Weight of Evidence for an Association between Adverse Reproductive and Developmental Effects and Exposure to Disinfection By-products: A Critical Review

Graves, Carol G.; Matanoski, Genevieve M.; Tardiff, Robert G.

doi:10.1006/rtph.2001.1494

Cited by 131 publications

(89 citation statements)

References 50 publications

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“…Several epidemiological studies suggest a link between consumption of chlorinated drinking water and reproductive and developmental outcomes, such as increased spontaneous abortions and intrauterine growth retardation [10][11][12][13][14], and bladder and gastrointestinal tract cancers [15][16][17][18][19][20][21]. At present, which by-products in chlorinated drinking water could be responsible for increasing cancer risk in human beings is not well established, because the potential synergistic interactions of chlorinated by-products and their role in the molecular mechanisms of carcinogenesis are still poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Modulation of cytochrome P450 and induction of DNA damage in Cyprinus carpio exposed in situ to surface water treated with chlorine or alternative disinfectants in different seasons

Canistro

Melega

Ranieri

et al. 2012

Mutation Research/Fundamental and Molecular Mechanisms of Mutag

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Epidemiological studies have shown an association between consumption of disinfected drinking water and adverse health outcomes. The chemicals used to disinfect water react with occurring organic matter and anthropogenic contaminants in the source water, resulting in the formation of disinfection byproducts (DBPs). The observations that some DBPs are carcinogenic in animal models have raised public concern over the possible adverse health effects for humans. Here, the modulation of liver cytochrome P450-linked monooxygenases (MFO) and the genotoxic effects in erythrocytes of Cyprinus carpio fish exposed in situ to surface drinking water in the presence of disinfectants, such as sodium hypochlorite (NaClO), chlorine dioxide (ClO 2 ) and peracetic acid (PAA), were investigated in winter and summer. A complex induction/suppression pattern of CYP-associated MFOs in winter was observed for all disinfectants. For example, a 3.4-to 15-fold increase was recorded of the CYP2B1/2-linked dealkylation of penthoxyresorufin with NaClO (10 days) and PAA (20 days). In contrast, ClO 2 generated the most notable inactivation, the CYP2E1-supported hydroxylation of p-nitrophenol being decreased up to 71% after 10 days' treatment. In summer, the degree of modulation was modest, with the exception of CYP3A1/2 and CYP1A1 supported MFOs (62% loss after 20 days PAA).The micronucleus (MN) induction in fish circulating erythrocytes was also analysed as an endpoint of genotoxic potential in the same fish population. Significant increases of MN induction were detected at the latest sampling time on fish exposed to surface water treated with chlorinate-disinfectants, both in winter (NaClO) and summer (NaClO and ClO 2 ), while no effect was observed in fish exposed to PAA-treated water.These results show that water disinfection may be responsible for harmful outcomes in terms of MFO perturbation and DNA damage; if extrapolated to humans, they ultimately offer a possible rationale for the increased urinary cancer risk recorded in regular drinking water consumers.

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Section: Introductionmentioning

confidence: 99%

Modulation of cytochrome P450 and induction of DNA damage in Cyprinus carpio exposed in situ to surface water treated with chlorine or alternative disinfectants in different seasons

Canistro

Melega

Ranieri

et al. 2012

Mutation Research/Fundamental and Molecular Mechanisms of Mutag

View full text Add to dashboard Cite

show abstract

“…Studies of pregnant women are particularly susceptible because the lifealtering event of pregnancy might cause direct changes in selfawareness and intentional changes in behavior over a relatively short-time period. Previous research has suggested that exposure to disinfection by-products (DBPs) in public tap water may be associated with adverse pregnancy outcomes (Nieuwenhuijsen et al, 2000;Graves et al, 2001;Bove et al, 2002), but many of the existing studies have relied solely on concentration of DBPs in municipal water sources, potentially resulting in exposure misclassification by ignoring variation in behaviors (Waller et al, 2001;Wright and Bateson 2005;Wright et al, 2006). Recent improvements in exposure assessment have resulted in collection and integration of information about individual women's water use habits .…”

Section: Introductionmentioning

confidence: 99%

Variability and predictors of changes in water use during pregnancy

Forssén

Wright

Herring

et al. 2008

J Expo Sci Environ Epidemiol

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Disinfection by-products in tap water have been found in some studies to be associated with adverse pregnancy outcomes, but little is known about how water use and consumption might change during early pregnancy. Estimating water-related activities only at one time during pregnancy could easily lead to exposure misclassification. To evaluate changes in water use among pregnant women, we used data from a large epidemiologic study in which 1990 women were interviewed around 9 and 20 weeks' gestation. The water variables that were examined included ingestion of cold and hot tap water as well as of bottled water, showering and bathing. Changes were detected between early and mid-pregnancy for ingested cold tap water and showering. Thirtythree percent of the subjects changed cold-water ingestion by Z1.0 liters/day and 44% changed their time showering by Z35 min per week during this period. Increases in cold tap water intake were associated with age 435 years, income o$40,000, and non-Hispanic white ethnicity. We also found that the proportion of the total variation due to within-subject variability was 62% for hot tap water ingestion but only 35% for showering and B50% for cold tap water, bottled water and bathing. Limited resources in epidemiologic studies often require a decision between collecting data for a large number of people or collecting multiple measurements for a smaller number of people. The results in this study will be useful to researchers who need to determine where to invest their effort when assessing water-related exposures and should help in evaluation of previously performed studies.

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“…Exposure to disinfection by-products (DBPs) has been associated with an increased risk of bladder cancer (Villanueva et al, 2004), and, while there might also be an association with adverse reproductive outcomes, the nature of this potential effect remains unclear (Nieuwenhuijsen et al, 2000a;Graves et al, 2001;Bove et al, 2002). Many of the epidemiological studies have relied on approximate measures of DBP exposure, such as concentration in the study subject's municipal water source, potentially resulting in substantial exposure misclassification.…”

Section: Introductionmentioning

confidence: 99%

Predictors of use and consumption of public drinking water among pregnant women

Forssén

Herring

Savitz

et al. 2006

J Expo Sci Environ Epidemiol

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Disinfection by-products (DBPs) in drinking water may be associated with adverse pregnancy outcomes. However, the results from previous epidemiological studies are not consistent, perhaps in part due to individual variation in water use and consumption. This study was performed to evaluate and describe demographic and behavioral characteristics as predictors of ingested water, showering, bathing, and swimming among pregnant women. Water use and consumption data were collected through telephone interviews with 2297 pregnant women from three geographical sites in the southern United States. The data were analyzed according to demographic, health, and behavioral variables expected to be predictors of water use and thus potential confounding factors relating water use to pregnancy outcome. The candidate predictors were evaluated using backward elimination in regression models. Demographic variables tended to be more strongly predictive of the use and consumption of water than health and behavior-related factors. NonHispanic white women drank 0.4 (95% confidence interval (CI) 0.2; 0.7) liters more cold tap water per day than Hispanic women and 0.3 (95% CI 0.1; 0.4) liters more than non-Hispanic black women. Non-Hispanic white women also reported drinking a higher proportion of filtered tap water, whereas Hispanic women replaced more of their tap water with bottled water. Lower socioeconomic groups reported spending a longer time showering and bathing, but were less likely to use swimming pools. The results of this study should help researchers to anticipate and better control for confounding and misclassification in studies of exposure to DBPs and pregnancy outcomes.

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Weight of Evidence for an Association between Adverse Reproductive and Developmental Effects and Exposure to Disinfection By-products: A Critical Review

Cited by 131 publications

References 50 publications

Modulation of cytochrome P450 and induction of DNA damage in Cyprinus carpio exposed in situ to surface water treated with chlorine or alternative disinfectants in different seasons

Modulation of cytochrome P450 and induction of DNA damage in Cyprinus carpio exposed in situ to surface water treated with chlorine or alternative disinfectants in different seasons

Variability and predictors of changes in water use during pregnancy

Predictors of use and consumption of public drinking water among pregnant women

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