Disinfection byproducts in chlorinated or brominated swimming pools and spas: Role of brominated DBPs and association with mutagenicity

Liberatore, Hannah K.; Daiber, Eric J.; Ravuri, Sridevi A.; Schmid, Judith E.; Richardson, Susan D.; DeMarini, David M.

doi:10.1016/j.jes.2022.04.049

Cited by 14 publications

(5 citation statements)

References 38 publications

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“…This genotoxicity was derived mainly from brominated THM but not chloroform [ 42 ]. The importance of brominated DBPs in the mutagenicity of recreational waters has been highlighted by other studies [ 43 , 44 ]. Likewise, the presence of nitrogen-containing organic matter from bathers leads to the formation of nitrogenated by-products such as chloramines (mochloramine,dichloramine, trichloramine), haloacetonitriles and carcinogenic nitrosamines, also important drivers of toxicity [ 45 , 46 ].…”

Section: Discussionmentioning

confidence: 93%

Lifetime exposure to brominated trihalomethanes in drinking water and swimming pool attendance are associated with chronic lymphocytic leukemia: a Multicase-Control Study in Spain (MCC-Spain)

Donat-Vargas,

Kogevinas,

Benavente

et al. 2023

J Expo Sci Environ Epidemiol

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Background Chronic lymphocytic leukemia (CLL) etiology is poorly understood, and carcinogenic chemicals in drinking and recreational water are candidates. Objective To evaluate the association between drinking-water exposure to trihalomethanes (THMs) and nitrate as well as lifetime swimming pool attendance and CLL. Methods During 2010–2013, hospital-based CLL cases and population-based controls were recruited in Spain, providing information on residential histories, type of water consumed and swimming pool attendance. Average THMs and nitrate levels in drinking water were linked to lifetime water consumption. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using mixed models. Results Final samples for residential tap water analyses and swimming pool attendance analyses were 144 cases/1230 controls and 157 cases/1240 controls, respectively. Mean (SD) values for average lifetime residential brominated THMs and chloroform in tap water (μg/L), and ingested nitrate (mg/day) were 48.1 (35.6), 18.5 (6.7) and 13.7 (9.6) respectively in controls; and 72.9 (40.7), 17.9 (5.4), and 14.1 (8.8) in CLL cases. For each 10 μg/L increase of brominated THMs and chloroform lifetime-average levels, the ORs (95% CI) were 1.22 (1.14, 1.31) and 0.54 (0.34, 0.87), respectively. For each 5 mg/day increase of ingested nitrate, the OR of CLL was 0.91 (0.80, 1.04). The OR of lifetime pool users (vs. non-users) was 2.38 (1.61, 3.52). Upon performing annual frequency of attending pools analysis through categorization, the second and third categories showed an ORs of 2.36 (1.49, 3.72) and 2.40 (1.51, 3.83), respectively, and P-trend of 0.001. Impact statement This study identifies an association of long-term exposure to THMs in drinking water, at concentrations below the regulatory thresholds and WHO guidelines, and swimming pool attendance, with chronic lymphocytic leukemia (CLL). These unprecedented findings are highly relevant since CLL is an incurable cancer with still unknown etiology and because the widespread exposure to chlorination by-products that remain in drinking and recreational water worldwide. Despite the demonstrated carcinogenicity in animals of several chlorination by-products, little is known about their potential risks on human health. This study makes a significant contribution to the search for environmental factors involved in the etiology of CLL and to the evidence of the health impact of these high prevalent water contaminants.

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Section: Discussionmentioning

confidence: 93%

Lifetime exposure to brominated trihalomethanes in drinking water and swimming pool attendance are associated with chronic lymphocytic leukemia: a Multicase-Control Study in Spain (MCC-Spain)

Donat-Vargas,

Kogevinas,

Benavente

et al. 2023

J Expo Sci Environ Epidemiol

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Section: Discussionmentioning

confidence: 99%

“…These athletes, indeed, train in a unique environment compared with other elite athletes, characterized by increased temperature and humidity and containing a great number of chemicals [25,26]. In particular, early and chronic exposure, typical of young competitive swimmers, appears to have a promoting effect on airway inflammation, hyperreactivity, and on the process of allergic sensitization [25]. However, conflicting results and bias due to study design, diverse environmental conditions, the number of subjects who swam in the same pool, different times and ways of exposure, and seasons emerged from previous studies performed both in the general population and in competitive swimmers [18,[27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Studying Respiratory Symptoms Related to Swimming Pools Attendance in Young Athletes: The SPHeRA Study

Zaccarin

Zanni

Gallé

et al. 2022

Toxics

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This study investigates the prevalence of respiratory symptoms and the training factors possibly associated with them in a sample of young Italian competitive swimmers. A questionnaire about training information and symptoms was administered to participants during the winter and summer 2021 training seasons. In total, 396 athletes took part in the study. In the winter training subgroup (n = 197), we found significant associations between increasing training hours per session and the presence of nasal congestion/rhinorrhoea (OR = 3.10; p = 0.039) and cough (OR = 3.48; p = 0.015). Total training hours per week were significantly associated with nasal congestion/rhinorrhoea (OR = 1.12; p = 0.010). In the summer group (n = 199), the same factors were not associated with respiratory symptoms. Having an allergy was significantly related to nasal congestion/rhinorrhea in both the logistic models (model 1 OR = 2.69, p = 0.013; model 2 OR = 2.70, p = 0.012), while having asthma significantly increased the risk of coughing (OR = 3.24, p = 0.033). The kind of environment (indoor or outdoor facilities) did not affect the studied symptoms either in summer or winter. Further investigations are needed to better understand the mechanisms involved in the development of respiratory symptoms in swimmers, particularly on how inflammation and remodelling develop and which environmental conditions can favour these processes.

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“…The chlorination by-product trihalomethanes (THMs) have been reported to be potentially genotoxic, carcinogenic, teratogenic, and mutagenic (Couto et al 2021, Liberatore et al 2022. Epidemiologic evidences indicated signi cantly increased risk for bladder cancer, melanoma, chronic lymphocytic leukemia, colorectal cancer and all-cause mortality with chronic exposure to THMs, and the WHO International Agency for Research on Cancer recognized TCM as group 2B carcinogen, and TBM as Group Sun et al 2021).…”

Section: Introductionmentioning

confidence: 99%

Cancer- and non-cancer risk assessment of chlorination by-products in indoor swimming pools in Shenzhen, China

Liu,

Shao,

Sun

et al. 2024

Preprint

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Background Trihalomethanes (THMs) generated in chlorinated pools have raised great concerns for potential genotoxic, carcinogenic and mutagenic features. The present study aimed to assess multi-exposure cancer and non-cancer risk of THMs in indoor swimming pools in Shenzhen, China. Methods Six representative indoor swimming pools located in west, central and east of Shenzhen were selected, with waters at 30 cm below and air at 1.2 m above water surface sampled. Headspace gas chromatography-electron capture detector (HSGC-ECD) was used to measure water THMs, and thermal desorption gas chromatography (TD-GC) was adopted to measure air THMs. Swimmer Exposure Assessment Model (SWIMODEL) recommended by USEPA was performed to assess the lifetime cancer and non-cancer risk of THMs. Results The median THMs in pool waters was 48.69 µg/L (IQR: 36.81–65.72), and 45.69 µg/m3 (IQR: 24.61–112.50) for ambient air, both with chloroform (TCM) and bromodichloromethane (BDCM) as predominant components. The daily THMs intake was 1.40E-02 µg/kg.d (range: 6.72E-03–3.96E-02), with estimated lifetime cancer risk 9.39E-07 (range: 3.59E-07–3.05E-06) and non-cancer risk 1.26E-03 (range: 6.21E-04–3.58E-03). Inhalation was major exposure route, accounting for 70.5% of total THMs intaking. Female swimmers had significantly higher cancer risk (P = 0.028) and non-cancer risk (P = 0.028) than male swimmers. Conclusions The estimated lifetime cancer risk of THMs in indoor swimming pools in Shenzhen was below the USEPA‘s regulatory threshold of 1.0E-06, and non-cancer risk was less than the unacceptable level of 1.0. The lifetime cancer- and non-cancer risk was acceptable for THMs in indoor swimming pools in Shenzhen, China.

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Disinfection byproducts in chlorinated or brominated swimming pools and spas: Role of brominated DBPs and association with mutagenicity

Cited by 14 publications

References 38 publications

Lifetime exposure to brominated trihalomethanes in drinking water and swimming pool attendance are associated with chronic lymphocytic leukemia: a Multicase-Control Study in Spain (MCC-Spain)

Lifetime exposure to brominated trihalomethanes in drinking water and swimming pool attendance are associated with chronic lymphocytic leukemia: a Multicase-Control Study in Spain (MCC-Spain)

Studying Respiratory Symptoms Related to Swimming Pools Attendance in Young Athletes: The SPHeRA Study

Cancer- and non-cancer risk assessment of chlorination by-products in indoor swimming pools in Shenzhen, China

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