Water and Health Laboratory, Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus.
Chemical Engineering Department, Kuwait University, Kuwait City, Kuwait.
J Expo Sci Environ Epidemiol. 2018 Mar;28(2):140-146. doi: 10.1038/jes.2017.27. Epub 2017 Oct 18.
The Eastern Mediterranean and the Middle Eastern regions are both understudied in terms of possible environmental health risks for their populations. Water scarcity and desalination treatment provide the general population of countries from these regions (e.g., Kuwait and Cyprus) with unique tap water characteristics. This study investigated the association between external (tap water and 24 h personal air samples) and internal (urine) THM exposure metrics that reflected information about THM-related habits and activities collected using questionnaires and time activity diaries. The study population comprised of young females residing in either Kuwait (n=13) or Cyprus (n=22). First morning urine voids were collected on 2 consecutive days. Urinary creatinine-adjusted total THM (TTHM) levels were higher in Kuwait (median (interquartile range): 1044 (814, 1270) ng/g) than in Cyprus (691 (510, 919) ng/g, P<0.05). Median personal air TTHM levels in Kuwait (1.4 (0.7, 1.7) μg/m) were higher than those in Cyprus (0.9 (0.5, 1.4) μg/m), but did not reach statistical significance (P=0.17). Median tap water TTHM in Kuwait (6.7 (5.4, 11.6) μg/l) did not correlate with urinary or air THM and they were lower than those in Cyprus (29.5 (20.1, 48.0) μg/l; P<0.01). Despite that tap water did not contain chloroform (TCM), TCM was detected in both air and urine samples in Kuwait, suggesting other TCM exposure sources, such as household cleaning activities. Total duration of activities and mopping were significantly correlated with air and urine THM in Kuwait, as reported in the time activity diary. Personal air and urine exposure metrics were correlated in Kuwait (TTHM ρ=0.62, P<0.05), but not in Cyprus (TTHM ρ=-0.32, P>0.05). Time-activity diaries and urinary THM seemed to be useful measures of THM exposures in Kuwait. Coupling both external with internal exposure metrics could find use in population health studies towards further refining the association between environmental exposures and health outcomes.
在中东和地中海东部地区，有关这些地区人群可能面临的环境健康风险的研究还很不足。水资源短缺和海水淡化处理为来自这些地区的国家的普通民众（例如科威特和塞浦路斯）提供了具有独特自来水特性的水。本研究调查了外部（自来水和 24 小时个人空气样本）和内部（尿液）三卤甲烷（THM）暴露指标之间的关联，这些指标反映了使用问卷和时间活动日记收集的与 THM 相关的习惯和活动信息。研究人群包括居住在科威特（n=13）或塞浦路斯（n=22）的年轻女性。连续两天采集早晨第一次尿液。科威特的晨尿中总三卤甲烷（TTHM）水平（中位数（四分位距）：1044（814，1270）ng/g）高于塞浦路斯（691（510，919）ng/g，P<0.05）。科威特的个人空气 TTHM 中位数（1.4（0.7，1.7）μg/m）高于塞浦路斯（0.9（0.5，1.4）μg/m），但未达到统计学意义（P=0.17）。科威特自来水 TTHM 的中位数（6.7（5.4，11.6）μg/l）与尿液或空气 THM 不相关，且低于塞浦路斯（29.5（20.1，48.0）μg/l；P<0.01）。尽管自来水中不含三氯甲烷（TCM），但在科威特的空气和尿液样本中均检测到 TCM，表明存在其他 TCM 暴露源，如家庭清洁活动。在科威特，时间活动日记报告的活动总时长和拖地与空气和尿液中的 THM 呈显著相关。科威特的个人空气和尿液暴露指标呈正相关（TTHM ρ=0.62，P<0.05），而塞浦路斯则无相关性（TTHM ρ=-0.32，P>0.05）。时间活动日记和尿液 THM 似乎是科威特评估 THM 暴露的有用指标。将外部和内部暴露指标结合起来，可能有助于进一步研究环境暴露与健康结果之间的关系，为人群健康研究提供帮助。
