Christelle Legay

Estimation of chlorination by-products presence in drinking water in epidemiological studies on adverse reproductive outcomes: A review

Chlorination of drinking water is essential to prevent waterborne disease. However, chlorine reacts with organic matter present in surface waters to form various by-products. In the last decade, several epidemiological studies have been conducted to determine the connection between exposure to these chlorination by-products (CBPs) and human health defects, such as adverse reproductive outcomes. However, the methodology used to assess exposure of pregnant women in these studies had serious limitations, particularly in relation to determining CBP presence in the subjects tap water. The purpose of this paper is to critically review of methods used to evaluate the CBP presence in a subjects tap water for exposure assessment purposes in epidemiological studies focused on adverse reproductive outcomes and CBPs in drinking water. Interest is directed more precisely at space-time features related to CBPs for an optimal estimation of their presence in a subjects tap water.

Maternal exposure to drinking-water chlorination by-products and small-for-gestational-age neonates.

Background: There is concern about possible effects of disinfection by-products on reproductive outcomes. The purpose of this study was to evaluate the association between maternal exposure to chlorination by-products and the risk of delivering a small for-gestational-age (SGA) neonate. Methods: We conducted a population-based case-control study in the Québec City (Canada) area. Term newborn cases with birth weights <10th percentile (n = 571) were compared with 1925 term controls with birth weights ≥10th percentile. Concentrations of trihalomethanes and haloacetic acids in the water-distribution systems of participants were monitored during the study period, and a phone interview on maternal habits was completed within 3 months after childbirth. We estimated chlorination by-products ingestion during the last trimester of pregnancy and trihalomethanes doses resulting from inhalation and dermal exposure. We evaluated associations between chlorination by-products in utero exposure and SGA by means of unconditional logistic regression with control of potential confounders. Results: When total trihalomethanes and the 5 regulated haloacetic acids concentrations were divided into quartiles, no clear dose-response relationship was found with SGA. However, increased risk was observed when haloacetic concentrations were above the fourth quartile and when either trihalomethanes or haloacetic acids concentrations were above current water standards (adjusted OR= 1.5 [95% confidence interval = 1.1–1.9] and 1.4 [1.1–1.9], respectively). Inhalation and dermal absorption of trihalomethanes did not contribute to this risk, but a monotonic dose-response was found with haloacetic acids ingestion. Conclusion: Oral exposure to high levels of chlorination by-products in drinking water could be a risk factor for term SGA.

Spatial variations of human health risk associated with exposure to chlorination by-products occurring in drinking water.

During disinfection, chlorine reacts with organic matter present in drinking water and forms various undesirable chlorinated by-products (CBPs). This paper describes a study of the spatial variability of human health risk (i.e., cancer effects) from CBP exposure through drinking water in a specific region. The region under study involves nine drinking water distribution systems divided into several zones based on their characteristics. The spatial distribution of cancer risk (CR) was estimated using two years of data (2006-2008) on various CBP species. In this analysis, trihalomethanes (THMs) and haloacetic acids (HAAs) served as surrogates for CBPs. Three possible routes of exposure (i.e., via ingestion, inhalation and dermal contact) were considered for each selected compound. The cancer risk assessment involved estimating a unit risk (R(T)) in each zone of the selected distribution systems. A probabilistic analysis based on Monte Carlo simulations was employed. Risk assessment results showed that cancer risk varied between systems, but also within individual systems. As a result, the population of the same region was not exposed to the same risk associated with CBPs in drinking water. Unacceptable levels (i.e., R(T) > 10(-4)) for the estimated CR were determined for several zones in the studied region. This study demonstrates that a spatial-based analysis performed to represent the spatial distribution of risk estimates can be helpful in identifying suitable risk management strategies. Suggestions for improving the risk analysis procedure are also presented.

Multi-level modelling of chlorination by-product presence in drinking water distribution systems for human exposure assessment purposes.

During drinking water treatment and distribution, chlorine reacts with organic matter occurring in water to form various chlorination by-products (CBPs) such as trihalomethanes (THMs) and haloacetic acids (HAAs). This paper presents the occurrence of THMs and HAAs in different water distribution systems (DS) of the same region and their modelling for exposure assessment purposes. This study was conducted in eight DS supplying chlorinated water to the population of Québec City, Canada. These systems differ in type of water source (i.e. surface, ground or mixed water), in treatment applied at the plant, and in size and structure of the DS. Two spatio-temporal databases for THMs and HAAs were implemented, one for model development and the other for model validation. The analysis of the data demonstrates significant seasonal and spatial variations of these compounds. A multi-level statistical modelling approach was applied to estimate the ranges for occurrence of THMs and HAAs in the eight DS (i.e. a single model for the study region for each CBP species). The modelling approach integrates available or easily measurable parameters. For both THMs and HAAs, a two-level model considering a sampling-site random effect was selected among various models initially developed. The model capacity for estimating the presence of THMs and HAAs in drinking water and its usefulness for exposure assessment purposes in the studied region was demonstrated.

The assessment of population exposure to chlorination by-products: a study on the influence of the water distribution system

BackgroundThe relationship between chlorination by-products (CBPs) in drinking water and human health outcomes has been investigated in many epidemiological studies. In these studies, population exposure assessment to CBPs in drinking water is generally based on available CBP data (e.g., from regulatory monitoring, sampling campaigns specific to study area). Since trihalomethanes (THMs) and haloacetic acids (HAAs) are the most documented CBP classes in drinking water, they are generally used as indicators of CBP exposure.MethodsIn this paper, different approaches to spatially assign available THM and HAA concentrations in drinking water for population exposure assessment purposes are investigated. Six approaches integrating different considerations for spatial variability of CBP occurrence within different distribution systems are compared. For this purpose, a robust CBP database (i.e., high number of sampling locations selected according to system characteristics) corresponding to nine distribution systems was generated.Results and conclusionThe results demonstrate the high impact of the structure of the distribution system (e.g., presence of intermediary water infrastructures such as re-chlorination stations or reservoirs) and the spatial variability of CBPs in the assigned levels for exposure assessment. Recommendations for improving the exposure assessment to CBPs in epidemiological studies using available CBP data from water utilities are also presented.

Women exposure during pregnancy to haloacetaldehydes and haloacetonitriles in drinking water and risk of small-for-gestational-age neonate

BACKGROUND Past studies have examined the effects of maternal exposure to water chlorination disinfection by-products (DBPs), such as trihalomethanes (THMs) and haloacetic acids (HAAs) during pregnancy. However, no human-based study has yet evaluated the effect of emerging DBPs, such as haloacetaldehydes (HAs) and haloacetonitriles (HANs) on small-for-gestational-age (SGA) status in newborns. OBJECTIVE This study aims to assess the association between maternal multiroute exposure to HAs and HANs during the third trimester of pregnancy and SGA status at birth, among neonates delivered by women residing in the Quebec City area (Province of Quebec, Canada). We also evaluated the interaction between exposure to these emerging unregulated by-products and regulated DBPs also found in drinking water (THMs and HAAs), for which a positive association with adverse reproductive outcomes has been suggested in previous studies. METHODS We conducted a population-based case-control study in the Quebec City area. SGA newborns (n=330) were compared to 1100 controls, with matching based on calendar week of birth. HA and HAN concentrations in drinking water at participants tap were estimated using spatio-temporal strategy based on bimonthly measurements carried out at several locations in the participants distribution system. A computer-assisted telephone interview was completed to collect information on individual habits of water consumption and water related activities in order to determine individual multiroute exposure. This enabled us to estimate the dose of HAs and HANs absorbed daily by each participant. Associations between total HA, HAN concentrations in drinking water and SGA were analyzed. Associations between the daily-absorbed doses of these emerging DBPs and SGA were also analyzed. Odds ratios (ORs) comparing the 4th quartile of exposure to the reference group (the first three quartiles) were obtained by means of conditional logistic regression, and controlling for potential confounders. RESULTS Globally, no evidence of increased risk of SGA was found with total HA and HAN concentrations in tap water when participants in the 4th quartile of exposure were compared to the first three quartiles (OR=1.0; 95% CI [0.7-1.5] and OR=0.8; 95% CI [0.6-1.2], respectively). Similarly, no association was found with the daily-absorbed doses of total HAs or HANs (OR=0.9; 95% CI [0.6-1.3] and OR=1.1; 95% CI [0.7-1.6], respectively). However, a small non statistically significant association was found between the dose of brominated HA and SGA (OR=1.4; 95% CI [0.9-2.1]). Also, in spite of the lack of interaction between other DBP classes, an unexpected negative interaction was observed between concentration of chloral hydrate (CH) (which represents the main HA species), and regulated DBPs (P=0.006). CONCLUSION In this population, exposure to low levels of HAs and HANs during the third trimester of pregnancy through drinking water was not associated to SGA status in newborns. Nonetheless, more research is needed to clarify possible effect of brominated compounds and interaction between different DBPs.

Behavior of non-regulated disinfection by-products in water following multiple chlorination points during treatment.

In this study, the behavior of regulated (trihalomethanes-THMs, haloacetic acids-HAAs) and non-regulated (haloacetonitriles-HANs, haloketones-HKs, chloropicrin-CPK) disinfection by-products (DBPs) was investigated during treatment and distribution in a municipal drinking water system that adds chlorine at multiple points within the water treatment plant (WTP). Three to eight locations in the WTP and four locations in the distribution network were sampled weekly for DBP measurements during the warmest period of the year. The results show that most DBPs found in the study area are formed during treatment, not distribution. However, the DBP species studied behave differently during treatment and distribution. Moreover, the location where DBP concentration is the highest in the distribution network differs among species of the same family, especially HAAs and HKs, and between the sampling campaigns. As a result, the relevance of using the sum of the concentrations of the species of the same DBP family to select sampling sites for DBP monitoring is questionable. This study illustrates the difficulties that drinking water supply managers must face to control and monitor the presence of DBPs.

Assessing regulatory violations of disinfection by-products in water distribution networks using a non-compliance potential index

ABSTRACTInactivating pathogens is essential to eradicate waterborne diseases. However, disinfection forms undesirable disinfection by-products (DBPs) in the presence of natural organic matter. Many regulations and guidelines exist to limit DBP exposure for eliminating possible health impacts such as bladder cancer, reproductive effects, and child development effects. In this paper, an index named non-compliance potential (NCP) index is proposed to evaluate regulatory violations by DBPs. The index can serve to evaluate water quality in distribution networks using the Bayesian Belief Network (BBN). BBN is a graphical model to represent contributing variables and their probabilistic relationships. Total trihalomethanes (TTHM), haloacetic acids (HAA5), and free residual chlorine (FRC) are selected as the variables to predict the NCP index. A methodology has been proposed to implement the index using either monitored data, empirical model results (e.g., multiple linear regression), and disinfectant kinetics through EPANET simulations. The index’s usefulness is demonstrated through two case studies on municipal distribution systems using both full-scale monitoring and modeled data. The proposed approach can be implemented for data-sparse conditions, making it especially useful for smaller municipal drinking water systems.

Estimation of urban water supply issues at the local scale: a participatory approach

Predicted climate change may significantly affect drinking water supply in urban areas. Local water stakeholders facing climate change will have to deal with uncertain information and unexpected events. To address this lack of data, the knowledge and experience of practitioners might be used to assess the potential impacts of climate change on different issues, including drinking water supply. This paper proposes a participatory approach to identify local issues associated with drinking water supply (from source to tap) in a climate change context. This approach relies on the experience and knowledge of local practitioners. The proposed approach was applied to the Québec City metropolitan area (Province of Quebec, Canada). It is based on assignment examples (in this case, a selected set of districts from the study territory) in order to generalize application to the entire territory. This approach helps stakeholders to rationally consider different dimensions and the complexity of drinking water supply.

Chlorination by-product levels in hot tap water: Significance and variability

People are exposed to chlorinated by-products (CBPs) through the consumption of cold tap water (CTW) (ingestion, inhalation, dermal contact) but also through the use of hot tap water (HTW) in such activities as showering and bathing (inhalation, dermal contact). This study focuses on the impact of residential water heating on CBP levels in tap water. Trihalomethane (THM) and haloacetic acid (HAA) levels were measured in the CTW and HTW of 50 residences located in two distribution systems supplied by chlorinated surface water during summer and winter. Results show important differences between CBP levels measured in cold and hot tap water. However, the magnitude of changes differs according to the specific species of THMs and HAAs, the season, the distribution system and the location within the same distribution system. Residential water heating led to an increase in average THM levels for the two distribution systems studied, which tended to be greater in winter. Residential water heating affected the two main HAA species found in the area studied (dichloroacetic (DCAA) and trichloroacetic (TCAA) acids) differently. In fact, the average DCAA levels increased due to water residential heating while a small change in average levels was observed for TCAA. However, the water heating impact on HAAs (in terms of importance and sometimes of tendency (increase vs. decrease)) may also differed between residences. The influence of seasons on the change in the average DCAA and TCAA levels (in μg/L) from residential water heating was not statistically significant except for TCAA levels in one distribution system. Results show the importance of considering site-specific characteristics of CTW (CBP level, temperature, residual chlorine, etc.) to estimate the levels of CBPs in HTW in CBP exposure assessment studies (and not to generalize for an entire population). The reported data can thus be useful in assessing for exposure to DBPs in epidemiological studies.