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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., (Copyright © 2019 Elsevier Inc. All rights reserved.)

This research evaluates the lifetime cancer risks from trihalomethanes in Tehran's drinking water. The Trihalomethanes were measured in seven different water districts. Sixty-three samples were taken from tap water across the city for 7 months. The samples were analyzed for trihalomethanes using US EPA method 524.2. The average concentration of total trihalomethanes in different districts were between 0.81 and 9.0 μg/L, and the highest concentrations were detected in district 2 at 19.5 μg/L. Total lifetime cancer risks assessment from exposure to trihalomethanes in drinking water (ingestion, inhalation, and skin routes) were performed for people living in different districts in Tehran. The lifetime cancer risk was 7.19 × 10(-5) in district 2 (a more affluent neighborhood) where mostly surface water sources is used to supply drinking water and 9.38 × 10(-6) in district 7 (a less affluent neighborhood) which is mainly supplied with well water sources. Based on the population data, the total expected lifetime cancer cases from exposure to trihalomethanes are 104, 108, 81, 81, 41, 27, and three for districts 1 through 7, respectively. The average lifetime cancer risk was 4.33 × 10(-5) which means a total of 606 lifetime cancer cases for the entire province of Tehran. The highest risk from THMs seems to be from the inhalation route followed by ingestion and dermal contacts.