentration of cadmium in bottled water samples, tap water samples, filtered tap water samples, and raw water samples ranged from nd - 0.0020mg/L, nd - 0.0049 mg/L, nd - 0.0018 mg/L and nd - 0.0049 mg/L. The summation of the total hazard index of bottled water samples, tap water samples, filtered tap water, and raw water samples was less than 1, was considered health-protective. The results will provide the direct evidence needed by child development centres managers to warn learners about the health risk of drinking water among children.

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“…Some DBPs present potential threats to human health as carcinogens, mutagens, and teratogens, but due to the hundreds to thousands of DBPs formed during disinfection and the large uncertainty of DBP composition, determining the true etiological chemical agents of disease is immensely challenging. Although THMs were once thought to be the drivers for an increased risk of bladder cancer, recent toxicology studies show that nitrosamines, halonitriles, and other non-nitrogenous DBPs may be more responsible for this risk. , More holistic strategies for controlling DBPs instead of identifying, regulating, and controlling one DBP class at a time are needed.…”

Section: A Global Cause For Concernmentioning

confidence: 99%

“…Although THMs were once thought to be the drivers for an increased risk of bladder cancer, recent toxicology studies show that nitrosamines, halonitriles, and other non-nitrogenous DBPs may be more responsible for this risk. 27 , 28 More holistic strategies for controlling DBPs instead of identifying, regulating, and controlling one DBP class at a time are needed.…”

Section: A Global Cause For Concernmentioning

confidence: 99%

The Minus Approach Can Redefine the Standard of Practice of Drinking Water Treatment

Reid

Igou

Zhao

et al. 2023

Environ. Sci. Technol.

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Chlorine-based disinfection for drinking water treatment (DWT) was one of the 20th century’s great public health achievements, as it substantially reduced the risk of acute microbial waterborne disease. However, today’s chlorinated drinking water is not unambiguously safe; trace levels of regulated and unregulated disinfection byproducts (DBPs), and other known, unknown, and emerging contaminants (KUECs), present chronic risks that make them essential removal targets. Because conventional chemical-based DWT processes do little to remove DBPs or KUECs, alternative approaches are needed to minimize risks by removing DBP precursors and KUECs that are ubiquitous in water supplies. We present the “Minus Approach” as a toolbox of practices and technologies to mitigate KUECs and DBPs without compromising microbiological safety. The Minus Approach reduces problem-causing chemical addition treatment (i.e., the conventional “Plus Approach”) by producing biologically stable water containing pathogens at levels having negligible human health risk and substantially lower concentrations of KUECs and DBPs. Aside from ozonation, the Minus Approach avoids primary chemical-based coagulants, disinfectants, and advanced oxidation processes. The Minus Approach focuses on bank filtration, biofiltration, adsorption, and membranes to biologically and physically remove DBP precursors, KUECs, and pathogens; consequently, water purveyors can use ultraviolet light at key locations in conjunction with smaller dosages of secondary chemical disinfectants to minimize microbial regrowth in distribution systems. We describe how the Minus Approach contrasts with the conventional Plus Approach, integrates with artificial intelligence, and can ultimately improve the sustainability performance of water treatment. Finally, we consider barriers to adoption of the Minus Approach.

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Chlorination by-products in drinking water and risk of bladder cancer – A population-based cohort study

Cited by 21 publications

References 23 publications

Prevalence and Trends of Drinking Water Disinfection Byproducts-Related Cancers in Addis Ababa, Ethiopia

Prevalence and Trends of Drinking Water Disinfection Byproducts-Related Cancers in Addis Ababa, Ethiopia

Quality and risk assessment of lead and cadmium in drinking water for child development centres use in Phatthalung province, Thailand

The Minus Approach Can Redefine the Standard of Practice of Drinking Water Treatment

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