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International audienceOver the last two decades, climate change has become a major environmental and public health concern due to the increase of the mean temperature on the Earth and its consequences on extreme meteorological events such as floods and droughts. These events induce very low or very high river flows that may impair surface water quality, and therefore result in potential health impacts when used for drinking water production. The present study aims at assessing the impact of hydrologic regime on surface water quality with a particular emphasis on total organic carbon (TOC) and nitrate. Water quality data from three French rivers acquired over a 27 years period, from January 1983 to December 2009, show the influence of extreme flows. Variation in TOC and nitrate concentrations showed opposite patterns for the whole range of flow rate (from less than 10% up to more than 100% of the mean flow). Regarding fluxes, TOC increased continuously with flow rate while nitrate was stable for very high discharges. The C/N ratio expressed from TOC and nitrate concentrations showed high values for extreme flows and particularly for very low flow rates, generally in summer, where nitrate is assimilated by biomass. Considering TOC and nitrate fluxes, it is confirmed that the worst situations were encountered for very high flow rates, namely for TOC exportation during surface runoff which was related to heavy rains or floods. These findings are of great importance with regard to the adaptation for drinking water treatment in facing extreme hydrological conditions, of which the frequency is increasing with climate change

The epidemiological evidence demonstrating the effect of disinfection by-products (DBPs) from drinking water on colon and rectal cancers is well documented. However, no systematic assessment has been conducted to assess the potential effect measure modification (EMM) in the relationship between DBPs and cancer. The objective of this paper is to conduct a systematic literature review to determine the extent to which EMM has been assessed in the relationship between DBPs in drinking water in past epidemiological studies. Selected articles (n = 19) were reviewed, and effect estimates and covariates that could have been used in an EMM assessment were gathered. Approximately half of the studies assess EMM (n = 10), but the majority of studies only estimate it relative to sex subgroups (n = 6 for bladder cancer and n = 2 both for rectal and colon cancers). Although EMM is rarely assessed, several variables that could have a potential modification effect are routinely collected in these studies, such as socioeconomic status or age. The role of environmental exposures through drinking water can play an important role and contribute to cancer disparities. We encourage a systematic use of subgroup analysis to understand which populations or territories are more vulnerable to the health impacts of DBPs.

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