Justification of temporary deviations in drinking water quality given new scientific data for health risk assessment

Introduction: Since 2024, Russian R 2.1.10.3968-23, Guidelines for assessing health risks from exposure to chemical environmental pollutants, have been in effect, which opens up new opportunities for analyzing adverse human health effects of environmental factors.

Objective: To justify temporary deviations in drinking water quality taking into account new scientific evidence and using the methodology of human health risk assessment.

Materials and methods: For the current study, we selected 214 results of water quality testing before supply to the urban distribution system for the years 2019–2022. The statistical analysis was conducted in Microsoft Excel using descriptive statistical techniques. Temporary deviations were justified for indicators which median values exceeded hygienic standards. Risk assessment was conducted according to both cancelled and updated Guidelines and included substances with established reference doses and carcinogenic potency factors. We calculated carcinogenic risks, non-carcinogenic hazard coefficients and indices using standard exposure factors.

Results: The statistical analysis showed that median levels of boron and magnesium exceeded hygienic standards. According to the results of health risk assessment, values of carcinogenic and non-carcinogenic risks were at an acceptable level. Unacceptable levels were mainly determined for the exposure to arsenic, the concentration of which can be taken as zero in accordance with the new guidelines. Boron exposure did not significantly contribute to risk levels, while for magnesium the reference dose is absent.

Discussion: Questions are raised related to the lack of reference doses for certain chemicals and exclusion of some pollutants from the analysis.

Conclusion: The health risk assessment values calculated in accordance with the updated guidelines are within the acceptable range, indicating that there is no threat to health. This finding supports the establishment of temporary deviations for boron and magnesium.

1. Karelin AO, Yeremin GB. Problems and prospects of using evidence-based medicine in hygiene (systematic review). Gigiena i Sanitariya. 2021;100(8):750-754. (In Russ.) doi: 10.47470/0016-9900-2021-100-8-750-754

2. Karelin AO, Yeremin GB, May IV, Lomtev AYu, Kiselev AV, Mozzhukhina NA. Usage of risk management system for improvement of sanitary-epidemiological control and surveillance. Uchenye Zapiski SPbGMU im. akad. I.P. Pavlova. 2015;22(1):81-85. (In Russ.)

3. Alekseeva AV, Savostikova ON. The threshold of toxicological concern for insufficiently explored chemicals occurring in drinking water during transportation. Health Risk Analysis. 2023;(3):49–61. doi: 10.21668/health.risk/2023.3.06.eng

4. Popova AYu, Gurvich VB, Kuzmin SV, Mishina AL, Yarushin SV. Modern issues of the health risk assessment and management. Gigiena i Sanitariya. 2017;96(12):1125-1129. (In Russ.) doi: 10.18821/0016-9900-2017-96-12-1125-1129

5. Zaitseva NV, Onishchenko GG, May IV, Shur PZ. Developing the methodology for health risk assessment within public management of sanitary-epidemiological welfare of the population. Health Risk Analysis. 2022;(3):4-20. doi: 10.21668/health.risk/2022.3.01.eng

6. Rakhmanin YuA, Dodina NS, Alekseeva AV. Modern methodological approaches to assessing public health risks due to chemicals exposure. Health Risk Analysis. 2023;(4):33–41. doi: 10.21668/health.risk/2023.4.03.eng

7. Bogdanova VD, Alenitckaya MV, Sakharova OB. Analysis of reference doses of chemicals introduced with drinking water. Health Risk Analysis. 2023;(3):49–62. doi: 10.21668/health.risk/2023.3.05.eng

8. Isaev DS, Mozzhukhina NA, Yeremin GB, Krutikova NN. Health risk assessment in towns based on background long-term concentrations of ambient air pollutants. Zdorov’e Naseleniya i Sreda Obitaniya. 2022;30(5):23-31. (In Russ.) doi: 10.35627/2219-5238/2022-30-5-23-31

9. Baken KA, Sjerps RMA, Schriks M, van Wezel AP. Toxicological risk assessment and prioritization of drinking water relevant contaminants emerging concern. Environ Int. 2018;118:293-303. doi: 10.1016/j.envint.2018.05.006

10. Bogdanova VD, Alenitskaya MV, Sahharova OB. Some methodological approaches to assessing health risks related to potable water quality in centralized water supply systems. Zdorov’e Naseleniya i Sreda Obitaniya. 2023;31(1):45-52. (In Russ.) doi: 10.35627/2219-5238/2023-31-1-45-52

11. Isaev DS, Yeremin GB, Mozzhuhina NA, Gribova XA, Stepanyan AA, Buzinov RV. Justification of temporary deviations from the standardized indicators of drinking water quality. Gigiena i Sanitariya. 2023;102(8):868-875. (In Russ.) doi: 10.47470/0016-9900-2023-102-8-868-875

12. Kiku PF, Kislitsyna LV, Bogdanova VD, Sabirova KM. Hygienic evaluation of the quality of drinking water and risks for the health of the population of the Primorye territory. Gigiena i Sanitariya. 2019;98(1):94-101. (In Russ.) doi: 10.18821/0016-9900-2019-98-1-94-101

13. Lead in drinking-water: Health risks, monitoring and corrective actions. Technical brief. Geneva: World Health Organization; 2022. Accessed May 27, 2024. https://www.who.int/publications/i/item/9789240020863

14. Guidelines for drinking-water quality: Fourth edition incorporating the first and second addenda. Geneva: World Health Organization; 2022. Accessed May 27, 2024. https://iris.who.int/bitstream/handle/10665/352532/9789240045064-eng.pdf?sequence=1

15. Water safety plan manual: step-by-step risk management for drinking water suppliers, 2nd ed. Geneva: World Health Organization; 2023. Accessed May 27, 2024. https://www.who.int/publications/i/item/9789240067691

16. Rakhmatullina LR, Suleymanov RA, Valeev TK, Baktybaeva ZB, Rakhmatullin NR. Assessing health risks associated with drinking water quality (on the example of regions in Bashkortostan where oil fields are located). Health Risk Analysis. 2021;(2):34-41. doi: 10.21668/health.risk/2021.2.03.eng

17. Kanatnikova NV, Egorova NA, Zakharchenko GL. Hygienic estimation of subsoil water for public drinking water supply of the city of Orel. Gigiena i Sanitariya. 2015;94(4):32-35. (In Russ.)

18. Leurs LJ, Schouten LJ, Mons MN, Goldbohm RA, van den Brandt PA. Relationship between tap water hardness, magnesium, and calcium concentration and mortality due to ischemic heart disease or stroke in The Netherlands. Environ Health Perspect. 2010;118(3):414-420. doi: 10.1289/ehp.0900782

19. Monarca S, Donato F, Zerbini I, Calderon RL, Craun GF. Review of epidemiological studies on drinking water hardness and cardiovascular diseases. Eur J Cardiovasc Prev Rehabil. 2006;13(4):495-506. doi: 10.1097/01.hjr.0000214608.99113.5c

20. Helte E, Säve-Söderbergh M, Larsson SC, Åkesson A. Calcium and magnesium in drinking water and risk of myocardial infarction and stroke – A population-based cohort study. Am J Clin Nutr. 2022;116(4):1091-1100. doi: 10.1093/ajcn/nqac186

21. Sinitsyna OO, Plitman SI, Ampleeva GP, Gil’denskiol’d OA, Ryashentseva TM. [Specifics of regulating essential elements in drinking water.] In: Zaitseva NV, Popova AYu, eds. Health Risk Analysis – 2020 with the International Meeting on Environment and Health RISE – 2020 and a Round Table on Food Safety: Proceedings of the 10th All-Russian Scientific and Practical Conference, Perm, May 13–15, 2020. Perm: Perm National Research Polytechnic University; 2020;1:41-50. (In Russ.)

22. Sinitsyna OO, Plitman SI, Ampleeva GP, Gil’denskiol’d OA, Ryashentseva TM. Essential elements and standards for their contents in drinking water. Health Risk Analysis. 2020;(3):29–37. doi: 10.21668/health.risk/2020.3.04.eng

23. Environmental Health Criteria 216. Disinfectants and disinfectant-by-products. Geneva: World Health Organization; 2000. Accessed May 27, 2024. https://iris.who.int/bitstream/handle/10665/42274/WHO_EHC_216.pdf?sequence=1

24. Environmental Health Criteria 239. Principles for modelling dose-response for the risk assessment of chemicals. Geneva: World Health Organization, International Programme on Chemical Safety; 2009. Accessed May 27, 2024. https://www.who.int/publications/i/item/9789241572392

25. Solecki R, Davies L, Dellarco V, et al. Guidance on setting of acute reference dose (ARfD) for pesticides. Food Chem Toxicol. 2005;43(11):1569-1593. doi: 10.1016/j.fct.2005.04.005

26. Taylor AA, Tsuji JS, Garry MR, et al. Critical review of exposure and effects: Implications for setting regulatory health criteria for ingested copper. Environ Manage. 2020;65(1):131-159. doi: 10.1007/s00267-019-01234-y

27. Rahaman MS, Rahman MM, Mise N, et al. Environmental arsenic exposure and its contribution to human diseases, toxicity mechanism and management. Environ Pollut. 2021;289:117940. doi: 10.1016/j.envpol.2021.117940

28. Stepanyan AA, Mozzhukhina NA, Yeremin GB, Shilov VV, Isaev DS, Topanov IO. Formation of the chemical composition of natural water in underground water sources used for centralized drinking water supply literature review. Zdorov’e – Osnova Chelovecheskogo Potentsiala: Problemy i Puti Ikh Resheniya. 2022;17(1):270- 277. (In Russ.)