Point-of-use chlorine residuals and disinfection byproduct occurrences in rural households served by public water utilities in Appalachian Virginia.

We characterized concentrations of trihalomethanes (THMs), a measure of disinfection byproducts (DBPs), in tap water samples collected from households with utility-supplied water in two rural counties in Appalachian Virginia, and assessed associations with pH, free chlorine, and metal ions which can impact THM formation. Free chlorine concentrations in all samples (n = 27 homes) complied with EPA drinking water guidelines, though 7% (n = 2) of first draw samples and 11% (n = 3) of 5-min flushed-tap water samples exceeded the US Safe Drinking Water Act (SDWA) maximum contaminant level (MCL) for THM (80 ppb). Regression analyses showed that free chlorine and pH were positively associated with the formation of THM levels above SDWA MCLs (OR = 1.04, p = 0.97 and OR = 1.74, p = 0.79, respectively), while temperature was negatively associated (OR = 0.78, p = 0.38). Of the eight utilities serving study households, samples from water served by three different utilities exceeded the EPA MCL for THM. Overall, these findings do not indicate substantial exposures to DBPs for rural households with utility-supplied water in this region of southwest Virginia. However, given the observed variability in THM concentrations between and across utilities, and established adverse health impacts associated with chronic and acute DBP exposure, more research on DBPs in rural Central Appalachia is warranted.

Exposure to disinfection by-products and risk of cancer: A systematic review and dose-response meta-analysis.

Disinfection by-products (DBPs), including trihalomethanes (THMs) and haloacetic acids (HAAs), have attracted attention due to their carcinogenic properties, leading to varying conclusions. This meta-analysis aimed to evaluate the dose-response relationship and the dose-dependent effect of DBPs on cancer risk. We performed a selective search in PubMed, Web of Science, and Embase databases for articles published up to September 15th, 2023. Our meta-analysis eventually included 25 articles, encompassing 8 cohort studies with 6038,525 participants and 10,668 cases, and 17 case-control studies with 10,847 cases and 20,702 controls. We observed a positive correlation between increased cancer risk and higher concentrations of total trihalomethanes (TTHM) in water, longer exposure durations, and higher cumulative TTHM intake. These associations showed a linear trend, with relative risks (RRs) and 95 % confidence intervals (CIs) being 1.02 (1.01-1.03), 1.04 (1.02-1.06), and 1.02 (1.00-1.03), respectively. Gender-specific analyses revealed slightly U-shaped relationships in both males and females, with males exhibiting higher risks. The threshold dose for TTHM in relation to cancer risk was determined to be 55 µg/L for females and 40 µg/L for males. A linear association was also identified between bladder cancer risk and TTHM exposure, with an RR and 95 % CI of 1.08 (1.05-1.11). Positive linear associations were observed between cancer risk and exposure to chloroform, bromodichloromethane (BDCM), and HAA5, with RRs and 95 % CIs of 1.02 (1.01-1.03), 1.33 (1.18-1.50), and 1.07 (1.03-1.12), respectively. Positive dose-dependent effects were noted for brominated THMs above 35 µg/L and chloroform above 75 µg/L. While heterogeneity was observed in the studies for quantitative synthesis, no publication bias was detected. Exposure to TTHM, chloroform, BDCM, or HAA5 may contribute to carcinogenesis, and the risk of cancer appears to be dose-dependent on DBP exposure levels. A cumulative effect is suggested by the positive correlation between TTHM exposure and cancer risk. Bladder cancer and endocrine-related cancers show dose-dependent and positive associations with TTHM exposure. Males may be more susceptible to TTHM compared to females.

Blood Trihalomethane Concentrations and Osteoarthritis among U.S. Population Aged over 50 Years.

Exposure to trihalomethanes (THMs) has been associated with inflammation and oxidative stress, which are implicated in osteoarthritis. However, the association of THM exposure with osteoarthritis is unknown. Therefore, we pooled seven independent National Health and Nutrition Examination Survey cycles (1999-2012) among participants aged over 50 years who had quantified blood concentrations of chloroform (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform (TBM). Among 4,077 adults aged over 50 years, 781 (21.3%) reported osteoarthritis. Logistic regression models showed increased odds of osteoarthritis across the categories of blood BDCM, DBCM, and brominated THM (Br-THM, which was the sum of BDCM, DBCM, and TBM) concentrations [odds ratios = 1.46 (95% CI 1.09-1.94), 1.53 (95% CI 1.15-2.04), and 1.35 (95% CI 0.97-1.88), respectively], comparing highest versus lowest exposure categories (quartiles or tertiles). Additionally, we found positive dose-response relationships between blood BDCM, DBCM, and Br-THM concentrations and serum markers of oxidative stress (i.e., gamma-glutamyltransferase). In summary, blood Br-THM concentrations were associated with elevated serum levels of gamma-glutamyltransferase as well as an increased risk of osteoarthritis among U.S. adults aged over 50 years. However, more prospective population studies are needed to verify these findings and explore the underlying mechanisms.

Exposure to Trihalomethanes and Bone Mineral Density in US Adolescents: A Cross-Sectional Study (NHANES).

Animal and human studies have suggested that trihalomethane (THM) has toxicity to bone. In this study, we included adolescents from the National Health and Nutrition Examination Survey who had quantified blood and tap water THM concentrations [chloroform (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform (TBM)] and lumbar spine or total body less head (TBLH) bone mineral density (BMD). A 2.7-fold increase in concentrations of blood TCM, DBCM, chlorinated THMs (the sum of TCM, BDCM, and DBCM), and total THMs (the sum of 4 THMs) was associated with lower lumbar spine BMD z-scores by -0.06 [95% confidence interval (CI): -0.12, -0.01], -0.06 (95% CI: -0.11, -0.003), -0.08 (95% CI: -0.14, -0.02), and -0.07 (95% CI: -0.13, -0.003), respectively, in adjusted models. Similarly, a 2.7-fold increase in blood BDCM, DBCM, and chlorinated THM concentrations was associated with lower TBLH BMD z-scores by -0.10 (95% CI: -0.17, -0.02), -0.10 (95% CI: -0.17, -0.03), and -0.11 (95% CI: -0.20, -0.01), respectively. Low-to-moderate predictive power was attained when tap water THM concentrations were used to predict blood THM measurements. Notably, the inverse associations for blood THMs persisted exclusively between water concentrations of DBCM and Br-THMs and the TBLH BMD z-scores. Our findings suggest that exposure to THMs may adversely affect the adolescent BMD.

Metabolomic Signatures of Exposure to Nitrate and Trihalomethanes in Drinking Water and Colorectal Cancer Risk in a Spanish Multicentric Study (MCC-Spain).

We investigated the metabolomic profile associated with exposure to trihalomethanes (THMs) and nitrate in drinking water and with colorectal cancer risk in 296 cases and 295 controls from the Multi Case-Control Spain project. Untargeted metabolomic analysis was conducted in blood samples using ultrahigh-performance liquid chromatography-quadrupole time-of-flight mass spectrometry. A variety of univariate and multivariate association analyses were conducted after data quality control, normalization, and imputation. Linear regression and partial least-squares analyses were conducted for chloroform, brominated THMs, total THMs, and nitrate among controls and for case-control status, together with a N-integration model discriminating colorectal cancer cases from controls through interrogation of correlations between the exposure variables and the metabolomic features. Results revealed a total of 568 metabolomic features associated with at least one water contaminant or colorectal cancer. Annotated metabolites and pathway analysis suggest a number of pathways as potentially involved in the link between exposure to these water contaminants and colorectal cancer, including nicotinamide, cytochrome P-450, and tyrosine metabolism. These findings provide insights into the underlying biological mechanisms and potential biomarkers associated with water contaminant exposure and colorectal cancer risk. Further research in this area is needed to better understand the causal relationship and the public health implications.

Blood trihalomethane concentrations in relation to sperm mitochondrial DNA copy number and telomere length among 958 healthy men.

BACKGROUND: In animal and human studies, exposure to trihalomethanes (THMs) has been associated with reduced semen quality. However, the underlying mechanisms remain poorly understood. OBJECTIVE: To investigate the associations of blood THM concentrations with sperm mitochondrial DNA copy number (mtDNAcn) and telomere length (TL) among healthy men. METHODS: We recruited 958 men who volunteered as potential sperm donors. A single blood sample was collected from each participant at recruitment and measured for chloroform (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform (TBM) concentrations. Within a 90-day follow-up, the last semen sample provided by each participant was quantified for sperm mtDNAcn and TL. We used multivariable linear regression models to assess the associations between blood THM concentrations and sperm mtDNAcn and TL. We also performed stratified analyses according to the time intervals between baseline blood THM determinations and semen collection (i.e., 0-9, 10-14, 15-69, or >69 days) to explore potential windows of susceptibility. RESULTS: After adjusting for potential confounders, we found inverse associations between quartiles (or categories) of blood TBM, brominated THM (Br-THM, the sum of BDCM, DBCM, and TBM), and total THM (TTHM, the sum of all four THMs) concentrations and sperm mtDNAcn (all P for trend≤0.03). Besides, we found inverse associations between quartiles of blood TCM, Br-THM, chlorinated THM (Cl-THM, the sum of TCM, BDCM, and DBCM), and TTHM concentrations and sperm TL (all P for trend<0.10). Stratified analyses showed stronger associations between Br-THM concentrations and sperm mtDNAcn determined 15-69 days since baseline exposure determinations, and between blood TCM and TTHM concentrations and sperm TL determined >69 days since baseline exposure determinations. CONCLUSION: Exposure to THMs may be associated with sperm mitochondrial and telomeric dysfunction.

Relationship of trihalomethane in drinking water with hypertension and arrhythmia among young and middle-aged adults in Petropavlovsk, Kazakhstan.

There are no studies investigating the association of chlorinated drinking water with the risk of cardiovascular diseases (CVDs) among young and middle-aged adults. This study was aimed to assess the associations between trihalomethanes (THMs) in drinking water and the risk of CVDs in in the target group in Petropavlovsk, Kazakhstan. 448 dwellers of Petropavlovsk were asked about their demographic, socioeconomic, lifestyle, behavioural characteristics, and drinking water preferences. THMs exposure was assessed to each participant based on their residence address. We used multivariable logistic regression analysis to assess the risk of CVDs in young and middle-aged adults. The results showed that the risk of hypertension in the adjusted logistic regression model was increased by 68% and a 2.7-fold in the second and third THM tertiles, respectively. Participants in the second and third THM exposure tertiles had a 2.3-fold and a 4.8-fold increase in the risk of arrhythmia.

Full-scale multisampling and empirical modeling of DBPs in water and air of indoor pools.

Disinfection by-products (DBPs) are formed in the water in swimming pools due to reactions between disinfectants (chlorine, bromine, ozone) and the organic matter introduced by bathers and supply water. High concentrations of DBPs are also reported in the air of indoor swimming pools. Based on a robust multisampling program, the levels and variations of DBPs in the air (trichloramine [TCAM] and trihalomethanes [THMs]) and water (THM) were assessed, as well as their precursors (total organic carbon, water temperature, pH, free, and total chlorine) and proxies (CO2 and relative humidity) in four indoor chlorinated swimming pools. High-frequency sampling was conducted during one high-attendance day for each pool. This study focused on parameters that are easy to measure in order to develop models for predicting levels of THMs and TCAM in the air. The results showed that the number of bathers had an important impact on the levels of THMs and TCAM, with a two-to-three-fold increase in air chloroform (up to 110 µg/m3) and a two-to-four-fold increase in TCAM (up to 0.52 mg/m3) shortly after pools opened. The results of this study for the first time showed that CO2 and relative humidity can serve as proxies for monitoring variations in airborne THMs and TCAM. Our results highlight the good predictive capacity of the developed models and their potential for use in day-to-day monitoring. This could help optimize and control DBPs formation in the air of indoor swimming pools and reduce contaminant exposure for both pool employees and users.

Using water quality parameters to prediction of the ion-based trihalomethane by an artificial neural network model.

Trihalomethanes (THMs) are the first disinfectant by-products in the drinking water distribution network and are classified as potential carcinogens. The presence of THMs in chlorinated water depends on the pH, water temperature, contact time between water and chlorine, type and dose of disinfection, bromide ion concentration, and type and concentration of natural organic materials (NOMs). In the present study, the formation of THMs was evaluated by six simple and easy water quality parameters and modeled by an artificial neural network (ANN) approach through five water distribution networks (WDNs) and the Karoun River in Khuzestan province. The results of this study that was conducted from October 2014 to September 2015 showed that THM concentration ranged in five WDNs, including Shoushtar, Ahvaz (2), Ahvaz (3), Mahshahr, Khorramshahr, and total WDNs through N.D.-9.39 µg/L, 7.12-28.60, 38.16-67.00, 17.15-90.46, 15.14-29.99, and N.D.-156, respectively. The concentration of THMs exceeded Iran and EPA standards in many cases in Mahshahr and Khorramshahr WDNs. Evaluation of R2, MSE, and RMSE showed the appropriate correlation between measured and modeled THMs, indicating a reasonable ANN potential for estimating THM formation in water sources.

Trihalomethanes in drinking water from three First Nation reserves in Manitoba, Canada.

Previous research indicates that the water distribution system used has a significant impact on the microbial quality of tap water sampled in First Nations reserves in Canada. This study tested tap water from homes in three First Nations reserves to compare the concentrations of four trihalomethanes and related water quality parameters between homes receiving piped water from a water treatment plant (WTP) versus homes equipped with cisterns that are filled by a water truck. Of all the samples collected across time from household taps, 75% of piped samples and 70% of cistern samples had TTHM concentrations exceeding Health Canada's maximum acceptable concentration (MAC) of 100 µg L-1 total trihalomethanes (TTHMs) in treated water. In all communities and across sampling times, trichloromethane (CHCl3) was the dominant trihalomethane (42-96%) followed by bromodichloromethane (CHBrCl2) (3-37%) and dibromochloromethane (CHClBr2) (1-18%). Tribromomethane (CHBr3) always accounted for < 5% of TTHMs. Within each of the three First Nations reserves, the water distribution system had no significant effect on TTHM concentration at the household level. Sampling month had a significant effect on TTHM concentration due to temporal changes in dissolved organic carbon of the source water. Results suggest that families in the studied First Nations reserves receive drinking water with high TTHM concentrations and that improvements to the water treatment plant might be the most effective way to minimize trihalomethane formation.

Trihalomethanes in developed and developing countries.

The reactions between natural organic matter, anthropogenic contaminants, ions, and disinfectants lead to the formation of disinfection by-products (DBPs) such as trihalomethanes (THMs) in drinking water. The formation of THMs is strongly related to the chlorination of water. The study's central objective was to compare the concentration of THMs in twenty developed and developing countries and their disinfection techniques. The THM concentration in 11 developed and 9 developing countries ranged from 0.5 µg/L (Germany) to 215 µg/L (Russia) and 3 µg/L (China) to 439.2 µg/L (Bangladesh), respectively. The developed country has partially succeeded in reducing THM concentration in drinking water, whereas significant steps are needed in developing countries to reduce the existing high THM concentration. The concentration of THMs in water varies among these countries because of the different water sources, water quality, environmental conditions, and efficiency of water treatment technologies. A meaningful relationship has been observed between the properties of water and the THM formation. The use of chemical disinfectants will result in new forms of DBPs that are undesirable due to their carcinogenic and mutagenic effects on human health. The DBP guidelines by various national and international agencies have helped to control and manage the THM concentration in drinking water. However, these regulatory standards are not continuously monitored. Therefore, the formation of these compounds should be prevented either by removing THMs forming precursors or by using an integrated approach for controlling THM formation by implementing advanced water treatment technology. Extensive research is desirable in domains like THM minimization strategies which are easy to deploy, scalable, and cost-effective.

Comparison of UV-based advanced oxidation processes for the removal of different fractions of NOM from drinking water.

This study examined the effectiveness for degradation of hydrophobic (HPO), transphilic (TPI) and hydrophilic (HPI) fractions of natural organic matter (NOM) during UV/H2O2, UV/TiO2 and UV/K2S2O8 (UV/PS) advanced oxidation processes (AOPs). The changing characteristics of NOM were evaluated by dissolved organic carbon (DOC), the specific UV absorbance (SUVA), trihalomethanes formation potential (THMFP), organic halogen adsorbable on activated carbon formation potential (AOXFP) and parallel factor analysis of excitation-emission matrices (PARAFAC-EEMs). In the three UV-based AOPs, HPI fraction with low molecular weight and aromaticity was more likely to degradate than HPO and TPI, and the removal efficiency of SUVA for HPO was much higher than TPI and HPI fraction. In terms of the specific THMFP of HPO, TPI and HPI, a reduction was achieved in the UV/H2O2 process, and the higest removal rate even reached to 83%. UV/TiO2 and UV/PS processes can only decrease the specific THMFP of HPI. The specific AOXFP of HPO, TPI and HPI fractions were all able to be degraded by the three UV-based AOPs, and HPO content is more susceptible to decompose than TPI and HPI content. UV/H2O2 was found to be the most effective treatment for the removal of THMFP and AOXFP under given conditions. C1 (microbial or marine derived humic-like substances), C2 (terrestrially derived humic-like substances) and C3 (tryptophan-like proteins) fluorescent components of HPO fraction were fairly labile across the UV-based AOPs treatment. C3 of each fraction of NOM was the most resistant to degrade upon the UV-based AOPs. Results from this study may provide the prediction about the consequence of UV-based AOPs for the degradation of different fractions of NOM with varied characteristics.

Determination of chloroform concentration and human exposure assessment in the swimming pool.

This cross-sectional study aimed to examine the concentration of the by-products of chlorination in the swimming pool and estimate human health risk for the swimmers of Shiraz University of Medical Sciences. In this study, the chloroform concentrations of 16 samples were measured using Gas Chromatography (GC). All the measured concentrations were less than the allowed amount announced by the World Health Organization (WHO). The results of the cancer risk (CR) and hazard index (HI) showed that the major exposure routes were found to be dermal during swimming and the 95 percentile of estimated CR and HI for the male group were 1.38 × 10-10 and 1.82 × 10-5 respectively, which is higher than the values of 5.48 × 10-10 and 2.25 × 10-5 respectively, for the women group. Sensitivity analyses indicated that the swimming exposure time (ET), and chloroform concentration were the most relevant variables in the health risk model. Therefore, knowledge about the sources of micro-pollutants in swimming pools might help promote the health methods of the pool environment.

Controlling the formation of halogenated byproducts in the chlorination of source waters by oxidative pre-treatment with the Fe(II)/Fe(III)-S(IV)-air system.

Breakpoint chlorination is a generally accepted method for removing ammonium ion from source waters in drinking water treatment technologies. This process is often accompanied by the formation of halogenated organic byproducts. The presence of these compounds in potable water is of primary concern. In this paper, we demonstrate that the concentration of the precursors of the halogenated species can sufficiently be decreased by oxidizing the organic pollutants with the Fe(II)/Fe(III) - S(IV) - air system. Pre-oxidative treatment of the source waters results in a substantial reduction of chemical oxygen demand, while the ammonium ion concentration remains unaffected. The breakpoint chlorination produces substantially less trihalomethanes (THMs) and adsorbable halogenated organic compounds (AOXs) in oxidatively pre-treated source waters than in raw waters. These results offer a possibility to improve drinking water treatment technologies for better controlling the formation of antagonistic byproducts. It is demonstrated that reaching the regulated concentration levels of THMs is feasible with this method even in source waters containing organic pollutants at relatively high concentration levels. The main advantage of the procedure is that the reagents used for the oxidative pre-treatment are converted into non-toxic products (Fe(III) and SO42-) by the end of the process.

Relationships between regulated DBPs and emerging DBPs of health concern in U.S. drinking water.

A survey was conducted at eight U.S. drinking water plants, that spanned a wide range of water qualities and treatment/disinfection practices. Plants that treated heavily-wastewater-impacted source waters had lower trihalomethane to dihaloacetonitrile ratios due to the presence of more organic nitrogen and HAN precursors. As the bromide to total organic carbon ratio increased, there was more bromine incorporation into DBPs. This has been shown in other studies for THMs and selected emerging DBPs (HANs), whereas this study examined bromine incorporation for a wider group of emerging DBPs (haloacetaldehydes, halonitromethanes). Moreover, bromine incorporation into the emerging DBPs was, in general, similar to that of the THMs. Epidemiology studies that show an association between adverse health effects and brominated THMs may be due to the formation of brominated emerging DBPs of heath concern. Plants with higher free chlorine contact times before ammonia addition to form chloramines had less iodinated DBP formation in chloraminated distribution systems, where there was more oxidation of the iodide to iodate (a sink for the iodide) by the chlorine. This has been shown in many bench-scale studies (primarily for iodinated THMs), but seldom in full-scale studies (where this study also showed the impact on total organic iodine. Collectively, the THMs, haloacetic acids, and emerging DBPs accounted for a significant portion of the TOCl, TOBr, and TOI; however, ∼50% of the TOCl and TOBr is still unknown. The correlation of the sum of detected DBPs with the TOCl and TOBr suggests that they can be used as reliable surrogates.

Insight into the formation of iodinated trihalomethanes during chlorination, monochloramination, and dichloramination of iodide-containing water.

In this study, the formation of iodinated trihalomethanes (I-THMs) was systematically evaluated and compared for three treatment processes - (i) chlorination, (ii) monochloramine, and (iii) dichloramination - under different pH conditions. The results demonstrated that I-THM formation decreased in the order of monochloramination > dichloramination > chlorination in acidic and neutral pH. However, the generation of I-THMs increased in the dichloramination < chlorination < monochloramination order in alkaline condition. Specifically, the formation of I-THMs increased as pH increased from 5 to 9 during chlorination and monochloramination processes, while the maximum I-THM formation occurred at pH 7 during dichloramination. The discrepancy could be mainly related to the stability of the three chlor (am) ine disinfectants at different pH conditions. Moreover, in order to gain a thorough insight into the mechanisms of I-THM formation during dichloramination, further investigation was conducted on the influencing factors of DOC concentration and Br-/I- molar ratio. I-THM formation exhibited an increasing and then decreasing trend as the concentration of DOC increased from 1 to 7 mg-C/L, while the yield of I-THMs increased with increasing Br-/I- molar ratio from 5:0 to 5:10. During the three processes mentioned above, similar I-THM formation results were also obtained in real water, which indicates that the excessive generation of I-THMs should be paid special attention during the disinfection of iodide-containing water.

Association of Blood Trihalomethane Concentrations with Risk of All-Cause and Cause-Specific Mortality in U.S. Adults: A Prospective Cohort Study.

Water chlorination can lead to the formation of disinfection byproducts, including trihalomethanes (THMs). However, few epidemiologic studies have explored associations between THM exposure and mortality. This study included 6720 adults aged ≥40 years from the National Health and Nutrition Examination Survey 1999-2012 who had blood THM concentrations quantified. A higher risk of all-cause mortality was found across increasing quartile concentrations of blood chloroform (TCM) and total THMs (TTHMs; sum of all four THMs) (both p for trend = 0.02). Adults in the highest quartile of TCM and TTHM concentrations had hazard ratios (HRs) of 1.35 (95% confidence intervals: 1.05-1.74) and 1.37 (1.05-1.79), respectively, for all-cause mortality, compared with adults in the lowest quartile. When cause-specific mortality was evaluated, a positive relationship was found between blood bromodichloromethane (BDCM), dibromochloromethane (DBCM), bromoform (TBM), total brominated THMs (Br-THMs; sum of BDCM, DBCM, and TBM), and TTHM concentrations and risk of cancer death and between blood TCM and TTHMs and risk of other cause (noncancer/nonheart disease) mortality. Our findings suggest that higher exposure to Br-THMs was associated with increased cancer mortality risk, whereas TCM was associated with a greater risk of noncancer/nonheart disease mortality.

Relationship between Blood Trihalomethane Concentrations and Serum Thyroid Function Measures in U.S. Adults.

Toxicological studies show that exposure to disinfection byproducts, including trihalomethanes (THMs), negatively affects thyroid function; however, few epidemiological studies have explored this link. This study included 2233 adults (ages ≥20 years) from the 2007-2008 National Health and Nutrition Examination Survey (NHANES) who were measured for blood THM concentrations [chloroform (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), or bromoform (TBM)] and serum thyroid function biomarkers [thyroid-stimulating hormone, free thyroxine (FT4), total thyroxine (TT4), free triiodothyronine (FT3), total triiodothyronine (TT3), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb)]. Multivariable linear regression models showed positive associations between blood TCM, BDCM, and total THMs (the sum of all four THMs) concentrations and serum FT4, whereas inverse associations were found between blood DBCM and total brominated THM (Br-THM; the sum of BDCM, DBCM, and TBM) concentrations and serum TT3 (all p < 0.05). Besides, positive associations were observed between blood TCM concentrations and FT4/FT3 ratio, between BDCM, DBCM, and Br-THM concentrations and TT4/TT3 ratio, and between DBCM and Br-THM concentrations and FT3/TT3 ratio (all p < 0.05). Blood THM concentrations were unrelated to the serum levels of thyroid autoantibodies TgAb or TPOAb. In summary, exposure to THMs was associated with altered serum biomarkers of thyroid function but not with thyroid autoimmunity among U.S. adults.

Associations of public water system trihalomethane exposure during pregnancy with spontaneous preterm birth and the cervicovaginal microbial-immune state.

BACKGROUND: Water total trihalomethanes (TTHMs) are disinfectant byproducts found in municipal water supplies. TTHM exposure has been linked to cancer and may be associated with adverse reproductive outcomes. A non-optimal cervicovaginal microbiota and low cervicovaginal beta-defensin-2 levels are associated with increased risk of spontaneous preterm birth. Whether TTHM exposure increases the risk of spontaneous preterm birth or alters the cervicovaginal microbial or immune state is unknown. OBJECTIVE: Investigate associations of water TTHM levels with spontaneous preterm birth, a non-optimal cervicovaginal microbiota, and beta-defensin-2 levels in a completed, diverse, urban pregnancy cohort. We hypothesized that higher TTHM levels would be associated with spontaneous preterm birth, a non-optimal cervicovaginal microbiota, and lower beta-defensin-2 levels. DESIGN: Methods: This was a secondary analysis of participants (n = 474) in the Motherhood & Microbiome (M&M) study (n = 2000), who lived in Philadelphia and had cervicovaginal samples analyzed for cervicovaginal microbiota composition and beta-defensin-2 levels. The microbiota was classified into community state types (CSTs). CST IV (non-optimal microbiota) is characterized by a paucity of Lactobacillus species and wide array of anaerobes. Municipal water TTHM levels were obtained from 16 sites monthly across the city of Philadelphia to establish mean residential water supply levels for each participant for the first four months of pregnancy (prior to vaginal swab collection at 16-20 weeks' gestation). Associations of water TTHM levels with spontaneous preterm birth and a non-optimal cervicovaginal microbiota birth were analyzed using multivariable logistic regression. Multivariable linear regression was used to model associations of water TTHM levels with log-transformed cervicovaginal beta-defensin-2 levels. Since water TTHM levels vary by season and beta-defensin-2 levels have been shown to differ by race, stratified models by warm (April-September) and cold (October-March) seasons as well as by self-identified race were utilized. RESULTS: Participants' water supply TTHM levels (mean µg/L [SD]) were higher in the warm (53.5 [9.4]) than cold (33.4 [7.5]) season (p < 0.0001). TTHM levels were non-significantly higher among Black participants than non-Black participants (44.8 [13.5] vs. 41.8 [11.8], p = 0.07). No associations were detected between TTHM with spontaneous preterm birth (per SD increment of TTHM, aOR 0.94, 95%CI: 0.66, 1.34) or with CST IV (aOR 0.94, 95%CI: 0.86, 1.16). Counter to our hypothesis, we observed positive associations of water TTHM with log-transformed cervicovaginal beta-defensin-2 levels in unadjusted models (ß 0.20 [95%CI: 0.02, 0.39]) per SD increment of TTHM), but the association was null after adjustment for season. However, in models adjusted for covariates including season and stratified by race, TTHM was significantly associated with lower beta-defensin-2 levels among non-Black participants (ß -0.75 [95%CI: -1.43, -0.08]) but not among Black participants (ß 0.17 [95%CI: -0.15, 0.49]), interaction p = 0.013). CONCLUSION: We did not detect associations of water TTHM levels with spontaneous preterm birth or the structure of the cervicovaginal microbiota. However, the finding of a significant interaction between TTHM and race on beta-defensin-2 levels suggest that environmental exposures may contribute to differences in reproductive tract innate immune function by race. Future studies to delineate environmental contributions to the cervicovaginal microbial-immune state, a potentially important biologic underpinning for preterm birth, are warranted.

Cancer risk assessment from exposure to trihalomethanes in showers by inhalation.

In many countries water disinfection for human consumption is still carried out via chlorination which generates by-products such as trihalomethanes (THM). Exposure to THM constitutes a public health risk as such substances are known to be carcinogenic. This study evaluated exposure to THMs by inhalation in showers and assessed the carcinogenic risk for lifetime exposure. The study population involved students at Universidad de los Andes residing in Bogotá, Colombia. The risk assessment was performed stochastically and the exposure parameters were taken as probability distributions. Most variables were measured in relation to the chosen population. The risk was calculated using two different methodologies but no significant variations were obtained. The average risk calculated for men and women was 56 cases in a million (5.6 × 10-5). A sensitivity analysis was carried out where it was found that the parameters that increase risk the most are the concentration of chloroform in the water, exposure time, and the volume of the shower cubicle.