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

Mark J. Nieuwenhuijsen, Rachel Smith, Spyros Golfinopoulos, Nicky Best, James Bennett, Gabriella Aggazzotti, Elena Righi, Guglielmina Fantuzzi, Luca Bucchini, Sylvaine Cordier, Cristina M. Villanueva, Victor Moreno, Carlo La Vecchia, Cristina Bosetti, Terttu Vartiainen, Radu Rautiu, Mireille Toledano, Nina Iszatt, Regina Grazuleviciene, Manolis Kogevinas

Research output: Contribution to journalArticlepeer-review

Abstract

There appears to be very good epidemiological evidence for a relationship between chlorination by-products, as measured by trihalomethanes (THMs), in drinking water and bladder cancer, but the evidence for other cancers, including colorectal cancer appears to be inconclusive and inconsistent. There appears to be some evidence for a relationship between chlorination by-products, as measured by THMs, and small for gestational age (SGA)/intrauterine growth retardation (IUGR) and preterm delivery, but evidence for other outcomes such as low birth weight (LBW), stillbirth, congenital anomalies and semen quality appears to be inconclusive and inconsistent. The overall aim of the HIWATE study is to investigate potential human health risks (e.g. bladder and colorectal cancer, premature births, SGA, semen quality, stillbirth, congenital anomalies) associated with long-term exposure to low levels of disinfectants (such as chlorine) and DBPs occurring in water for human consumption and use in the food industry. The study will comprise risk-benefit analyses including quantitative assessments of risk associated with microbial contamination of drinking water versus chemical risk and will compare alternative treatment options. The outcome will be improved risk assessment and better information for risk management. The work is divided into different topics (exposure assessment, epidemiology, risk assessment and management) and studies.

Original languageEnglish
Pages (from-to)185-207
Number of pages23
JournalJournal of Water and Health
Volume7
Issue number2
DOIs
Publication statusPublished - 2009

Keywords

  • Cancer
  • Chlorination
  • Disinfection by-products
  • Epidemiology
  • Reproductive health
  • Risk assessment

ASJC Scopus subject areas

  • Water Science and Technology
  • Waste Management and Disposal
  • Infectious Diseases
  • Microbiology (medical)
  • Public Health, Environmental and Occupational Health

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