Evaluating Evidence for Association of Human Bladder Cancer with Drinking-Water Chlorination Disinfection By-Products.

Exposure to chlorination disinfection by-products (CxDBPs) is prevalent in populations using chlorination-based methods to disinfect public water supplies. Multifaceted research has been directed for decades to identify, characterize, and understand the toxicology of these compounds, control and minimize their formation, and conduct epidemiologic studies related to exposure. Urinary bladder cancer has been the health risk most consistently associated with CxDBPs in epidemiologic studies. An international workshop was held to (1) discuss the qualitative strengths and limitations that inform the association between bladder cancer and CxDBPs in the context of possible causation, (2) identify knowledge gaps for this topic in relation to chlorine/chloramine-based disinfection practice(s) in the United States, and (3) assess the evidence for informing risk management. Epidemiological evidence linking exposures to CxDBPs in drinking water to human bladder cancer risk provides insight into causality. However, because of imprecise, inaccurate, or incomplete estimation of CxDBPs levels in epidemiologic studies, translation from hazard identification directly to risk management and regulatory policy for CxDBPs can be challenging. Quantitative risk estimates derived from toxicological risk assessment for CxDBPs currently cannot be reconciled with those from epidemiologic studies, notwithstanding the complexities involved, making regulatory interpretation difficult. Evidence presented here has both strengths and limitations that require additional studies to resolve and improve the understanding of exposure response relationships. Replication of epidemiologic findings in independent populations with further elaboration of exposure assessment is needed to strengthen the knowledge base needed to better inform effective regulatory approaches.

Anion exchange resins as a source of nitrosamines and nitrosamine precursors.

Anion exchange resins are important tools for the removal of harmful anionic contaminants from drinking water, but their use has been linked to the presence of carcinogenic nitrosamines in treated drinking water. In bench-scale batch and column experiments, anion exchange resins from a large, representative group were investigated as sources of the nitrosamines N-nitrosodimethylamine (NDMA), N-nitrosodiethylamine (NDEA), N-nitrosodi-n-propylamine (NDPA), and N-nitrosodi-n-butylamine (NDBA) and their precursors. Several resins were found to release high levels (up to >2000 ng/L, orders of magnitude above drinking water regulatory levels) of nitrosamines upon initial rinsing with lab-grade water, with levels subsiding within 50-100 bed volumes of rinsing. Resins released similarly high levels of nitrosamine precursors, with spikes in precursor release triggered by regeneration of resins with sodium chloride or by interruptions in flow resulting in prolonged contact times. Free chlorine or preformed monochloramine in feedwater led to the production of nitrosamines. Resins released different nitrosamines and precursors depending on their functional groups, with some resins releasing as many as three different nitrosamines and their precursors. These findings have significant implications for the pretreatment and appropriate use of anion exchange resins by drinking water utilities and for the production of anion exchange resins by manufacturers.

Efficacy of selected pretreatment processes in the mitigation of low-pressure membrane fouling and its correlation to their removal of microbial DOM.

Membrane fouling by dissolved organic matter (DOM), especially microbially-derived DOM, is a major challenge for ultrafiltration (UF) membranes in water purification. Fouling may be mitigated by pretreating feed waters; however, there are no comprehensive studies that compare the fouling reduction efficacies across different pretreatment processes. Further, there is a limited understanding of the relationship between fouling reduction efficacy and microbially-derived DOM removal from source waters. Accordingly, the objectives of this study were to: (i) evaluate and compare the efficacies of five pretreatment processes in reducing UF membrane fouling by DOM; and (ii) investigate whether a relationship exists between membrane fouling reduction and microbially-derived DOM removal by pretreatment processes. We investigated seven water sources and a polyvinylidene fluoride hollow-fiber UF membrane using bench-scale fouling tests. Dissolved organic carbon content, ultraviolet absorbance and fluorescence excitation-emission matrix spectroscopy were used to assess DOM concentration and composition. Alum and ferric chloride coagulation were the most effective pretreatment processes in reducing membrane fouling, anion exchange was moderately effective, and PAC adsorption and chlorine pre-oxidation were the least effective. Consistent with previous studies, microbially-derived DOM was the major contributor to UF membrane fouling regardless of water source or pretreatment type. Fouling reduction was strongly correlated with the reduction of microbially-derived DOM in foulant layers but not from source waters. This result indicates that a fraction of the total microbially-derived DOM in feed waters was responsible for UF fouling. Overall, pretreatment processes that remove microbially-derived DOM are well-suited for UF membrane fouling reduction.

Drinking water disinfection by-product exposure and fetal growth.

BACKGROUND: Previous studies suggest that elevated exposure to drinking water disinfection by-products (DBPs)--in particular, total trihalomethanes (TTHMs)--may lead to fetal growth restriction. We examined the effects of exposure to TTHMs, haloacetic acids, and total organic halide on the probability of delivering a small-for-gestational-age (SGA) infant and on birth weight at term. METHODS: Women early in pregnancy (< or =12 weeks' gestation) or planning a pregnancy were enrolled in a prospective pregnancy study conducted in 3 US communities from 2000 through 2004. Weekly (or biweekly) water samples were collected at each site as well as individual-level participant data. Associations between DBP exposures (TTHMs, haloacetic acids, total organic halide) and fetal growth were assessed using log-binomial regression for SGA (n = 1958) and linear regression for term birth weight (n = 1854). We conducted a Bayesian analysis to examine associations between individual DBP species and fetal growth. RESULTS: Haloacetic acids and total organic halide were not associated with SGA or term birth weight. The probability of delivering an SGA infant was elevated when comparing women with an average third-trimester residential TTHM concentration > or =80 microg/L to women with exposure <80 microg/L (risk ratio = 2.0 [95% confidence interval = 1.1-3.6]), but not when examining other exposure contrasts. Bayesian analyses did not support a consistent association between any DBP species and fetal growth, although these analyses were based on small sample sizes. CONCLUSIONS: Our results do not suggest an adverse effect of haloacetic acid or total organic halide exposure on fetal growth. An association of TTHM with SGA was seen only for average residential concentrations above the current regulatory standard.

Drinking water disinfection by-product exposure and duration of gestation.

BACKGROUND: Recent studies suggest elevated exposure to drinking water disinfection by-products (DBPs) may be associated with decreased risk of preterm birth. We examined this association for exposure to total trihalomethanes (TTHMs), 5 haloacetic acids (HAA5), and total organic halides. METHODS: Analysis included 2039 women in a prospective pregnancy study conducted from 2000 through 2004 in 3 study sites. Water samples were collected and analyzed for DBP concentrations. Participant data were collected through interviews, an early ultrasound, and birth records. We assessed the associations between DBPs and preterm birth (<37-weeks' gestation) using log-binomial regression. Discrete-time hazard analysis was used to model the conditional odds of delivery each week in relation to DBP exposure. RESULTS: Average second trimester DBP levels were associated with lower risk of preterm birth. Adjusted risk ratios for TTHM levels of 33.1-55.0, 55.1-66.3, 66.4-74.8, and 74.9-108.8 microg/L versus 2.2-4.6 microg/L were 0.8 (95% confidence intervals = 0.5-1.3), 0.9 (0.6-1.4), 0.7 (0.4-1.1), and 0.5 (0.3-0.9), respectively. Risk ratios for HAA5 levels of 17.9-22.0, 22.1-31.5, 31.6-40.4, and 40.5-52.8 microg/L versus 0-0.9 microg/L were 1.1 (0.8-1.7), 0.8 (0.5-1.2), 0.5 (0.3-0.8), and 0.7 (0.4-1.1), respectively. The conditional odds of delivery each week were decreased for the highest TTHM and HAA5 exposure groups versus the low exposure group for gestational weeks 33-40. CONCLUSIONS: The probability of preterm birth was not increased with high DBP exposure.

Modeling the removal of dissolved organic carbon by ion exchange in a completely mixed flow reactor.

A mathematical model was developed to describe removal of dissolved organic carbon (DOC) by a macroporous, strong-base anion exchange resin in a completely mixed flow reactor with resin recycle and partial resin regeneration. The two-scale model consisted of a microscale model describing the uptake of DOC by the resin coupled with a macroscale model describing the continuous-flow process. Equilibrium and kinetic parameters were estimated from batch laboratory experiments. The model was validated using continuous-flow data from two pilot plant studies. Model predictions were found to be in good agreement with the observed pilot plant data.

The healthy men study: an evaluation of exposure to disinfection by-products in tap water and sperm quality.

BACKGROUND: Chlorination of drinking water generates disinfection by-products (DBPs), which have been shown to disrupt spermatogenesis in rodents at high doses, suggesting that DBPs could pose a reproductive risk to men. In this study we assessed DBP exposure and testicular toxicity, as evidenced by altered semen quality. METHODS: We conducted a cohort study to evaluate semen quality in men with well-characterized exposures to DBPs. Participants were 228 presumed fertile men with different DBP profiles. They completed a telephone interview about demographics, health history, water consumption, and other exposures and provided a semen sample. Semen outcomes included sperm concentration and morphology, as well as DNA integrity and chromatin maturity. Exposures to DBPs were evaluated by incorporating data on water consumption and bathing and showering with concentrations measured in tap water. We used multivariable linear regression to assess the relationship between exposure to DBPs and adverse sperm outcomes. RESULTS: The mean (median) sperm concentration and sperm count were 114.2 (90.5) million/mL and 362 (265) million, respectively. The mean (median) of the four trihalomethane species (THM4) exposure was 45.7 (65.3) microg/L, and the mean (median) of the nine haloacetic acid species (HAA9) exposure was 30.7 (44.2) microg/L. These sperm parameters were not associated with exposure to these classes of DBPs. For other sperm outcomes, we found no consistent pattern of increased abnormal semen quality with elevated exposure to trihalomethanes (THMs) or haloacetic acids (HAAs). The use of alternate methods for assessing exposure to DBPs and site-specific analyses did not change these results. CONCLUSIONS: The results of this study do not support an association between exposure to levels of DBPs near or below regulatory limits and adverse sperm outcomes in humans.

Redox reactions in the Fe-As-O2 system.

We have examined two redox reactions involving arsenic and iron at near-neutral pH: the reduction of As(V) by Fe(II) under anoxic conditions, and the co-oxidation of As(III) during Fe(II) oxygenation. We also considered the impact of goethite, pH buffers, and radical scavengers on these reactions. In a series of anoxic experiments, Fe(II) was found to reduce As(V) in the presence of goethite, but not in homogeneous solution. The reaction rate increased with increasing pH and Fe(II) concentration, but in all cases was relatively slow. In aerobic experiments, the kinetics of Fe(II) oxygenation at neutral pH, and the corresponding oxidation of As(III) were found to depend heavily on pH buffer type and concentration. The classic formulation of Fe(II) oxidation by oxygen, involving four single-electron transfers, was reviewed and found to be inadequate for explaining observed oxidation of Fe(II) and As(III). Widely cited rate constants for Fe(II) oxygenation originate from experiments conducted in carbonate buffer, and do not match observations made in phosphate, MES, or HEPES systems. In phosphate buffer, Fe(II) oxidation is rapid and dependent on phosphate concentration. In MES and HEPES buffers, Fe(II) oxidation is much slower due to the lack of labile ferrous iron species. Oxygenation of Fe(II) appears to proceed through different mechanisms in phosphate and MES or HEPES systems. In both cases, reactive intermediary species are produced which can oxidize As(III). These oxidants are not the hydroxyl radical, but may be Fe(IV) species.

Changes in breath trihalomethane levels resulting from household water-use activities.

Common household water-use activities such as showering, bathing, drinking, and washing clothes or dishes are potentially important contributors to individual exposure to trihalomethanes (THMs), the major class of disinfection by-products of water treated with chlorine. Previous studies have focused on showering or bathing activities. In this study, we selected 12 common water-use activities and determined which may lead to the greatest THM exposures and result in the greatest increase in the internal dose. Seven subjects performed the various water-use activities in two residences served by water utilities with relatively high and moderate total THM levels. To maintain a consistent exposure environment, the activities, exposure times, air exchange rates, water flows, water temperatures, and extraneous THM emissions to the indoor air were carefully controlled. Water, indoor air, blood, and exhaled-breath samples were collected during each exposure session for each activity, in accordance with a strict, well-defined protocol. Although showering (for 10 min) and bathing (for 14 min), as well as machine washing of clothes and opening mechanical dishwashers at the end of the cycle, resulted in substantial increases in indoor air chloroform concentrations, only showering and bathing caused significant increases in the breath chloroform levels. In the case of bromodichloromethane (BDCM), only bathing yielded a significantly higher air level in relation to the preexposure concentration. For chloroform from showering, strong correlations were observed for indoor air and exhaled breath, blood and exhaled breath, indoor air and blood, and tap water and blood. Only water and breath, and blood and breath were significantly associated for chloroform from bathing. For BDCM, significant correlations were obtained for blood and air, and blood and water from showering. Neither dibromochloromethane nor bromoform gave measurable breath concentrations for any of the activities investigated because of their much lower tap-water concentrations. Future studies will address the effects that changes in these common water-use activities may have on exposure.

A pilot-scale evaluation of magnetic ion exchange treatment for removal of natural organic material and inorganic anions.

The objective of this research was to evaluate a magnetic ion exchange process (MIEX) for the removal of natural organic material (NOM) and bromide on a continuous-flow pilot-scale basis under different operating conditions and raw water characteristics. The most important operating variable was the effective resin dose (ERD), which is the product of the steady-state resin concentration in the contactor and the regeneration ratio. The raw water employed in this study had a moderate concentration of ultraviolet (UV)-absorbing substances and dissolved organic carbon (DOC), and a low turbidity, alkalinity, and concentration of competing anionic species. Experiments were conducted using the ambient raw water and raw water spiked with bromide, chloride, and sulfate. Substantial removal of UV-absorbing substances and DOC was achieved at ERDs as low as 0.16mL/L. Moderate bromide removal was achieved, depending on the ERD. Increasing the sulfate concentration resulted in decreased removal of UV-absorbing substances, DOC, and bromide. Consistent results were observed between the continuous-flow pilot plant tests and batch equilibrium studies.

Considerations for improving the accuracy of exposure to disinfection by-products by ingestion in epidemiologic studies.

Disinfection by-product (DBP) exposure characterization studies are often based on the analysis of a limited number of samples collected from a distribution system (DS) in which DBP levels are variable over time and space. A compositing technique was developed to simplify the sample collection procedures for integrating over temporal variations in DBPs measured in terms of trihalomethanes (THMs), haloacetic acids (HAAs), and total organic halogen (TOX). Over the course of 5 days analysis, the single composited sample was within 94-100% of the average THM concentration in all grab samples, 92-105% of HAAs, and 130% of the TOX concentration. Additionally, temporal variability factors such as timing of sample collection and the handling of tap water prior to consumption were found to influence DBP levels in consumers' drinking water. Included in our study of home water use are the effects of boiling which removed up to 98% of THMs and point of use (POU) devices which all showed DBP removal but differed depending on the device used. These factors should be taken into consideration in DBP exposure characterization for epidemiologic studies.

Minimization of short-term low-pressure membrane fouling using a magnetic ion exchange (MIEX(®)) resin.

Two challenges to low-pressure membrane (LPM) filtration are limited rejection of dissolved organic matter (DOM) and membrane fouling by DOM. The magnetic ion exchange resin MIEX(®) (Ixom Watercare Inc.) has been demonstrated to remove substantial amounts of DOM from many source waters, suggesting that MIEX can both reduce DOM content in membrane feed waters and minimize LPM fouling. We tested the effect of MIEX pretreatment on the reduction of short-term LPM fouling potential using feed waters varying in DOM concentration and composition. Four natural and two synthetic waters were studied and a polyvinylidene fluoride (PVDF) hollow-fiber ultrafiltration membrane was used in membrane fouling tests. To evaluate whether MIEX removes the fractions of DOM that cause LPM fouling, the DOM in raw, MIEX-treated, and membrane feed and backwash waters was characterized in terms of DOM concentration and composition. Results showed that: (i) the efficacy of MIEX to reduce LPM fouling varies broadly with source water; (ii) MIEX preferentially removes terrestrial DOM over microbial DOM; (iii) microbial DOM is a more important contributor to LPM fouling than terrestrial DOM, relative to their respective concentrations in source waters; and (iv) the fluorescence intensity of microbial DOM in source waters can be used as a quantitative indicator of the ability of MIEX to reduce their membrane fouling potential. Thus, when ion exchange resin processes are used for DOM removal towards membrane fouling reduction, it is advisable to use a resin that has been designed to effectively remove microbial DOM.

Bench-scale testing of a magnetic ion exchange resin for removal of disinfection by-product precursors.

The objective of this research was to compare enhanced coagulation with anion exchange for removal of disinfection by-product (DBP) precursors (i.e. natural organic matter (NOM) and bromide). Treatment with a magnetic ion exchange resin (MIEX((R))) was the primary focus of this study. Raw waters from four utilities in California were evaluated. The waters had low turbidity, low to moderate organic carbon concentrations, a wide range of alkalinities, and moderate to high bromide ion concentrations. The treated waters were compared based on removal of ultraviolet (UV) absorbance, dissolved organic carbon (DOC), trihalomethane formation potential (THMFP), and haloacetic acid formation potential (HAAFP). The results indicated that treatment with MIEX is more effective than coagulation at removing UV-absorbing substances and DOC. Treatment with MIEX and treatment with MIEX followed by coagulation yielded similar results, suggesting that coagulation of MIEX-treated water does not provide additional removal of organic carbon. MIEX treatment reduced the THMFP and HAAFP in all waters, and did so to a greater extent than coagulation. Treatment with MIEX was most effective in raw waters having a high specific UV absorbance and a low anionic strength. Following MIEX treatment, subsequent chlorination resulted in a shift to the more brominated THM and HAA species as compared to chlorination of the raw water. MIEX also removed bromide to varying degrees, depending on the raw water alkalinity and initial bromide ion concentration.

Inhibition of calcite crystal growth by polyphosphates.

The inhibition of calcite crystal growth by pyrophosphate (P(2)O(7)(4-)), tripolyphosphate (P(3)O(10)(5-)), hexametaphosphate (P(6)O(18)(6-)) and binary-polyphosphate blends in calcite-seeded solutions was investigated with various solution compositions using a pH-stat system. In a single polyphosphate system, tripolyphosphate was found to be the strongest inhibitor, followed by pyrophosphate and hexametaphosphate. The inhibition can be explained by the adsorption of polyphosphates on the calcite surface conforming to a simple Langmuir adsorption model. Through a detailed speciation analysis, CaP(2)O(7)(2-) and CaP(3)O(10)(3-) were found to be the primary species of pyrophosphate and tripolyphosphate responsible for adsorption of phosphate on the calcite surface, while the responsible species for hexametaphosphate could not be determined because of a lack of published stability constants. By comparing the equilibrium constants for the adsorption reaction, the inhibitory capabilities of polyphosphates are about two orders of magnitude greater than that of orthophosphate. In binary-polyphosphate systems, the inhibition of calcite crystal growth can be described by a competitive Langmuir adsorption model using the stability constants derived from single solute systems. The inhibitory behavior of commercially available phosphate blends that are marketed to prevent calcite scale formation were demonstrated to be similar to those of laboratory-prepared blends with the same chemical composition.

Insights to false positive total cyanide measurements in wastewater plant effluents.

Many publicly owned treatment works in North America are exceeding permitted limits for total cyanide in their wastewater treatment effluents. A recently introduced rapid, segmented, flow-injection analysis procedure using UV digestion and amperometric detection of the membrane-separated cyanide was used to investigate the various scenarios by which elevated cyanide levels might be present in wastewater treatment plant effluent. A number of significant interferences can produce false positive bias during sample analysis with the traditional acid distillation technique, but are minimized or absent with the new analytical method. However, increased levels of cyanide were found in some chlorinated wastewaters compared to the levels before chlorination, suggesting a fast reaction mechanism associated with the disinfectant and some precursor in the wastewater. In particular, the contact of chlorine with nitrite in the presence of a carbon precursor appears to contribute to cyanide formation during wastewater treatment and sample handling. This paper explores the scenarios under which cyanide can form during wastewater treatment as well as those in which a false bias for total cyanide can be obtained during sample processing and provides guidance for appropriate sample handling, screening, and processing to ensure valid analytical results.

Enhanced coagulation using a magnetic ion exchange resin.

The objective of this investigation was to examine the effectiveness of a magnetic ion exchange resin (MIEX) to enhance the coagulation of disinfection by-product precursors in nine surface waters, each representing a different element of the USEPA's 3 x 3 enhanced coagulation matrix. The effect of MIEX-pretreatment on the requisite alum dose needed for subsequent coagulation of turbidity was also evaluated. Enhanced coagulation with MIEX was found to be very effective for removing trihalomethane (THM) and haloacetic acid (HAA) precursors from the nine waters examined. THM and HAA formation potential was reduced by more than 60% in all of the waters studied; reductions approaching 90% were seen in the waters with the highest specific ultraviolet absorbance values. The residual total organic carbon concentration, ultraviolet absorbance, and THM and HAA formation potential were all substantially lower as a result of MIEX and alum treatment compared to alum coagulation alone. MIEX pre-treatment also lowered the coagulant demand of each of the waters substantially.

Impact of a magnetic ion exchange resin on ozone demand and bromate formation during drinking water treatment.

The objective of this research was to examine the impact of a magnetic ion exchange resin (MIEX) on ozone demand and bromate formation in two different ozonated waters at bench scale. The first raw water had a high bromide ion concentration, a high ozone demand, and was highly colored. Based on experimental findings from the first water, the second water was selected as a model water in which more controlled experiments were performed. The waters were treated with the MIEX resin using jar test procedures to find the optimal MIEX dosage based upon the removal of ultraviolet (UV)-absorbing substances, dissolved organic carbon (DOC), and bromide. The optimal resin dosage was chosen for bulk MIEX treatment and subsequent ozonation in a semi-batch reactor. The ozone demand and formation of bromate were analyzed as a function of ozone dosage and dissolved ozone concentration for the MIEX pre-treated water, and compared to the results obtained by ozonating the water without MIEX pre-treatment. The results indicate that pre-treatment of the water with the MIEX resin significantly reduces total organic carbon, DOC, UV absorbance, color, and to some extent, bromide. MIEX pre-treatment of the water prior to ozonation substantially lowered the ozone demand and formation of bromate during subsequent ozonation.

Effect of magnetic ion exchange and ozonation on disinfection by-product formation.

The purpose of this research was to investigate the performance of treatment with magnetic ion exchange (MIEX) resin followed by ozonation in achieving disinfection goals while controlling bromate and chlorinated disinfection by-product (DBP) formation. Three water samples were collected from raw water supplies impacted by the San Francisco Bay Delta to represent the varying levels of bromide and total organic carbon (TOC) that occur throughout the year. A fourth water was prepared by spiking bromide into a portion of one of the samples. Samples of each water were pre-treated with alum or virgin MIEX resin, and the raw and treated waters were subsequently ozonated under semi-batch conditions to assess the impact of treatment on ozone demand, ozone exposure for disinfection ("CT"), and bromate formation. Finally, aliquots of raw, coagulated, resin-treated, and ozonated waters were chlorinated in order to measure trihalomethane formation potential (THMFP). In the waters studied, MIEX resin removed 41-68% of raw water TOC, compared to 12-44% for alum. MIEX resin also reduced the bromide concentration by 20-50%. The removal of TOC by alum and MIEX resin significantly reduced the ozone demand of all waters studied, resulting in higher dissolved ozone concentrations and CT values for a given amount of ozone transferred into solution. For a given level of disinfection (CT), the amount of bromate produced by ozonation of MIEX-treated waters was similar to or slightly less than that of raw water and significantly less than that of alum-treated water. MIEX resin removed 39-85% of THMFP compared to 16-56% removal by alum. Ozonation reduced THMFP by 35-45% in all cases. This work indicates that in bromide-rich waters in which ozone disinfection is used, MIEX resin is a more appropriate treatment than alum for the removal of organic carbon, as it achieves superior TOC and THM precursor removal and decreases the production of bromate from ozone.

Comparison of trihalomethanes in tap water and blood: a case study in the United States.

BACKGROUND: Epidemiological studies have used various measures to characterize trihalomethane (THM) exposures, but the relationship of these indicators to exposure biomarkers remains unclear. OBJECTIVES: We examined temporal and spatial variability in baseline blood THM concentrations and assessed the relationship between these concentrations and several exposure indicators (tap water concentration, water-use activities, multiroute exposure metrics). METHODS: We measured water-use activity and THM concentrations in blood and residential tap water from 150 postpartum women from three U.S. locations. RESULTS: Blood ΣTHM [sum of chloroform (TCM), bromodichloromethane (BDCM), dibromo-chloromethane (DBCM), and bromoform (TBM)] concentrations varied by site and season. As expected based on variable tap water concentrations and toxicokinetic properties, the proportion of brominated species (BDCM, DBCM, and TBM) in blood varied by site (site 1, 24%; site 2, 29%; site 3, 57%) but varied less markedly than in tap water (site 1, 35%; site 2, 75%; site 3, 68%). The blood-water ΣTHM Spearman rank correlation coefficient was 0.36, with correlations higher for individual brominated species (BDCM, 0.62; DBCM, 0.53; TBM, 0.54) than for TCM (0.37). Noningestion water activities contributed more to the total exposure metric than did ingestion, but tap water THM concentrations were more predictive of blood THM levels than were metrics that incorporated water use. CONCLUSIONS: Spatial and temporal variability in THM concentrations was greater in water than in blood. We found consistent blood-water correlations across season and site for BDCM and DBCM, and multivariate regression results suggest that water THM concentrations may be an adequate surro-gate for baseline blood levels.

Occurrence and removal of pharmaceuticals and personal care products (PPCPs) in an advanced wastewater reclamation plant.

The occurrence of nineteen pharmaceutically active compounds and personal care products was followed monthly for 12 months after various stages of treatment in an advanced wastewater reclamation plant in Gwinnett County, GA, U.S.A. Twenty-four hour composite samples were collected after primary clarification, activated sludge biological treatment, membrane filtration, granular media filtration, granular activated carbon (GAC) adsorption, and ozonation in the wastewater reclamation plant. Compounds were identified and quantified using high performance liquid chromatography/tandem mass spectrometry (LC-MS/MS) and gas chromatography/mass spectrometry (GC-MS) after solid-phase extraction. Standard addition methods were employed to compensate for matrix effects. Sixteen of the targeted compounds were detected in the primary effluent; sulfadimethoxine, doxycycline, and iopromide were not found. Caffeine and acetaminophen were found at the highest concentrations (∼10(5) ng/L), followed by ibuprofen (∼10(4) ng/L), sulfamethoxazole and DEET (∼10(3) ng/L). Most of the other compounds were found at concentrations on the order of hundreds of ng/L. After activated sludge treatment and membrane filtration, the concentrations of caffeine, acetaminophen, ibuprofen, DEET, tetracycline, and 17α-ethynylestradiol (EE2) had decreased by more than 90%. Erythromycin and carbamazepine, which were resistant to biological treatment, were eliminated by 74 and 88%, on average, by GAC. Primidone, DEET, and caffeine were not amenable to adsorption by GAC. Ozonation oxidized most of the remaining compounds by >60%, except for primidone and DEET. Of the initial 16 compounds identified in the primary effluent, only sulfamethoxazole, primidone, caffeine and DEET were frequently detected in the final effluent, but at concentrations on the order of 10-100 ng/L. Removal of the different agents by the various treatment processes was related to the physical-chemical properties of the compounds.