Age-sex specific and cause-specific health risk and burden of disease induced by exposure to trihalomethanes (THMs) and haloacetic acids (HAAs) from drinking water: An assessment in four urban communities of Bushehr Province, Iran, 2017

Sina Dobaradaran; Elham Shabankareh Fard; Agnes Tekle-Röttering; Mozhgan Keshtkar; Vahid Noroozi Karbasdehi; Mehrnoosh Abtahi; Reza Gholamnia; Reza Saeedi

doi:10.1016/j.envres.2019.109062

Age-sex specific and cause-specific health risk and burden of disease induced by exposure to trihalomethanes (THMs) and haloacetic acids (HAAs) from drinking water: An assessment in four urban communities of Bushehr Province, Iran, 2017

Environ Res. 2020 Mar:182:109062. doi: 10.1016/j.envres.2019.109062. Epub 2019 Dec 21.

Authors

Sina Dobaradaran¹, Elham Shabankareh Fard², Agnes Tekle-Röttering³, Mozhgan Keshtkar², Vahid Noroozi Karbasdehi², Mehrnoosh Abtahi⁴, Reza Gholamnia⁵, Reza Saeedi⁶

Affiliations

¹ Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran; Department of Environmental Health Engineering, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran; The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
² Department of Environmental Health Engineering, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran.
³ Westfälische Hochschule Gelsenkirchen, Neidenburger Strasse 43, Gelsenkirchen, 45877, Germany.
⁴ Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁵ Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Health and Safety, and Environment (HSE), School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁶ Workplace Health Promotion Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Health and Safety, and Environment (HSE), School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: r.saeedi@sbmu.ac.ir.

PMID: 31883495
DOI: 10.1016/j.envres.2019.109062

Abstract

Health risk and burden of disease induced by exposure to trihalomethanes (THMs, four compounds) and haloacetic acids (HAAs, 5 compounds) from drinking water through ingestion, dermal absorption, and inhalation routes were assessed based on one-year water quality monitoring in four urban communities (Bandar Deylam, Borazjan, Bushehr, and Choghadak) of Bushehr Province, Iran. The total average concentrations of THMs and HAAs at all the communities level were determined to be 92.9 ± 43.7 and 70.6 ± 26.5 μg/L, respectively. The dominant components of the THMs and HAAs were determined to be tribromomethane (TBM, 41.6%) and monobromoacetic acid (MBAA, 60.8%), respectively. The average contributions of ingestion, dermal absorption, and inhalation routes in exposure to the chlorination by-products (CBPs) were respectively 65.0, 15.4, and 19.6%. The total average non-carcinogenic risk as the hazard index (HI) and incremental lifetime cancer risk (ILCR) of the CBPs at all the communities level were found to be 4.03 × 10^-1 and 3.16 × 10^-4, respectively. The total attributable deaths, death rate (per 100,000 people), age-weighted disability-adjusted life years (DALYs), and age-weighted DALY rate for all ages both sexes combined at all the communities level were estimated to be 1.0 (uncertainty interval: UI 95% 0.3 to 2.8), 0.27 (0.08-0.75), 30.8 (11.3-100.1), and 8.1 (3.0-26.4), respectively. The average contribution of mortality (years of life lost due to premature mortality: YLLs) in the attributable burden of disease was 94.7% (94.4-95.6). Although in most of cases the average levels of the CBPs were in the permissible range of Iranian standards for drinking water quality, the average values of ILCRs as well as attributable burden of disease were not acceptable (the ILCRs were higher than the boundary limit of 10^-5); therefore, implementation of interventions for reducing exposure to CBPs through drinking water especially in Kowsar Dam Water Treatment Plant is strictly recommended.

Keywords: Disinfection by-product; Drinking water quality; Environmental risk factor; Exposure assessment; Health effect.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Disinfection
Drinking Water*
Female
Humans
Iran
Male
Risk Assessment
Trihalomethanes* / toxicity
Water Pollutants, Chemical* / toxicity
Water Purification*

Substances

Drinking Water
Trihalomethanes
Water Pollutants, Chemical