Nieuwenhuijsen Mark J, Smith Rachel, Golfinopoulos Spyros, Best Nicky, Bennett James, Aggazzotti Gabriella, Righi Elena, Fantuzzi Guglielmina, Bucchini Luca, Cordier Sylvaine, Villanueva Cristina M, Moreno Victor, La Vecchia Carlo, Bosetti Cristina, Vartiainen Terttu, Rautiu Radu, Toledano Mireille, Iszatt Nina, Grazuleviciene Regina, Kogevinas Manolis
Centre for research in Environmental, Epidemiology (CREAL), Parc de Recerca Biomédical de Barcelona-PRBB, Barcelona, Spain.
J Water Health. 2009 Jun;7(2):185-207. doi: 10.2166/wh.2009.073.
There appears to be very good epidemiological evidence for a relationship between chlorination by-products, as measured by trihalomethanes (THMs), in drinking water and bladder cancer, but the evidence for other cancers, including colorectal cancer appears to be inconclusive and inconsistent. There appears to be some evidence for a relationship between chlorination by-products, as measured by THMs, and small for gestational age (SGA)/intrauterine growth retardation (IUGR) and preterm delivery, but evidence for other outcomes such as low birth weight (LBW), stillbirth, congenital anomalies and semen quality appears to be inconclusive and inconsistent.The overall aim of the HIWATE study is to investigate potential human health risks (e.g. bladder and colorectal cancer, premature births, SGA, semen quality, stillbirth, congenital anomalies) associated with long-term exposure to low levels of disinfectants (such as chlorine) and DBPs occurring in water for human consumption and use in the food industry. The study will comprise risk-benefit analyses including quantitative assessments of risk associated with microbial contamination of drinking water versus chemical risk and will compare alternative treatment options. The outcome will be improved risk assessment and better information for risk management. The work is divided into different topics (exposure assessment, epidemiology, risk assessment and management) and studies.
有非常充分的流行病学证据表明，饮用水中以三卤甲烷（THMs）衡量的氯化副产物与膀胱癌之间存在关联，但对于包括结直肠癌在内的其他癌症，证据似乎尚无定论且相互矛盾。有一些证据表明，以THMs衡量的氯化副产物与小于胎龄儿（SGA）/宫内生长迟缓（IUGR）及早产之间存在关联，但对于其他结局，如低出生体重（LBW）、死产、先天性异常和精液质量，证据似乎尚无定论且相互矛盾。HIWATE研究的总体目标是调查长期接触低水平消毒剂（如氯）和饮用水及食品工业用水中出现的消毒副产物（DBPs）可能对人类健康造成的风险（如膀胱癌和结直肠癌、早产、SGA、精液质量、死产、先天性异常）。该研究将包括风险效益分析，包括对饮用水微生物污染相关风险与化学风险的定量评估，并将比较替代处理方案。结果将是改进风险评估并为风险管理提供更好的信息。这项工作分为不同的主题（暴露评估、流行病学、风险评估与管理）和研究。
