Health risk of swimming pool disinfection by-products: a regulatory perspective

Abstract While disinfection of swimming pools is indispensable for microbiological safety, it may lead to the formation of disinfection by-products. Most studies agree that inhalation exposure is the predominant pathway of the associated health risks, but assumptions are based on concentrations measured in water and evaporation models. Pool water and air were sampled in 19 swimming pools. Trihalomethanes were detected in all sites; chloroform being the most abundant species. Concentrations ranged between 12.8–71.2 μg/L and 11.1–102.2 μg/m3 in pool water and air, respectively. The individual lifetime carcinogenic risk associated with chloroform in swimming pools exceeded 10−6 in all age groups for recreational swimmers and 10−5 for elite swimmers and staff, even if the pool complied with the national standards. Inhalation exposure was estimated and found to be the most relevant, however, different mass transfer models from water measurements significantly under- or overestimated the health burden compared to direct calculation from the concentration in air. The observed health risks call for defining regulatory values and monitoring requirement of indoor air quality in swimming pools.

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Occurrence of Disinfection By-Products in Swimming Pools in the Area of Thessaloniki, Northern Greece. Assessment of Multi-Pathway Exposure and Risk

Molecules ◽

10.3390/molecules26247639 ◽

2021 ◽

Vol 26 (24) ◽

pp. 7639

Author(s):

Akrivi Sdougkou ◽

Kyriaki Kapsalaki ◽

Argyri Kozari ◽

Ioanna Pantelaki ◽

Dimitra Voutsa

Keyword(s):

Management Strategies ◽

Age Groups ◽

Carcinogenic Risk ◽

Quality Parameters ◽

Dermal Absorption ◽

Residual Chlorine ◽

Swimming Pools ◽

Northern Greece ◽

Exposure Routes ◽

By Products

This study investigated the occurrence of disinfection by-products (DBPs) (trihalomethanes (THMs), haloacetic acids (HAAs), halonitriles (HANs), halonitromethane (TCNM) and haloketones (HKs)) in different type of swimming pools in the area of Thessaloniki, northern Greece by employing the EPA methods 551.1 and 552.3. Moreover, general water quality parameters (pH, residual chlorine, dissolved organic carbon, UV254 absorption, total nitrogen, alkalinity and conductivity) were also measured. The concentrations of DBPs showed great variability among swimming pools as well as within the same pool between sampling campaigns. HAAs exhibited the highest concentrations followed by THMs, HANs, TCNM and HKs. Exposure doses for four age groups (3–<6 y, 6–<11 y, 11–<16 y and adults) were calculated. Route-specific exposures varied among DBPs groups. Inhalation was the dominant exposure route to THMs and TCNM (up to 92–95%). Ingestion and dermal absorption were the main exposure routes to HAAs (40–82% and 18–59%, respectively), depending on the age of swimmers. HANs contributed up to 75% to the calculated cytotoxicity of pool water. Hazard indices for different exposure routes were <1, suggesting non-carcinogenic risk. Inhalation posed the higher carcinogenic risk for THMs, whereas risk via oral and dermal routes was low. Ingestion and dermal contact posed the higher risk for HAAs. Risk management strategies that minimise DBPs exposure without compromising disinfection efficiency in swimming pools are necessary.

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An exploration of disinfection by-products formation and governing factors in chlorinated swimming pool water

Journal of Water and Health ◽

10.2166/wh.2018.067 ◽

2018 ◽

Vol 16 (6) ◽

pp. 861-892 ◽

Cited By ~ 4

Author(s):

Huma Ilyas ◽

Ilyas Masih ◽

Jan Peter van der Hoek

Keyword(s):

Water Quality ◽

Dichloroacetic Acid ◽

Swimming Pool ◽

Residual Chlorine ◽

Swimming Pools ◽

Who Guidelines ◽

Global Database ◽

Pool Water ◽

Swimming Pool Water ◽

By Products

Abstract This paper investigates disinfection by-products (DBPs) formation and their relationship with governing factors in chlorinated swimming pools. The study compares concentrations of DBPs with WHO guidelines for drinking water quality recommended to screen swimming pool water quality. The statistical analysis is based on a global database of 188 swimming pools accumulated from 42 peer-reviewed journal publications from 16 countries. The mean and standard deviation of dichloroacetic acid and trichloroacetic acid were estimated as 282 ± 437 and 326 ± 517 μg L−1, respectively, which most often surpassed the WHO guidelines. Similarly, more than half of the examined pools had higher values of chloral hydrate (102 ± 128 μg L−1). The concentration of total chloramines (650 ± 490 μg L−1) was well above the WHO guidelines in all reported cases. Nevertheless, the reported values remained below the guidelines for most of the studied pools in the case of total trihalomethanes (134 ± 160 μg L−1), dichloroacetonitrile (12 ± 12 μg L−1) and dibromoacetonitrile (8 ± 11 μg L−1). Total organic carbon, free residual chlorine, temperature, pH, total nitrogen and bromide ions play a pivotal role in DBPs formation processes. Therefore, proper management of these governing factors could significantly reduce DBPs formation, thereby, contributing towards a healthy swimming pool environment.

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Content of Selected Macro- and Microelements in the Liver of Free-Living Wild Boars (Sus scrofa L.) from Agricultural Areas and Health Risks Associated with Consumption of Liver

Animals ◽

10.3390/ani10091519 ◽

2020 ◽

Vol 10 (9) ◽

pp. 1519

Author(s):

Anna Kasprzyk ◽

Janusz Kilar ◽

Stanisław Chwil ◽

Michał Rudaś

Keyword(s):

Trace Elements ◽

Wild Boar ◽

Health Risks ◽

Age Groups ◽

Carcinogenic Risk ◽

Free Living ◽

Potential Health ◽

Wild Boars ◽

Group I ◽

Agricultural Areas

The aim of the study was to determine the levels of selected toxic and non-toxic elements in the liver of free-living wild boars from agricultural areas and to assess health risks associated with liver consumption. Samples were collected from 70 wild boars. The animals were divided into three age groups (group I up to one year, group II from one to three years, group III over three to five years). It was shown that wild boar liver is a rich source of mineral compounds (K, Fe, Mg, Ca, Zn, and Cu). The age was found to exert an effect on the concentration of most minerals. The sex significantly determined the content of Fe, Ca, and Cd. The maximum allowable level of Cd in the liver was exceeded in two and three samples from groups I and III, respectively. Therefore, regular monitoring of the content of this element in tissues of game animals is extremely important and advisable to assess the consumer exposure to this metal. From the point of view of human health, the estimation of the non-carcinogenic risk indicated that the intake of individual trace elements through the consumption of the liver was safe, whereas consumption of combined trace elements (only in the case of the consumption of the wild boar liver twice a week) suggested a potential health risk to children.

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Pool water disinfection by ozone-bromine treatment: Assessing the disinfectant efficacy and the occurrence and in vitro toxicity of brominated disinfection by-products

Water Research ◽

10.1016/j.watres.2021.117648 ◽

2021 ◽

Vol 204 ◽

pp. 117648

Author(s):

Fatima El-Athman ◽

Lisa Zehlike ◽

Alexander Kämpfe ◽

Ralf Junek ◽

Hans-Christoph Selinka ◽

...

Keyword(s):

Water Disinfection ◽

In Vitro Toxicity ◽

Pool Water ◽

By Products ◽

Disinfectant Efficacy

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Human Health Risk Distribution and Safety Threshold of Cadmium in Soil of Coal Chemical Industry Area

Minerals ◽

10.3390/min11070678 ◽

2021 ◽

Vol 11 (7) ◽

pp. 678

Author(s):

Kai Zhang ◽

XiaoNan Li ◽

ZhenYu Song ◽

JiaYu Yan ◽

MengYue Chen ◽

...

Keyword(s):

Heavy Metal ◽

Health Risk ◽

Human Health ◽

Health Risks ◽

Chemical Industry ◽

Human Health Risk ◽

Oral Intake ◽

Carcinogenic Risk ◽

Kriging Interpolation Method ◽

Industry Area

Cadmium (Cd) is a highly carcinogenic metal that plays an important role in the risk management of soil pollution. In this study, 153 soil samples were collected from a coal chemical plant in northwest China, and the human health risks associated with Cd were assessed through multiple exposure pathways. Meanwhile, by the Kriging interpolation method, the spatial distribution and health risks of Cd were explored. The results showed that the average concentration of Cd in the soil was 0.540 mg/kg, which was 4.821 and 5.567 times that of the soil background value in Ningxia and China, respectively. In comparison, the concentration of Cd in the soil was below the national soil environmental quality three-level standard (1.0 mg/kg). In addition, health risk assessment results showed that the total carcinogenic risk of Cd was 1.269 × 10−6–2.189 × 10−6, both above the acceptable criteria (1 × 10−6), while the hazard quotient was within the acceptable level. Oral intake and ingestion of soil particles were the main routes of exposure, and the carcinogenic risk control value of oral intake was the lowest (0.392 mg/kg), which could be selected as the strict reference of the safety threshold for Cd in the coal chemical soil. From Kriging, a prediction map can be centrally predicted on heavy metal pollution in the area surrounding the coal entrance corridor and pedestrian entrance. This study can provide a theoretical basis for the determination of the heavy metal safety threshold of the coal chemical industry in China.

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Optimal pH in chlorinated swimming pools – balancing formation of by-products

Journal of Water and Health ◽

10.2166/wh.2013.156 ◽

2013 ◽

Vol 11 (3) ◽

pp. 465-472 ◽

Cited By ~ 24

Author(s):

Kamilla M. S. Hansen ◽

Hans-Jørgen Albrechtsen ◽

Henrik R. Andersen

Keyword(s):

Body Fluid ◽

Product Formation ◽

Swimming Pools ◽

Batch Experiments ◽

Ph Values ◽

Precursor Ratio ◽

Decreasing Ph ◽

Ph Range ◽

By Products ◽

Optimal Ph

In order to identify the optimal pH range for chlorinated swimming pools, the formation of trihalomethanes, haloacetonitriles and trichloramine was investigated in the pH-range 6.5–7.5 in batch experiments. An artificial body fluid analogue was used to simulate bather load as the precursor for by-products. The chlorine-to-precursor ratio used in the batch experiments influenced the amounts of by-products formed, but regardless of the ratio the same trends in the effect of pH were observed. Trihalomethane formation was reduced by decreasing pH, but haloacetonitrile and trichloramine formation increased. To evaluate the significance of the increase and decrease of the investigated organic by-products at the different pH values, the genotoxicity was calculated based on literature values. The calculated genotoxicity was approximately at the same level in the pH range 6.8–7.5 and increased when pH was 6.7 or lower. An optimal pH range for by-products formation in swimming pools was identified at pH 7.0–7.2. In the wider pH range (pH 6.8–7.5), the effect on by-product formation was negligible. Swimming pools should never be maintained at lower pH than 6.8 since formation of both haloacetonitriles and trichloramine increase significantly below this value.

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Quantification of doses and health risks to organs and tissues corresponding to different age groups due to radon in water

Journal of Radioanalytical and Nuclear Chemistry ◽

10.1007/s10967-021-08050-x ◽

2021 ◽

Author(s):

Amit Sarin ◽

Anjali Kaushal ◽

Bikramjit Singh Bajwa ◽

Navjeet Sharma

Keyword(s):

Health Risks ◽

Age Groups ◽

Radon In Water

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Evaluation of ultrafiltrated dairy by-products as fat replacers in the production of reduced fat washed curd cheese

10.21203/rs.3.rs-19081/v1 ◽

2020 ◽

Author(s):

Ana Raquel Borges ◽

Arona Figueiroa Pires ◽

Natalí Garcia Marnotes ◽

David Gama Gomes ◽

Marta Fernandes Henriques ◽

...

Keyword(s):

Dry Matter ◽

Cheese Whey ◽

National Standards ◽

Small Scale ◽

Yellow Colour ◽

Fat Replacers ◽

Reduced Fat ◽

Specific Composition ◽

By Products ◽

Small Scale Dairy

Abstract In the present study different dairy by-products were used as ingredients in the production of reduced-fat (RF) washed curd cheeses. Whey, buttermilk and sheep’s second cheese whey, previously concentrated y ultrafiltration (UF), were used envisaging the improvement of texture and flavour of the RF cheeses. UF concentration, is a technique that can be easily available to small scale dairy plants, allowing for the recovery of those dairy by-products. Conventional full-fat (FF) cheeses presented more than 45% fat (d/b) while RF cheeses presented values in the range 20-30%, being in most cases classified as low-fat cheeses according to national standards. The ratio protein in dry matter/fat in dry matter was lower than 1 in FF cheeses and in the range 1.8-2.7 in RF cheeses. The paste of FF cheeses presented a more pronounced yellow colour at the 60th and 90th days of ripening, indicating that fat plays a major role regarding this parameter. The different by-products showed different performances when added to milk used in the production of cheeses. After the 60th day of ripening, FF cheeses and RF cheeses with added buttermilk presented lower values for the hardness of the paste (5.0-7.5 N) when compared to the remaining cheeses. At the end of ripening, chewiness of the paste was also significantly lower in these cheeses. RF cheeses with 5% incorporation of UF concentrated buttermilk presented the best results both concerning texture and sensory evaluation. This fact can be related to the specific composition of buttermilk, namely to its richness in phospholipids.

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Consentimento Informado - Visão e Perspetivas de Adolescentes, Pais e Profissionais: Estudo Multicêntrico em Seis Hospitais

Acta Médica Portuguesa ◽

10.20344/amp.10826 ◽

2019 ◽

Vol 32 (1) ◽

pp. 61 ◽

Cited By ~ 1

Author(s):

Maria do Céu Machado ◽

Rodrigo Sousa ◽

Rosário Stone ◽

Maria Inês Barreto ◽

Filipa Garcês ◽

...

Keyword(s):

Informed Consent ◽

Age Groups ◽

National Standards ◽

Cross Sectional ◽

Information Leaflets ◽

Written Information ◽

Directorate General ◽

Group Information ◽

The Right ◽

Attending Physicians

Introduction: According to the Convention on the Rights of Children and the national standards of the Portuguese Directorate-General for Health, adolescents have the right to make decisions about their own health. The aim of this study was to identify the dynamics of the implementation of assent and informed consent in hospital settings.Material and Methods: Cross-sectional and multicentre study based on surveys, which included adolescents from 14 to 18 years and their parents. Heads of departments of Pediatrics and attending physicians were also interviewed.Results: 194 responses from adolescents and parents were collected, and 46 interviews were conducted with physicians and heads of department. Adolescents and parents consider participation in decision making important, but parents value their own participation significantly higher (91.7% vs 47.8%, p < 0.001 in the 14 - 15 year group, 91.8% vs 53, (89.6% vs 69.6%, p = 0.016 in the 14 - 15 year group, 91.8% vs 69.4%, p = 0.005 in the 16 - 17 years group). Information leaflets are difficult to understand by teenagers. The eight heads of department felt that doctors have awareness towards communication with teenagers but have little time available. Of the 38 attending physicians, 36 said they had learned from their older colleagues and confirmed gaps in postgraduate training.Discussion: This pioneering study in Portugal enabled the identification of areas that can be optimized, through health education programs for parents and adolescents, written information that is adequate to the different age groups, training in undergraduate education for medical students and also education in health institutions for professionals.Conclusion: Adolescents and parents, are unaware of legal and ethical standards for consent and assent. The implementation of the adolescents’ right to informed assent / informed consent was not observed. Our proposal is to implement local programs for adolescents and parents.

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