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~ ndex A Acetaldehyde, 152- 153 Acetic acid (AA), 134-135 Acetonitrile, 43 Acrolein, 152 Acute effects of chlorophenols, 170- 172 of chloropicrin, 165- 166 of haloacetonitriles, 159 of haloacids, 138- 139 of haloaldehydes, 146-147 of haloketones, 155 of monochloramine, 93-94, 95 of trihalomethanes, 117-118 Ames Salmonella assay, 47-49 Amino acids, 42-45 Ammonia, 14 B Bladder cancer, 2 national study, 57-58, 196-197 Blood urea nitrogen (BUN), 85-86 201 Breakpoint, defined, 82 Breakpoint chlorination, 82 Bromine comparative efficacy, 12 in drinking water disinfection, 13 efficacy in demand-free system, 11 Bromochloroacetonitrile, see Haloacetonitriles C Cancer, bladder, see Bladder cancer Carbon, total organic (TOC), 39-41 Carcinogenicity of chlorate, 108 of chlorite, 108 of chlorophenols, 172 of chloropicrin, 167 of haloacetonitriles, 161 of haloacids, 141 of haloaldehydes, 150-151 of monochloramine, 97 of trihalomethanes, 122- 129 Carcinogens, 80-81 Case-control sampling strategy, 198-199

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202 Index Case-control studies using personal interview, 55-58 Chloral hydrate, 144 See also Haloaldehydes Chloramination, 2, 9, 13-14 chemistry and toxicity of disinfection, 60-66 Chloramine analysis, 61-62 Chloramine B and Chloramine T. 91 Chloramines, 7, 90-99 comparative efficacy, 12 in drinking water disinfection, 13 efficacy in demand-free system, 11 inactivation of Giardia muris cysts, 19 organic, 92 See also Dichloram~ne; Monochloramine Chlorate, 99- 111 carcinogenicity, 108 chronic effects, 107- 108 conclusions and recommendations, 110- 111 developmental effects, 108- 109 health effects in humans, 101-104 health effects in other species, 104-110 metabolism, 100- 101 mutagenicity, 108 NOEL, 110 references, 178-179 reproductive toxicity, 109- 110 SNARL, 110-111 subchronic effects, 104-107 Chloride-36, 93 Chlorination, 1-2, 6-8 breakpoint, 82 by-products, 1-2 conclusions and recommendations on, 190-191 marginal, 82 reactions and by-products, 27-50 toxicity, 45-50 Chlorine, 7, 81-83 in drinking water disinfection, 13 efficacy in demand-free system, 10 free, see Free chlorine health effects in humans, 82 health effects in other species, 82-83 Norwalk agent and, 23-24 references, 173-174 Chlorine demand, 7 Chlorine dioxide, 9, 66, 83-90 comparative efficacy of, 12 conclusions and recommendations on, 89-90 in drinking water disinfection, 13 efficacy in demand-free system, 10 health aspects in humans, 84-87 health aspects in other species, 87-89 inactivation of Giardia muris cysts, 22 metabolism, 84 mutagenicity, 88 NOEL, 90 references, 174-175 reproductive effects, 88 SNARL, 90 subchronic effects, 87-88 teratogenicity, 88-89 use pattern, 66-67 Chlorine disinfectants, inactivation of selected viruses, 23 Chlorine-to-carbon (Cl/C) ratio, 191- 192 Chlorite, 58, 99-111 carcinogenicity, 108 chronic effects, 107- 108 conclusions and recommendations, 110- 111 developmental effects, 108-109 health effects in humans, 101-110 health effects in other species, 104-110 metabolism, 100-101 mutagenicity, 108 NOEL, 110 references, 178-179 reproductive toxicity, 109-110 SNARL, 110-111 subchronic effects, 104- 107 1-Chloro-2,4-dinitrobenzene (DNCB), 134-135 Chloroacetaldehyde, see Haloaldehydes Chloroform, 1, 111 carcinogenic risk for, 131 - 132 generation of, 29 precursors of, 37, 38 2-Chlorophenol, see Chlorophenols tumor incidence with, 131-133 See also Trihalomethanes Chlorophenols, 169- 173 acute effects, 170-172 carcinogenicity, 172 conclusions and recommendations, 172- 173 health effects in other species, 170-172 mutagenicity, 172

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Index 203 NOEL, 173 references, 188- 189 reproductive effects, 170, 172 SNARL, 173 subchronic effects, 170 Chloropicrin, 44, 162- 168 acute effects, 165- 166 carcinogenicity, 167 chemistry and environmental fate, 163- 164 chronic effects, 166 conclusions and recommendations, 168 health effects in humans, 165 health effects in other species, 165-168 metabolism, 164 mutagenicity, 167-168 references, 186-188 subchronic effects, 166 2-Chloropropionate (2-CP), 140 Cholera, 4 Cholinesterase activity, 121 Chronic effects of chlorate, 107- 108 of chlorite, 107- 108 of chloropicrin, 166 of monochloramine, 96 of trihalomethanes, 120- 122 Coagulation, 67 Contaminant level, maximum (MCL), 13 Correlational studies, 51-52 Cytochrome P450, 112- 113 D Deoxyribonucleic acid (DNA), 20 Developmental effects of chlorate and chlorite, 108- 109 Dibromoacetonitrile, see Haloacetonitriles Dibromochloromethane, 111- 112 carcinogenic risk, 133 See also Trihalomethanes Dichloramine comparative efficacy of, 12 See also Chloramines Dichloramine T. 91 Dichloroacetaldehyde, see Haloaldehydes Dichloroacetic acid (DCA), 34-35, 37, 39, 40, 133 See also Haloacids Dichloroacetonitrile, 43-44 See also Haloacetonitriles Dichlorophenols, see Chlorophenols Diethylnitrosamine (DENA), 128-129 Dimethyl sulfoxide (DMSO), 156 N. N' -Diphenyl-p -phenylenediamine (DPPD), 113 Disinfectant by-products, e~ct of, in conjunction with other risk factors for disease, 199-200 Disinfectants approaches to assessment of human health risks, 197- 198 chlorine, inactivation of selected viruses, 23 "life-cycle" studies, 191 selected, chemistry and toxicity, 80- 189 Disinfection chemistry and toxicity, 27-79 conclusions and recommendations, 191-200 methods and efficacy, 4-26 conclusions and recommendations, 190-191 Dowicide 2S, see Chlorophenols Drinking water, see Water entries Dysentery, 4 E Epidemiological observational studies, potential contributions, 200 Epidemiological studies of contaminants, 50-60 case-control studies using personal interview, 55-58 correlational studies, 51-52 groups at increased risk in, 58-60 mortality case-control studies, 52-55 Epidemiology, improvement, 196-200 Erie County, New York, correlational study, 51 Escherichia coli, 16, 21 Ethylnitrosourea (ENU), 126 F Ferrate in drinking water disinfection, 13 Flocculation, 67

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204 Index Free chlorine, 82 inactivation of Giardia lamblia cysts, 17 inactivation of Giardia muris cysts, 18 Fulvic acid, isolated aquatic, 34-42 Furanones, 37 G Giardia lamblia, 15-18, 20, 21 Giardia muris, 16, 18-22 Glucose-6-phosphate dehydrogenase (G-6 PD) deficiency, 58-59 Glutathione S-transferase (GST), 134- 135 Glyoxylate aminotransferase (GAT), 134 H Haloacetonitriles, 156-162 acute effects, 159 carcinogenicity, 161 chemical and physical properties, 157 conclusions and recommendations, 161- 162 health effects in other species, 159- 161 metabolic fate, 158 metabolism, 157-158 mutagenicity in other species, 160-161 NOEL, 161 references, 186 reproductive toxicity, 160 SNARL, 161-162 subchronic effects, 159- 160 Haloacids, 133-143 acute effects, 138- 139 carcinogenicity, 141 conclusions and recommendations, 143 health effects in humans, 136-138 health effects in other species, 138- 142 metabolism, 134- 136 mutagenicity in other species, 141 neurotoxic effects, 141 - 142 NOEL, 143 references, 182- 183 reproductive toxicity, 142 SNARL, 143 subchronic effects, 139- 141 Haloaldehydes, 143-154 acute effects, 146- 147 carcinogenicity, 150-151 conclusions and recommendations, 153- 154 health effects in humans, 146 health effects in other species, 146-153 metabolism, 144-146 mutagenicity, 150 references, 183-185 subchronic effects, 147-150 teratogenicity, 151- 152 Halogen, total organic (TOX), 39-40 Haloketones, 154-156 acute effects, 155 conclusions and recommendations, 156 health effects, 154- 156 mutagenicity, 155-156 references. 185-186 Health effects in humans of chlorate, 101- 104 of chlorine, 82 of chlorine dioxide, 84-87 of chlorite, 101- 104 of chloropicrin, 165 of haloacids, 136- 138 of haloaldehydes, 146 of monochloramine, 93-95 of trihalomethanes, 114- 117 Health effects in other species of chlorate, 104-110 of chlorine, 82-83 of chlorine dioxide, 87-89 of chlorite, 104- 110 of chlorophenols, 170-172 of chloropicrin, 165- 168 of haloacetonitriles, 159- 161 of haloacids, 138- 142 of haloaldehydes, 146- 153 of haloketones, 155- 156 of monochloramine, 95-98 oftrihalomethanes, 117-129 Hepatitis A virus, 14, 15, 22-23 Hepatomegaly, 117 Hexachloroacetone, see Haloketones Humic acid, isolated aquatic, 34-42 Humic molecules, 28-34 Hydrogen peroxide in drinking water disinfection, 13 Hydroxyl type chloroform precursors, 38 Hypochlorite ions, 7-8, 82 comparative efficacy of, 12 Hypochlorous acid, 7-8, 82

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Index 205 comparative efficacy, 12 reaction products, 30 Illinois mortality case-control study, 52-53 Iodine comparative efficacy, 12 in drinking water disinfection, 13 efficacy in demand-free system, 11 Ionizing radiation in drinking water disinfection, 13 Iowa correlational study, 52 L "Life-cycle" studies of disinfectants, 191 Louisiana mortality case-control study, 53 54 M Marginal chlorination, 82 Massachusetts correlational study, 51-52 mortality case-control study, 55 Maximum contaminant level (MCL), 13 Maximum tolerated dose (MTD), 128 Metabolism of chlorate, 100- 101 of chlorine dioxide, 84 of chlorite, 100- 101 of chloropicrin, 164 of haloacetonitriles, 157-158 of haloacids, 134- 136 of haloaldehydes, 144-146 of monochloramine, 91-93 of trihalomethanes, 112- 114 Methemoglobin, 102 Monochloramine, 2, 60-62, 90-99 acute effects in humans, 93-94 acute effects in other species, 95 bactericidal action, 16, 20 carcinogenicity, 97 chronic effects in other species, 96 comparative efficacy, 12 conclusions and recommendations, 98- 99 health effects in humans, 93-95 health effects in other species, 95-98 metabolism, 91-93 mutagenicity, 96-97 NOEL, 99 references, 175-178 SNARL, 99 subchronic effects in humans, 94-95 subchronic effects in other species, 95- 96 teratogenicity, 97-98 See also Chloramines Monochlorophenols, see Chlorophenols Mortality case-control studies, 52-55 Mutagenicity, 45-46 of chlorate, 108 of chlorine dioxide, 88 of chlorite, 108 of chlorophenols, 172 of Chloropicrin 167- 168 of haloacetonitriles, 160- 161 of haloacids, 141 of haloaldehydes, 150 of haloketones, 155- 156 of monochloramine, 96-97 of trihalomethanes, 122 N National Bladder Cancer Study, 57-58, 196-197 Neonates, 59-60 Neurotoxic effects of haloacids, 141-142 New York mortality case-control study, 54-55 Nitrite, 43 Nitrochloroform, see Chloropicrin Nitrochloromethane, see Chloropicrin Nitrogen compounds, organic, 42-44, 62- 66 No-observed-effect level (NOEL), 81 of chlorate, 110 of chlorine dioxide, 90 of chlorite, 110 of chlorophenols, 173 of haloacetonitriles, 161 of haloacids, 143 of monochloramine, 99 North Carolina case-control study using personal interview, 55-56

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206 Index Norwalk virus, 14, 15 chlorine and, 23-24 o Oxidation processes, 67-68 2-Oxothiazolidine-4-carboxylic acid (OTZ), 112 Ozonation, 66 Ozone, 9, 66 comparative efficacy, 12 in drinking water disinfection, 13 efficacy in demand-free system, 10 microorganism inactivation, 21 use pattern, 66-67 Ozone decomposition, 68 p pH conditions, high, in drinking water disinfection, 13 Phenobarbital, 126 Potassium permanganate in drinking water disinfection, 13 Preozonation, 49 Propenals, 152 Pyruvate dehydrogenase (PDH), 134-136 Q Quantification, risk, 80 R Red-blood-cell (RBC) counts, 105, 121 Redox process, 67 Reproductive toxicity of chlorate, 109- 110 of chlorine dioxide, 88 of chlorite, 109- 110 of chlorophenols, 170, 172 of haloacetonitriles, 160 of haloacids, 142 Resorcinol, 29 aqueous chlorination of, 34 reaction products from, 31-33 Ribonucleic acid (RNA), 20 Risk quantification, 80 S Salmonella assay, Ames, 47-49 Second International Symposium on Health Effects of Drinking Water Disinfectants and Disinfection By Products, vii-viii Serum glutamic oxaloacetic transaminase (SCOT), 116, 119 Serum glutamic pyruvate transaminase (SGPT), 116, 119 Short-term exposure limit (STEL), 162 Silver in drinking water disinfection, 13 Sister chromatic exchange (SCE) activity, 48 SNARL, see Suggested no-adverse-effect level Sodium chlorate, see Chlorate Sodium chlorite, see Chlorite Subchronic effects in humans, of monochloramine, 94-95 in other species of chlorate, 104- 107 of chlorine dioxide, 87-88 of chlorite, 104- 107 of chlorophenols, 170 of chloropicrin, 166 of haloacetonitriles, 159- 160 of haloacids, 139- 141 of haloaldehydes, 147- 150 of monochloramine, 95-96 of trihalomethanes, 118- 120 Suggested no-adverse-effect level (SNARL), 81 of chlorate, 110- 111 of chlorine dioxide, 90 of chlorite, 110- 111 of chlorophenols, 173 estimated, 193 of haloacetaonitriles, 161- 162 of haloacids, 143 of monochloramine, 99 Superoxide ion, 68 T Teratogenicity of chlorine dioxide, 88-89 of haloaldehydes, 151 - 152 of monochloramine, 97-98

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Index 207 1,1,3,3-Tetrachloroacetone, see Haloketones Threshold limit value (TLV), 82 Trichloroacetyl type chloroform precursors, 38 Trichloroacetaldehyde, 144 See also Haloaldehydes Trichloroacetic acid (TCA), 34-35, 37, 39, 40, 133, 145-146 See also Haloacids 1, 1,1-Trichloroacetone, see Haloketones Trichloroacetonitrile, see Haloacetonitriles Trichloroethanol (TCEA), 145-146 Trichloroethylene (ICE), 145 Trichloromethane (chloroform), 111 See also Trihalomethanes Trichloromethyl cyanide, see Haloacetonitriles Trichloromethylnitrile, see Haloacetonitriles Trichloronitromethane, see Chloropicrin Trichlorophenols, see Chlorophenols Trihalomethanes (THMs), 1-2, 111-133 acute effects, 117-118 carcinogenicity, 122- 129 chronic effects, 120- 122 conclusions and recommendations, 129- 133 health effects in humans, 114- 117 health effects in other species, 117-129 metabolism, 112- 114 mutagenicity, 122 references, 179- 182 subchronic effects, 118- 120 Tritox, see Haloacetonitriles Typhoid fever, 4 U Ultraviolet (UV) radiation, 20 in drinking water disinfection, 13 V Vapor hazard index, 165 Viruses, 22-24 Vitamin E, 113 W Water collection, 5-6 epidemiological studies, 50-60 See also Epidemiological studies of contaminants mutagenicity of, 45-46 See also Mutagenicity toxicity, 46-50 treatment practices, 6 Water distribution system, 6 Water treatment practices, 6 Waterborne diseases, 4-5 conclusions and recommendations, 190- 191 outbreaks, 14-15 Waterborne pathogens, 14-24 White-blood-cell (WBC) counts, 121 Wisconsin case-control study using personal interview, 56-57 mortality case-control study, 53