Health impacts of long-term exposure to disinfection by-products in drinking water in Europe: HIWATE

Nieuwenhuijsen, Mark; Smith, Rachel B.; Golfínopoulos, Spyros K.; Best, Nicky; Bennett, James L.; Aggazzotti, Gabriella; Righi, Elena; Fantuzzi, Guglielmina; Bucchini, Luca; Cordier, Sylvaine; Villanueva, Cristina M.; Moreno, Vı́ctor; Vecchia, Carlo La; Bosetti, Cristina; Vartiainen, Terttu; Rãutiu, R.; Toledano, Mireille B.; Iszatt, Nina; Gražulevičienė, Regina; Kogevinas, Manolis

doi:10.2166/wh.2009.073

Cited by 96 publications

(70 citation statements)

References 124 publications

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“…Several epidemiological studies suggest a link between consumption of chlorinated drinking water and reproductive and developmental outcomes, such as increased spontaneous abortions and intrauterine growth retardation [10][11][12][13][14], and bladder and gastrointestinal tract cancers [15][16][17][18][19][20][21]. At present, which by-products in chlorinated drinking water could be responsible for increasing cancer risk in human beings is not well established, because the potential synergistic interactions of chlorinated by-products and their role in the molecular mechanisms of carcinogenesis are still poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Modulation of cytochrome P450 and induction of DNA damage in Cyprinus carpio exposed in situ to surface water treated with chlorine or alternative disinfectants in different seasons

Canistro

Melega

Ranieri

et al. 2012

Mutation Research/Fundamental and Molecular Mechanisms of Mutag

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Epidemiological studies have shown an association between consumption of disinfected drinking water and adverse health outcomes. The chemicals used to disinfect water react with occurring organic matter and anthropogenic contaminants in the source water, resulting in the formation of disinfection byproducts (DBPs). The observations that some DBPs are carcinogenic in animal models have raised public concern over the possible adverse health effects for humans. Here, the modulation of liver cytochrome P450-linked monooxygenases (MFO) and the genotoxic effects in erythrocytes of Cyprinus carpio fish exposed in situ to surface drinking water in the presence of disinfectants, such as sodium hypochlorite (NaClO), chlorine dioxide (ClO 2 ) and peracetic acid (PAA), were investigated in winter and summer. A complex induction/suppression pattern of CYP-associated MFOs in winter was observed for all disinfectants. For example, a 3.4-to 15-fold increase was recorded of the CYP2B1/2-linked dealkylation of penthoxyresorufin with NaClO (10 days) and PAA (20 days). In contrast, ClO 2 generated the most notable inactivation, the CYP2E1-supported hydroxylation of p-nitrophenol being decreased up to 71% after 10 days' treatment. In summer, the degree of modulation was modest, with the exception of CYP3A1/2 and CYP1A1 supported MFOs (62% loss after 20 days PAA).The micronucleus (MN) induction in fish circulating erythrocytes was also analysed as an endpoint of genotoxic potential in the same fish population. Significant increases of MN induction were detected at the latest sampling time on fish exposed to surface water treated with chlorinate-disinfectants, both in winter (NaClO) and summer (NaClO and ClO 2 ), while no effect was observed in fish exposed to PAA-treated water.These results show that water disinfection may be responsible for harmful outcomes in terms of MFO perturbation and DNA damage; if extrapolated to humans, they ultimately offer a possible rationale for the increased urinary cancer risk recorded in regular drinking water consumers.

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Section: Introductionmentioning

confidence: 99%

Modulation of cytochrome P450 and induction of DNA damage in Cyprinus carpio exposed in situ to surface water treated with chlorine or alternative disinfectants in different seasons

Canistro

Melega

Ranieri

et al. 2012

Mutation Research/Fundamental and Molecular Mechanisms of Mutag

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“…Most of the studies on water and cancer were ecological studies on the role of water as a carrier of carcinogens, as a consequence of chlorination or industrial contamination (Nieuwenhuijsen et al, 2009). Only a few data are available on the relation between cancer and water intended as 'food'.…”

Section: Discussionmentioning

confidence: 99%

Adherence to the European food safety authority's dietary recommendations and colorectal cancer risk

et al. 2012

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Background/Objective: The European Food Safety Authority (EFSA) recently published dietary guidelines for the intakes of carbohydrates, fiber, fats and water. We evaluated their role on the risk of a specific disease, known to be related to diet. Subjects/Methods: We used data from an Italian case-control study including 1953 colorectal cancer (CRC) cases and 4154 controls. We developed a so-called EFSA index summing up 1 point for adherence to each EFSA guideline. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) of CRC and its subsites were derived from unconditional multiple logistic regression models, for both the index and its components. Results: When each EFSA index component was analyzed separately, we found significant increased risks of CRC for non adherence to the guidelines on linoleic (OR ¼ 1.20, 95% CI, 1.07-1.36) and alpha-linolenic fatty acids (OR ¼ 1.19, 95% CI, 1.06-1.34). When all the guidelines were included in the same model, no significant association emerged. Compared with minimal adherence, the ORs of CRC for subsequent EFSA index scores were 1.03 (95% CI, 0.72-1.47), 1.05 (95% CI, 0.75-1.48), 1.04 (95% CI, 0.81-1.60), 0.99 (95% CI, 0.69-1.43), and 1.04 (95% CI, 0.67-1.61). No significant association emerged for colon and rectal cancer separately, and for males and females. Conclusions: Overall adherence to the EFSA dietary guidelines is not associated to colorectal, colon and rectal cancer risk in our population. Adherence to guidelines on linoleic and alpha-linolenic fatty acids may have a modest beneficial role on CRC risk.

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“…The formation and occurrence of DBPs is dependent on many variables. Epidemiological results from one study area may not be extended to others because the mixtures of DBPs present in water may be different as a result of differences in for instance water treatment, organic content in water or pH (Nieuwenhuijsen et al, 2009). In several epidemiological studies the type of water disinfection method has been used as a surrogate for chlorite and chlorate exposure.…”

Section: Epidemiological Studiesmentioning

confidence: 99%

Risks for public health related to the presence of chlorate in food

Publication¹

2015

EFS2

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Following a request from the European Commission, the risks to human health related to the presence of chlorate in food were assessed by the EFSA Panel on Contaminants in the Food Chain (CONTAM Panel). The presence of chlorate in food can arise from the use of chlorinated water for food processing and the disinfection of foodprocessing equipment. Inhibition of iodine uptake in humans was identified as the critical effect for chronic exposure to chlorate. A tolerable daily intake (TDI) of 3 µg chlorate/kg body weight (b.w.) was set by readacross from a TDI of 0.3 µg/kg b.w. derived for this effect for perchlorate, multiplied by a factor of 10 to account for the lower potency of chlorate. Formation of methaemoglobin was identified as the critical acute effect of chlorate. An acute reference dose (ARfD) of 36 µg chlorate/kg b.w. was derived from a no-observedeffect-level for chlorate in a controlled clinical study. Chronic exposure of adolescent and adult age classes did not exceed the TDI. However, at the 95th percentile the TDI was exceeded in all surveys in 'Infants' and 'Toddlers' and in some surveys in 'Other children'. Chronic exposures are of concern in particular in younger age groups with mild or moderate iodine deficiency. Mean and 95th percentile acute exposures were below the ARfD for all age groups indicating no concern. Based on the current practices in food industry, application of a hypothetical maximum residue limit (MRL) of 0.7 mg/kg for all foodstuffs and drinking water would only minimally reduce acute/chronic exposures and related risks. Assuming chlorate concentrations of 0.7 mg/kg for all foods and drinking water consumed in a day, acute exposures would increase by up to about 5-fold and the ARfD be exceeded at mean estimates in 'Infants' and 'Toddlers' and at 95th percentile also in 'Other children'and 'Adults'. Chlorate is formed as a by-product when using chlorine, chlorine dioxide or hypochlorite for the disinfection of drinking water, water for food production and surfaces coming into contact with food. Chlorination of animal-derived food is not allowed in the EU, while washing of plant-derived food with chlorine disinfected water can be permitted under national regulations. No maximum levels for chlorate in drinking water have been set in the European Union (EU) while the World Health Organisation (WHO) has established a guideline level for chlorate in drinking water of 0.7 mg/L. © EuropeanIn many fruit and vegetable commodities chlorate levels exceeding the default MRL of 0.01 mg/kg are found.Based on the available information, the CONTAM Panel assumes that chlorate residues in food result mainly from the use of chlorinated water for food processing (e.g. washing) and from the disinfection of surfaces and food processing equipment coming into contact with food.The EFSA Evidence Management Unit (DATA Unit) launched a call for data on chlorate levels in food and drinking water. After a quality assessment of the analytical data and their evaluation, 8 028 samples remained for anal...

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Health impacts of long-term exposure to disinfection by-products in drinking water in Europe: HIWATE

Cited by 96 publications

References 124 publications

Modulation of cytochrome P450 and induction of DNA damage in Cyprinus carpio exposed in situ to surface water treated with chlorine or alternative disinfectants in different seasons

Modulation of cytochrome P450 and induction of DNA damage in Cyprinus carpio exposed in situ to surface water treated with chlorine or alternative disinfectants in different seasons

Adherence to the European food safety authority's dietary recommendations and colorectal cancer risk

Risks for public health related to the presence of chlorate in food

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