Background: Safe drinking water is essential for well-being. Although microbiological contamination remains the largest cause of water-related morbidity and mortality globally, chemicals in water supplies may also cause disease, and evidence of the human health consequences is limited or lacking for many of them.
Objectives: We aimed to summarize the state of knowledge, identify gaps in understanding, and provide recommendations for epidemiological research relating to chemicals occurring in drinking water.
Discussion: Assessing exposure and the health consequences of chemicals in drinking water is challenging. Exposures are typically at low concentrations, measurements in water are frequently insufficient, chemicals are present in mixtures, exposure periods are usually long, multiple exposure routes may be involved, and valid biomarkers reflecting the relevant exposure period are scarce. In addition, the magnitude of the relative risks tends to be small.
Conclusions: Research should include well-designed epidemiological studies covering regions with contrasting contaminant levels and sufficient sample size; comprehensive evaluation of contaminant occurrence in combination with bioassays integrating the effect of complex mixtures; sufficient numbers of measurements in water to evaluate geographical and temporal variability; detailed information on personal habits resulting in exposure (e.g., ingestion, showering, swimming, diet); collection of biological samples to measure relevant biomarkers; and advanced statistical models to estimate exposure and relative risks, considering methods to address measurement error. Last, the incorporation of molecular markers of early biological effects and genetic susceptibility is essential to understand the mechanisms of action. There is a particular knowledge gap and need to evaluate human exposure and the risks of a wide range of emerging contaminants.
1Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; 2IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; 3CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; 4National Institute of Public Health, Athens, Greece; 5Inserm (Institut National de la Santé et de la Recherche Médicale) UMR 1085, IRSET (Institut de Recherche Santé Environnement et Travail), Université de Rennes 1, Rennes, France; 6Imperial College London, Department of Civil and Environmental Engineering, London, United Kingdom; 7Environmental Epidemiology Division, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands; 8Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA; 9Université Laval, Québec, Québec, Canada; 10Institut National de Santé Publique du Québec, Québec, Canada; 11Centre de recherche du Centre hospitalier universitaire (CHU) de Québec, Québec, Canada
Recommended Citation:
Cristina M. Villanueva,1,2,et al. Assessing Exposure and Health Consequences of Chemicals in Drinking Water: Current State of Knowledge and Research Needs[J]. Environmental Health Perspectives,2014-01-01,Volume 122(Issue 3):213