Health Effects of Trihalomethanes as Chlorinated Disinfection by Products: A Review Article
Trihalomethanes (THMs) were among the first
disinfection byproducts to be discovered in chlorinated water. The
substances form during a reaction between chlorine and organic
matter in the water. Trihalomethanes are suspected to have negative
effects on birth such as, low birth weight, intrauterine growth
retardation in term births, as well as gestational age and preterm
delivery. There are also some evidences showing these by-products to
be mutagenic and carcinogenic, the greatest amount of evidence being
related to the bladder cancer. However, there exist inconsistencies
regarding such effects of THMs as different studies have provided
different results in this regard. The aim of the present study is to
provide a review of the related researches about the above mentioned
health effects of THMs.
[1] O. Our planet our health: report of the WHO commission health and
environment. World Health Organization, 1992, Geneva.
[2] S. D. Richardson, M. J. Plewa, E. D. Wagner, R. Schoeny, D. M.
DeMarini, Occurrence, genotoxicity, and carcinogenicity of regulated
and emerging disinfection by-products in drinking water: A review and
roadmap for research, 636, PP 178-242, 2007.
[3] S.D. Richardson, "Disinfection by-products and other emerging
contaminants in drinking water", Trends in Analytical Chemistry, vol 22.
no 10, pp. 666- 692, 2003.
[4] G. Becher, "Drinking water chlorination and health", Acta Hydrochem.
Hydrobiol, 27 (1999) 100-102.
[5] J.J. Rook, "Formation of haloforms during chlorination of natural waters,
Water Treat". Exam. Vol 23 pp. 234-243, 1974.
[6] M. Casals, "Trihalomethanes Contaminants in Drinking Water ",
available online at http:// holisticwellnesshow.com/. March 3rd, 2010.
[7] S.D. Richardson, J.E. Simmons, G. Rice, Environ, Sci. Technol. Vol 36,
pp. 198-202, 2002.
[8] F. Benoit, H. Nicolidakis, K. Cardinall, C. Alleyne, B. Mori, Proc. Am.
Soc. Mass Spectrom, pp. 212-215, 1997.
[9] L.C. Backer, D.L. Ashley, M.A. Bonin, F.L. Cardinali, S.M. Kieszak,
J.V.J. Wooten, Expos. Anal. Environ, Epidemiology, vol 10 pp 321-325,
2000.
[10] C.P.Weisel, H. Kim, P. Haltmeier, J.B. Klotz, "Environ. Health Perspect
", vol 107, pp. 103-109, 1999.
[11] H. George, What are Trihalomethanes?, WiseGEEK, 2003.
[12] IARC, Monograph on the Evaluation of Carcinogenic Risk to Human:
Chlorinated Drinking Water, Chloroform By-product, Some Other
Halogenated Compound Cobalt and Cobalt Compound, 52 Lyon IARC,
1991.
[13] S.R. Bielmeier, D.S. Best, D.L. Guidici, M.G. Narotsky, "Pregnancy loss
in the rat caused by bromodichloromethane ", Toxicol. Sci. vol 59, pp
309-315, 2001.
[14] K.Waller, S.H. Swan, G. Delorenze, B. Hopkins, " Trihalomethane in
drinking water and spontaneous abortion ", Epidemiology. Vol 9, pp.
134-140, 1998.
[15] R.S. Marris, A.M. Audet, I.F. Angelildo, T.F. Chalmers, P. Mosteller,
"Chlorination evaluation by product and cancerÔÇöa meta analysis ", Am.
J. Public Health, vol 82, pp. 955-963, 1992.
[16] J. Tibbets, What's in the Water: The Disinfectant Dilemma.
Environmental Health Perspectives 1995. 103(1), available online at:
http://ehpnet1.niehs.nih.gov/members/1995/103-1/focus1.html
[17] M.E. Hildesheim, K.P. Cantor, C.F. Lynch, M. Dosemeci, J. Lubin, M.
Alavanja, & G. Craun Drinking water source and chlorination
byproducts: risk of colon and rectal cancers. Epidemiology, vol 9, no 1,
pp. 28-36, 1998.
[18] McGeehin MA, Reif JS, Becher JC, Mangione EJ, "Case-control study
of bladder cancer and water disinfection methods in Colorado ", Am J
Epidemiol, vol 138, no 7, pp. 492-501, 1993.
[19] W.D. King, L.D. Marrett, Case-control study of bladder cancer and
chlorination by-products in treated water. Cancer Causes and Control,
vol 7, pp. 596-604, 1996.
[20] K.P. Cantor, C.F. Lynch, M. Hildeshiem, Chlorinated drinking water and
risk of glioma: a case-control study in Iowa, USA. Epidemiology, vol 7,
no 4, S83, 1996.
[21] D.M. Parkin, F. Bray, J. Farlay, P. Pisani, Global Cancer Statistics, CA
Cancer J Clin, vol 55, pp. 74-108, 2002.
[22] E.F. Heineman, S.H. Zahm, J.K. Mclaughlin, J.B.Vaught, Increased risk
of colorectal-cancer among smokers-resluts of a 26-year follow-up of
U.S. veterans and a review, Int J Cancer, vol 59, no 6, pp. 728-738, 1994.
[23] P.H. Chyou, A.M. Nomura, G.N. Stemmermann, A prospective study of
colon and rectal cancer amoung Hawaii Japanese men, Ann Epidemiol,
pp 6, no 4, pp. 276-282, 1996.
[24] J.L. Freudenheim, S. Graham, J.R. Marshall, B.P. Haughey, G.
Wilkeson, A case-control study of diet and rectal cancer in Western New
York, Am J Epidemiol, vol 131, no 4, pp. 612-624, 1990.
[25] A. Pedersen, C. Johansen, M. Gronbaek, Relations between amount and
type of alcohol and colon and rectal cancer in a Danish population based
cohort study. Gut, vol 52, no 6, pp. 861-867, 2003.
[26] M.L. Slattery, C. Sweeney, M. Murtaugh, K.N. Ma, B.J. Caan, J.D.
Potter, R.Wolff, Associations between vitamin D, vitamin D receptor
gene and the androgen receptor gene with colon and rectal cancer. Int J
Cancer, vol 118, no 12, pp. 3140-3146, 2006.
[27] E. Weiderpass, H. Vainio, T. Kauppinen, K. Vasama-Neuvonen, T.
Partanen, E. Pukkala, Occupational exposures and gastrointestinal
cancers among Finnish women. J Occup Environ Med, vol 45, no 3, pp.
305-315, 2003.
[28] K.B. Michels, E. Giovannucci, K.J. Joshipura, B.A. Rosner, M.J.
Stampfer, C.S. Fuchs, G.A. Colditz, F.E. Speizer, W.C. Willet,
Prospective study of fruit and vegetable consumption and incidence of
colon and rectal cancers, J Natl Cancer Inst, vol 92, no 21, pp. 1740-
1752, 2000.
[29] A. Chao, M.J. Thun, C.J. Connell, M.L. McCullough, E.J. Jacobs, W.D.
Flanders, C. Rodriguez, R. Sinha, E.E. Calle, Meat consumption and risk
of colorectal cancer, JAMA, vol 293, no 2, pp. 172-182, 2005.
[30] M.E. Hildesheim, et al. "Drinking Water Source and Chlorination Byproducts
II. Risk of Colon and Rectal Cancer". Epidemiology. Vol 9, no
1, pp. 29-35, 1998.
[31] IARC, Monographs on the Evaluation of Carcinogenic Risks to Humans.
Some Chemicals that Cause Tumours of the Kidney or Urinary Bladder
in Rodents and Some Other Substances, International Agency for
Research on Cancer, 73 Lyon, France, 1999.
[32] IARC, Re-evaluation of Some Organic Chemicals, Hydrazine and
Hydrogen Peroxide, International Agency for Research on Cancer,71
Lyon, France, 1999.
[33] IARC, Monographs on the Evaluation of Carcinogenic Risks to Humans.
Coffee, Tea, Mate, Methylxanthines and Methylglyoxal, International
Agency for Research on Cancer, 51Lyon, France, 1991.
[34] D.R. Geter, M.H. George, T.M. Moore, S. Kilburn, G. Huggins-Clark,
A.B. DeAngelo, Vehicle and mode of administration effects on the
induction of aberrant crypt foci in the colons of male F344/N rats
exposed to bromodichloromethane, J. Toxicol. Environ. Health A, vol
67,pp. 23-29, 2005.
[35] IARC, Monographs on the Evaluation of Carcinogenic Risks to Humans.
Some Chemicals that Cause Tumours of the Kidney or Urinary Bladder
in Rodents and Some Other Substances, vol. 73, International Agency for
Research on Cancer, Lyon, France, 1999.
[36] IARC, Monographs on the Evaluation of Carcinogenic Risks to Humans.
Some Chemicals that Cause Tumours of the Kidney or Urinary Bladder
in Rodents and Some Other Substances, vol. 73, International Agency for
Research on Cancer, Lyon, France, 1999.
[37] J.L. Larson, D.C. Wolf, & B.E. Butterworth, Induced cytolethality and
regenerative cell proliferation in the livers and kidneys of male B6C3F1
mice given chloroform by gavage. Fundam Appl Toxicol, vol 23, pp.
537-543, 1994.
[38] J.L. Larson, D.C. Wolf, & B.E. Butterworth, Induced cytotoxicity and
cell proliferation in the hepatocarcinogenicity of chloroform in female
B6C3F1 mice: Comparison of administration by gavage in corn oil vs. ad
libitum in drinking water. Fundam Appl Toxicol, vol 22, no 1, pp. 90-
102, 1994.
[39] D.C. Wolf, B.E. Butterworth, Risk assessment of inhaled chloroform
based on its mode of action, Toxicol. Pathol. Vol 25, pp. 49-52, 1997.
[40] G.C. Hard, G.A. Boorman, D.C. Wolf, Re-evaluation of the 2- year
chloroform drinking water carcinogenicity bioassay in Osborne-Mendel
rats supports chronic renal tubule injury as the mode of action underlying
the renal tumor response, Toxicol. Sci. vol 53, pp. 237-244, 2000.
[41] M.V. Templin, J.L. Larson, B.E. Butterworth, K.C. Jamison, J.R.
Leininger, S. Mery, K.T. Morgan, B.A. Wong, D.C. Wolf, A 90-day
chloroform inhalation study in F-344 rats: profile of toxicity and
relevance to cancer studies, Toxicol. Sci. vol 32, pp. 109-125, 1996.
[42] T.L. Leavens, B.C. Blount, D.M. DeMarini, M.C. Madden, J.L.
Valentine, M.W. Case, L.K. Silva, S.H. Warren, N.M. Hanley, R.A.
Pegram, Disposition of bromodichloromethane in humans following oral
and dermal exposure, Toxicol. Sci. vol 99, pp. 432-445, 2007.
[43] M.K. Ross, R.A. Pegram, In vitro biotransformation and genotoxicity of
the drinking water disinfection byproduct bromodichloromethane: DNA
binding mediated by glutathione transferase theta 1-1, Toxicol. Appl.
Pharmacol. Vol 195, pp. 166-181, 2004.
[44] M.K. Ross, R.A. Pegram, Glutathione transferase theta 1-1- dependent
metabolism of the water disinfection byproduct bromodichloromethane,
Chem. Res. Toxicol. Vol 16, pp. 216-226, 2003.
[45] T. Keegar, H. Whitaker, M.J. Nicewenknijsen, M.B. Toledanar, P.
Ellvot, J. Fawell, M. Wilkirson, N. Best, Use of routinely collected data
on trihalomethane in drinking water for epidemiological purpose, Occup.
Environ. Med. Vol 58, pp. 447-452, 2001.
[46] M.J .Nieuwenhuisjen, M. Toledano, N. Eaton, et al, Chlorination
disinfection by-products in water and their association with adverse
reproductive outcomes: a review. Occup. Environ. Med, vol 57, pp. 73-
85, 2000.
[47] WHO, Guidelines for drinking-water quality, Addendum to Volume 2
(WHO/EOS/98.1): Health criteria and other supporting information,
1998.
[48] J.M. Wright, J. Schwartz , D.W. Dockery, Effect of trihalomethane
exposure on fetal development, Occup Environ Med, vol 60, no 3, pp.
173-80, 2003.
[49] M.I. Cedergren, A.J. Selbing, O. Löfman, B.A. K├ñllen, Chlorination
byproducts and nitrate in drinking water and risk for congenital cardiac
defects, Environ Res, vol 89, pp. 124-130, 2002.
[50] G.M. Shaw, D. Ranatunga, T.Quach, E. Neri, A. Correa, R.R. Neutra,
Trihalomethane exposures from municipal water supplies and selected
congenital malformations. Epidemiology, vol 14, pp. 191-199, 2003.
[51] B.F. Hwang, P. Magnus, J.J.K. Jaakkola, Risk of specific birth defects in
the relation to chlorination and among of the natural organic matter in
the water supply, Am J Epidemiol, vol 156, pp. 374-382, 2002.
[52] M.j. Nieuwenhuijsen, M.B. Toledano, J. Bennett, N. Best, P. Hambly, C.
de Hoogh, D. Wellesley, P.A. Boyd, L. Abramsky, N. Dattani, J. Fawell,
D. Briggs, L. Jarup, P. Elliott, Chlorination disinfection by-products and
risk of congenital anomalies in England and Wales. Environ Health
Perspect, vol 16 pp. 216-222, 2008.
[53] G.R. Klinefelter, J.D. Suarez, N.L. Roberts, & A.B. DeAngelo,
Preliminary screening for the potential of drinking water disinfection by
products to alter male reproduction. Reprod Toxicol, vol 9, pp. 571-578,
1996.
[54] L. Dodds , W. King, Relation between trihalomethane compounds and
birth defects, Occup Environ Med. Vol 58, no 7, pp. 443-446, 2001.
[55] M.J. Plewa, E.D. Wagner, M.G. Muellner, K.M. Hsu, S.D. Richardson,
Comparative mammalian cell toxicity of N-DBPs and C-DBPs, in: T.
Karanfil, S.W. Krasner, P. Westerhoff, Y. Xie (Eds.), Occurrence,
Formation, Health Effects and Control of Disinfection By-products in
Drinking Water, American Chemical Society, Washington, DC, in press.
[56] R.A. Pegram, M.E. Andersen, S.H. Warren, T.M. Ross, L.D. Claxton,
Glutathione S-transferase -mediated mutagenicity of trihalomethanes in
Salmonella typhimurium: contrasting results with bromodichloromethane
or chloroform, Toxicol. Appl. Pharmacol. Vol 144, pp. 183-188, 1997.
[57] D.M. DeMarini, M.L. Shelton, S.H. Warren, T.M. Ross, J.Y. Shim, A.M.
Richard, R.A. Pegram, Glutathione S-transferase- mediated induction of
GC ! AT transitions by halomethanes in Salmonella, Environ. Mol.
Mutagen. Vol 30, pp. 440-447, 1997.
[58] M.J. Plewa, E.D. Wagner, A.C. Kim, R. Nelson, S.D. Richardson,
Mammalian Cell Cytotoxicity and Genotoxicity of New Drinking Water
DBPs, Presentation, Environ. Mutagen Soc. Conf, Miami Beach, FL,
USA, 2003.
[1] O. Our planet our health: report of the WHO commission health and
environment. World Health Organization, 1992, Geneva.
[2] S. D. Richardson, M. J. Plewa, E. D. Wagner, R. Schoeny, D. M.
DeMarini, Occurrence, genotoxicity, and carcinogenicity of regulated
and emerging disinfection by-products in drinking water: A review and
roadmap for research, 636, PP 178-242, 2007.
[3] S.D. Richardson, "Disinfection by-products and other emerging
contaminants in drinking water", Trends in Analytical Chemistry, vol 22.
no 10, pp. 666- 692, 2003.
[4] G. Becher, "Drinking water chlorination and health", Acta Hydrochem.
Hydrobiol, 27 (1999) 100-102.
[5] J.J. Rook, "Formation of haloforms during chlorination of natural waters,
Water Treat". Exam. Vol 23 pp. 234-243, 1974.
[6] M. Casals, "Trihalomethanes Contaminants in Drinking Water ",
available online at http:// holisticwellnesshow.com/. March 3rd, 2010.
[7] S.D. Richardson, J.E. Simmons, G. Rice, Environ, Sci. Technol. Vol 36,
pp. 198-202, 2002.
[8] F. Benoit, H. Nicolidakis, K. Cardinall, C. Alleyne, B. Mori, Proc. Am.
Soc. Mass Spectrom, pp. 212-215, 1997.
[9] L.C. Backer, D.L. Ashley, M.A. Bonin, F.L. Cardinali, S.M. Kieszak,
J.V.J. Wooten, Expos. Anal. Environ, Epidemiology, vol 10 pp 321-325,
2000.
[10] C.P.Weisel, H. Kim, P. Haltmeier, J.B. Klotz, "Environ. Health Perspect
", vol 107, pp. 103-109, 1999.
[11] H. George, What are Trihalomethanes?, WiseGEEK, 2003.
[12] IARC, Monograph on the Evaluation of Carcinogenic Risk to Human:
Chlorinated Drinking Water, Chloroform By-product, Some Other
Halogenated Compound Cobalt and Cobalt Compound, 52 Lyon IARC,
1991.
[13] S.R. Bielmeier, D.S. Best, D.L. Guidici, M.G. Narotsky, "Pregnancy loss
in the rat caused by bromodichloromethane ", Toxicol. Sci. vol 59, pp
309-315, 2001.
[14] K.Waller, S.H. Swan, G. Delorenze, B. Hopkins, " Trihalomethane in
drinking water and spontaneous abortion ", Epidemiology. Vol 9, pp.
134-140, 1998.
[15] R.S. Marris, A.M. Audet, I.F. Angelildo, T.F. Chalmers, P. Mosteller,
"Chlorination evaluation by product and cancerÔÇöa meta analysis ", Am.
J. Public Health, vol 82, pp. 955-963, 1992.
[16] J. Tibbets, What's in the Water: The Disinfectant Dilemma.
Environmental Health Perspectives 1995. 103(1), available online at:
http://ehpnet1.niehs.nih.gov/members/1995/103-1/focus1.html
[17] M.E. Hildesheim, K.P. Cantor, C.F. Lynch, M. Dosemeci, J. Lubin, M.
Alavanja, & G. Craun Drinking water source and chlorination
byproducts: risk of colon and rectal cancers. Epidemiology, vol 9, no 1,
pp. 28-36, 1998.
[18] McGeehin MA, Reif JS, Becher JC, Mangione EJ, "Case-control study
of bladder cancer and water disinfection methods in Colorado ", Am J
Epidemiol, vol 138, no 7, pp. 492-501, 1993.
[19] W.D. King, L.D. Marrett, Case-control study of bladder cancer and
chlorination by-products in treated water. Cancer Causes and Control,
vol 7, pp. 596-604, 1996.
[20] K.P. Cantor, C.F. Lynch, M. Hildeshiem, Chlorinated drinking water and
risk of glioma: a case-control study in Iowa, USA. Epidemiology, vol 7,
no 4, S83, 1996.
[21] D.M. Parkin, F. Bray, J. Farlay, P. Pisani, Global Cancer Statistics, CA
Cancer J Clin, vol 55, pp. 74-108, 2002.
[22] E.F. Heineman, S.H. Zahm, J.K. Mclaughlin, J.B.Vaught, Increased risk
of colorectal-cancer among smokers-resluts of a 26-year follow-up of
U.S. veterans and a review, Int J Cancer, vol 59, no 6, pp. 728-738, 1994.
[23] P.H. Chyou, A.M. Nomura, G.N. Stemmermann, A prospective study of
colon and rectal cancer amoung Hawaii Japanese men, Ann Epidemiol,
pp 6, no 4, pp. 276-282, 1996.
[24] J.L. Freudenheim, S. Graham, J.R. Marshall, B.P. Haughey, G.
Wilkeson, A case-control study of diet and rectal cancer in Western New
York, Am J Epidemiol, vol 131, no 4, pp. 612-624, 1990.
[25] A. Pedersen, C. Johansen, M. Gronbaek, Relations between amount and
type of alcohol and colon and rectal cancer in a Danish population based
cohort study. Gut, vol 52, no 6, pp. 861-867, 2003.
[26] M.L. Slattery, C. Sweeney, M. Murtaugh, K.N. Ma, B.J. Caan, J.D.
Potter, R.Wolff, Associations between vitamin D, vitamin D receptor
gene and the androgen receptor gene with colon and rectal cancer. Int J
Cancer, vol 118, no 12, pp. 3140-3146, 2006.
[27] E. Weiderpass, H. Vainio, T. Kauppinen, K. Vasama-Neuvonen, T.
Partanen, E. Pukkala, Occupational exposures and gastrointestinal
cancers among Finnish women. J Occup Environ Med, vol 45, no 3, pp.
305-315, 2003.
[28] K.B. Michels, E. Giovannucci, K.J. Joshipura, B.A. Rosner, M.J.
Stampfer, C.S. Fuchs, G.A. Colditz, F.E. Speizer, W.C. Willet,
Prospective study of fruit and vegetable consumption and incidence of
colon and rectal cancers, J Natl Cancer Inst, vol 92, no 21, pp. 1740-
1752, 2000.
[29] A. Chao, M.J. Thun, C.J. Connell, M.L. McCullough, E.J. Jacobs, W.D.
Flanders, C. Rodriguez, R. Sinha, E.E. Calle, Meat consumption and risk
of colorectal cancer, JAMA, vol 293, no 2, pp. 172-182, 2005.
[30] M.E. Hildesheim, et al. "Drinking Water Source and Chlorination Byproducts
II. Risk of Colon and Rectal Cancer". Epidemiology. Vol 9, no
1, pp. 29-35, 1998.
[31] IARC, Monographs on the Evaluation of Carcinogenic Risks to Humans.
Some Chemicals that Cause Tumours of the Kidney or Urinary Bladder
in Rodents and Some Other Substances, International Agency for
Research on Cancer, 73 Lyon, France, 1999.
[32] IARC, Re-evaluation of Some Organic Chemicals, Hydrazine and
Hydrogen Peroxide, International Agency for Research on Cancer,71
Lyon, France, 1999.
[33] IARC, Monographs on the Evaluation of Carcinogenic Risks to Humans.
Coffee, Tea, Mate, Methylxanthines and Methylglyoxal, International
Agency for Research on Cancer, 51Lyon, France, 1991.
[34] D.R. Geter, M.H. George, T.M. Moore, S. Kilburn, G. Huggins-Clark,
A.B. DeAngelo, Vehicle and mode of administration effects on the
induction of aberrant crypt foci in the colons of male F344/N rats
exposed to bromodichloromethane, J. Toxicol. Environ. Health A, vol
67,pp. 23-29, 2005.
[35] IARC, Monographs on the Evaluation of Carcinogenic Risks to Humans.
Some Chemicals that Cause Tumours of the Kidney or Urinary Bladder
in Rodents and Some Other Substances, vol. 73, International Agency for
Research on Cancer, Lyon, France, 1999.
[36] IARC, Monographs on the Evaluation of Carcinogenic Risks to Humans.
Some Chemicals that Cause Tumours of the Kidney or Urinary Bladder
in Rodents and Some Other Substances, vol. 73, International Agency for
Research on Cancer, Lyon, France, 1999.
[37] J.L. Larson, D.C. Wolf, & B.E. Butterworth, Induced cytolethality and
regenerative cell proliferation in the livers and kidneys of male B6C3F1
mice given chloroform by gavage. Fundam Appl Toxicol, vol 23, pp.
537-543, 1994.
[38] J.L. Larson, D.C. Wolf, & B.E. Butterworth, Induced cytotoxicity and
cell proliferation in the hepatocarcinogenicity of chloroform in female
B6C3F1 mice: Comparison of administration by gavage in corn oil vs. ad
libitum in drinking water. Fundam Appl Toxicol, vol 22, no 1, pp. 90-
102, 1994.
[39] D.C. Wolf, B.E. Butterworth, Risk assessment of inhaled chloroform
based on its mode of action, Toxicol. Pathol. Vol 25, pp. 49-52, 1997.
[40] G.C. Hard, G.A. Boorman, D.C. Wolf, Re-evaluation of the 2- year
chloroform drinking water carcinogenicity bioassay in Osborne-Mendel
rats supports chronic renal tubule injury as the mode of action underlying
the renal tumor response, Toxicol. Sci. vol 53, pp. 237-244, 2000.
[41] M.V. Templin, J.L. Larson, B.E. Butterworth, K.C. Jamison, J.R.
Leininger, S. Mery, K.T. Morgan, B.A. Wong, D.C. Wolf, A 90-day
chloroform inhalation study in F-344 rats: profile of toxicity and
relevance to cancer studies, Toxicol. Sci. vol 32, pp. 109-125, 1996.
[42] T.L. Leavens, B.C. Blount, D.M. DeMarini, M.C. Madden, J.L.
Valentine, M.W. Case, L.K. Silva, S.H. Warren, N.M. Hanley, R.A.
Pegram, Disposition of bromodichloromethane in humans following oral
and dermal exposure, Toxicol. Sci. vol 99, pp. 432-445, 2007.
[43] M.K. Ross, R.A. Pegram, In vitro biotransformation and genotoxicity of
the drinking water disinfection byproduct bromodichloromethane: DNA
binding mediated by glutathione transferase theta 1-1, Toxicol. Appl.
Pharmacol. Vol 195, pp. 166-181, 2004.
[44] M.K. Ross, R.A. Pegram, Glutathione transferase theta 1-1- dependent
metabolism of the water disinfection byproduct bromodichloromethane,
Chem. Res. Toxicol. Vol 16, pp. 216-226, 2003.
[45] T. Keegar, H. Whitaker, M.J. Nicewenknijsen, M.B. Toledanar, P.
Ellvot, J. Fawell, M. Wilkirson, N. Best, Use of routinely collected data
on trihalomethane in drinking water for epidemiological purpose, Occup.
Environ. Med. Vol 58, pp. 447-452, 2001.
[46] M.J .Nieuwenhuisjen, M. Toledano, N. Eaton, et al, Chlorination
disinfection by-products in water and their association with adverse
reproductive outcomes: a review. Occup. Environ. Med, vol 57, pp. 73-
85, 2000.
[47] WHO, Guidelines for drinking-water quality, Addendum to Volume 2
(WHO/EOS/98.1): Health criteria and other supporting information,
1998.
[48] J.M. Wright, J. Schwartz , D.W. Dockery, Effect of trihalomethane
exposure on fetal development, Occup Environ Med, vol 60, no 3, pp.
173-80, 2003.
[49] M.I. Cedergren, A.J. Selbing, O. Löfman, B.A. K├ñllen, Chlorination
byproducts and nitrate in drinking water and risk for congenital cardiac
defects, Environ Res, vol 89, pp. 124-130, 2002.
[50] G.M. Shaw, D. Ranatunga, T.Quach, E. Neri, A. Correa, R.R. Neutra,
Trihalomethane exposures from municipal water supplies and selected
congenital malformations. Epidemiology, vol 14, pp. 191-199, 2003.
[51] B.F. Hwang, P. Magnus, J.J.K. Jaakkola, Risk of specific birth defects in
the relation to chlorination and among of the natural organic matter in
the water supply, Am J Epidemiol, vol 156, pp. 374-382, 2002.
[52] M.j. Nieuwenhuijsen, M.B. Toledano, J. Bennett, N. Best, P. Hambly, C.
de Hoogh, D. Wellesley, P.A. Boyd, L. Abramsky, N. Dattani, J. Fawell,
D. Briggs, L. Jarup, P. Elliott, Chlorination disinfection by-products and
risk of congenital anomalies in England and Wales. Environ Health
Perspect, vol 16 pp. 216-222, 2008.
[53] G.R. Klinefelter, J.D. Suarez, N.L. Roberts, & A.B. DeAngelo,
Preliminary screening for the potential of drinking water disinfection by
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@article{"International Journal of Earth, Energy and Environmental Sciences:53868", author = "M. R. Mohamadshafiee and L. Taghavi", title = "Health Effects of Trihalomethanes as Chlorinated Disinfection by Products: A Review Article", abstract = "Trihalomethanes (THMs) were among the first
disinfection byproducts to be discovered in chlorinated water. The
substances form during a reaction between chlorine and organic
matter in the water. Trihalomethanes are suspected to have negative
effects on birth such as, low birth weight, intrauterine growth
retardation in term births, as well as gestational age and preterm
delivery. There are also some evidences showing these by-products to
be mutagenic and carcinogenic, the greatest amount of evidence being
related to the bladder cancer. However, there exist inconsistencies
regarding such effects of THMs as different studies have provided
different results in this regard. The aim of the present study is to
provide a review of the related researches about the above mentioned
health effects of THMs.", keywords = "Trihalomethans, by-products, disinfection,carcinogenic", volume = "6", number = "8", pages = "490-7", }
