Drinking Water Disinfection By-products and Their Carcinogenicity; A Review of an Unseen Crisis

Abstract

Context: Cancer continues to be the first cause of mortality and morbidity all over the world, while the incidence of cancer is expected to increase by 50% over the next 20 years. Since the incidence of most of the cancers is increasing daily, it has been more important to find related environmental risk factors. The epidemiological evidence indicates the effect of disinfection byproducts (DBPs) through drinking water, as an environmental exposure, on most of the cancers. The goal of the current study was to combine the results of most recent publications regarding the relationship between DBPs and their carcinogenic effects. Evidence Acquisition: Using the main keywords of "cancer", "drinking water", and "disinfection byproducts", a comprehensive search was done among several research databases. Results: Based on the previous studies, DBPs could cause most types of cancers, mainly including gastrointestinal, renal, bladder, breast, liver, and thyroid cancers. Liver and renal cancers are the most common target organs for toxicity by DBPs. Among the various DBPs, trihalomethanes are the most studied due to their relatively high prevalence and concentration in drinking water. Also, haloacetic acids, such as trichloroacetic acid and dichloroacetic acid, have been known as one of the most affecting risk factors. Unregulated DBPs, such as Mutagen X and Formaldehyde, are also of importance as they mostly have irreversible systemic effects. Providing safe drinking water resources, restriction of unreasonable usage of disinfectants, and alternating disinfectants with less harmful products could be the possible ways to overcome this crisis. Conclusions: Disinfection byproducts can result in cancer development, especially in liver and kidneys. Providing safe drinking water resources, using the membrane filters and changing the chlorination point are effective ways to encounter the risk of DBP poisoning.

Microbial Diversity in Drinking Water of Dishna City, Qena, Egypt and its Relation to Water Physico-Chemo Aspects

“…Chloroform (also called trichloromethane) is the most important THMs in drinking water, it is a chemical used to make other chemicals and a byproduct of chlorinating water (MDH, 2016) [39]. Its high levels in drinking water for a long time cause damage to kidney and liver cancer (Aslani et al, 2019) [40]. Dishina city has acceptable limits of chloroform (0.01-0.03 mgL -1 ).…”

Inactivation of Spores and Vegetative Forms of Clostridioides difficile by Chemical Biocides: Mechanisms of Biocidal Activity, Methods of Evaluation, and Environmental Aspects

“…A significant environmental issue related to the use of preparations based on active chlorine is their ability to chlorinate organic matter and produce disinfection by-products (DBPs), which potentially harm the environment and human health [ 46 , 47 ]. Previous results [ 48 , 49 , 50 , 51 ] show that chlorination or chloramination in water environments containing amino acids or humic substances derived from soil can result in the production of the toxic substances cyanogen chloride, dichloracetonitrile, and organochloramines.…”

Sono-Enzymatically Embedded Antibacterial Silver-Lignin Nanoparticles on Cork Filter Material for Water Disinfection

“…Chlorine-based disinfectants (e.g., sodium or calcium hypochlorite, chlorine gas, chlorine dioxide) and ozone are among the most common chemicals used for water disinfection [ 4 ], providing an effective and robust barrier for pathogens proliferation [ 5 ]. However, most of these compounds lead to the formation of toxic byproducts (e.g., trihalomethanes) [ 5 , 6 , 7 ] which have been related to the development of gastrointestinal, kidney, and bladder disorders, including cancer [ 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. In addition, long-term chlorination processes have led to the emergence of chlorine-resistant bacteria [ 15 ], especially common pathogenic spores that pose a serious threat to public health [ 16 ].…”