Sustainable and effective control of trihalomethanes in the breakpoint chlorination of wastewater effluents.

The control of trihalomethanes (THMs) in waters subjected to chlorination is essential for protecting public health. However, the necessary means are not always available, especially in developing countries and regions. Under circumstances of scarce resources, one can utilize various means available for the control of THMs: a simple and affordable analytical method for testing of THMs, the study of the parameters tested routinely that could be used as indicators and the dose of chlorine used for the chlorination process. The objective of this work was to study the potential formation of THMs in wastewater effluents using a simple method of detection and various doses of chlorine in relation to the breakpoint and to validate some commonly determined parameters as indicators of THM formation. THM concentrations were measured using a simple spectrophotometric method based on the Fujiwara reaction. To determine the chlorine demand, a super-chlorination was performed and free and residual chlorine was measured; the mean value of chlorine demand was 166.6 mgCl2/L. The chlorination with concentrations well below the chlorine demand produces a significant reduction in microbial content. With regard to the formation of THMs the higher the dose of chlorine added, the higher the concentration of THMs. In relation to commonly determined parameters our data only provide a logarithmic linear regression between THMs and ammonium. According to our results, the breakpoint must be determined for the chlorination of sewage and their effluents, and chlorination should be performed with concentrations of chlorine at approximately 1/3 of the demand.

Elucidating causal effects of type 2 diabetes on ischemic heart disease from observational data on middle-aged Swedish women: a triangular analytical approach.

The association between type 2 diabetes (T2D) and ischemic heart disease (IHD) is well established but the potential causal association needs further studying. In an attempt to elucidate the causal effect of T2D on IHD, we used three different analytical approaches in two different datasets. A well-defined cohort of 6047 women aged 50-59 years were included at baseline (1995 to 2000) and followed until 2015 for IHD. The median follow-up was 16.3 years. We used a Marginal Structural Cox model (MSM Cox) to account for time-varying exposure (time at onset of T2D) and for ten confounders (using inverse probability weighting, IPW). We also compared the MSM-Cox models with traditional Cox regression modelling in the cohort. Finally, we analyzed information on individuals from Swedish population-based registers with national coverage in a comprehensive co-relative design and extrapolated the results to MZ twins. The Hazard Ratio (HR) for IHD in relation to T2D at baseline and T2D occurring during the follow-up in the MSM Cox model weighted by IPW (based on the ten included confounders) was 1.43 (95% confidence interval [CI] 1.07-1.92). The corresponding HR from the traditional Cox regression model was of similar effect size. The average extrapolated MZ twin estimate from our co-relative model was 1.61 (95% CI 1.48-1.86). Our findings, based on a triangular approach, support the existence of a causal association between T2D and IHD and that preventive long-term measures in order to avoid or postpone IHD should include monitoring and treatment of both the T2D itself as well as other cardiovascular risk factors.