氯化消毒副产物的生殖发育毒性

饮水氯化消毒是目前全球应用最广的消毒措施,对氯化消毒副产物对健康的影响应引起足够的重视。本文对氯化消毒副产物的生殖发育毒性从毒理学和流行病学研究方面进行了综述。     

男性生殖健康和男性参与生殖健康研究进展

近 2 0年来 ,生殖健康 ( reproductive health)的概念被介绍到国内 ,并且逐渐被政府和学术界所接纳 ,成为关注的领域和研究的热点。本文就男性生殖健康和男性参与生殖健康的研究进展 ,结合文献复习作一简单回顾 ,以推动世界卫生组织 ( WorldHealth Organization,WHO)和我国卫生部合作项目的实施。概念、内涵和发展1 975年 WHO公告中提出了性健康 ( sexualhealth)的概念 ,“个人的最基本的权利包括性健康的权利和享受并控制性与生殖行为的权利 ,同时要与社会人文道德规范一致。”1 994年后 WHO对 1 988年提出的生殖健康 4个重点领域 ,即…     

饮用水消毒副产物与健康研究进展

当前及今后一段时期内,我国饮用水消毒仍然以加氯消毒为主。而饮水氯化消毒副产物已被证实具有遗传毒性或致癌性、生殖发育毒性等,对人群健康构成潜在威胁。华中科技大学同济医学院公共卫生学院鲁文清教授长期从事饮水氯化消毒副产物与健康研究,主持开展多项国家级重点科研项目,取得重要进展。本刊特邀鲁文清教授就近期研究成果组织整理,进行集中报道,以推动该研究的深入发展。     

饮用水消毒副产物暴露评价研究进展

介绍了饮用水消毒副产物暴露评价的基本定义,对饮用水暴露评价的主要消毒副产物进行了归纳总结,综述了现阶段饮用水消毒副产物暴露评价方法的进展及不足,并结合具体案例对饮用水消毒副产物暴露评价的具体步骤进行较为详细阐述,并对饮用水消毒副产物暴露评价研究的发展趋势及将来研究的重点进行了展望。     

饮用水氯化消毒副产物对人体健康的影响

饮用水消毒始于上世纪初，消毒的目的在于杀灭水中病原体、防止介水传染病（waterborne disease）的传播和流行。目前世界上用于饮用水消毒的方法主要有氯化消毒、二氧化氯消毒、紫外线消毒和臭氧消毒，其中，氯化消毒使用最早，已成功地应用了一个多世纪，至今仍为许多国家广泛采用，成为保证饮水流行病学安全的主要措施。     

饮用水中消毒副产物研究进展

从饮用水中消毒副产物 (DBPS)种类、毒性、流行病学调查以及饮用水中的分布状况 ,综述了DBPS研究的进展 ;并且从相应的卫生标准或限量值的制定以及去除方法等方面 ,综述了管理和治理情况。结果发现 ,经加氯消毒后的饮用水中DBPS 的种类很多 ,饮用水中存在的主要物质为三卤甲烷和卤乙酸类的物质 ,对人体毒性较大的物质是三卤甲烷、卤乙酸、溴酸盐和亚氯酸盐。国内外饮用水中DBPS 卫生标准或限量值在不断修改或补充 ,监测指标在不断增多 ,限量值在不断加严 ,其目的是利用消毒剂消灭病原体的同时 ,将其对人体危害降至最低。     

饮用水氯化消毒副产物与出生缺陷

饮用水氯化消毒处理过程中可形成多种类型的消毒副产物(DBPs)．包括三卤甲烷、卤代乙酸、卤代乙腈、卤代酮及氯代呋喃酮等。一系列研究显示DBPs与神经管缺陷、先天性心脏病、泌尿系统畸形、头面部缺陷等有相关性。但是．以往的一些研究无法正确估计暴露水平及各种DBPs之间或与饮水中其他物质之间的联合作用。因此．有必要通过正确的暴露估计和流行病学研究及合理的毒理学试验．深入探索氯化消毒副产物对出生缺陷的影响。     

男性生殖健康和男性参与生殖健康研究进展(二)

男性参与生殖健康1 991年初美国福特基金会 ( Ford Fund)开始与中国有关方面探讨在云南省建立新的生殖健康项目。当时发现 ,“reproductive health”的中译名表述 ,没有一个适当的词汇 ,能使官员、专家和基层卫生技术人员达成共识 ,以开始着手“参与性研究”。最后经过集中讨论 ,使用“生育健康”的译名。云南妇女生育健康和发展项目 ( women sreproductive health development project,WRHDP)在澄江县和陆良县对农村妇女进行了生育健康的需求评估 ( needs assessment) ,从社会、文化、资源、性别、经济、社区和健康的不同层面取得了丰富…     

襄阳市城区生活饮用水中氯化消毒副产物暴露水平及健康风险评价

目的 了解襄阳市城区生活饮用水消毒副产物暴露水平,评价其人群健康风险,为饮用水安全风险管控提供参考依据.方法 根据国标方法采样和实验室检测,利用美国环境保护署USEPA提供的评估模型进行风险评价.结果 襄阳市生活饮用水中三氯甲烷、二氯一溴甲烷、一氯二溴甲烷、三溴甲烷均有检出.经液氯消毒的水中卤代烃类消毒副产物含量大于二...     

不可忽视男性生殖健康

<正> 男性生殖科学成为一门系统学科,在世界历史上也不过30年。男性生殖健康所关心的问题包括计划生育、性传播疾病的预防和治疗、性行为和性机能障碍、不育症、泌尿科疾病等。男性生殖科学的发展不仅需要国内外男科学家们付出艰苦的努力,同时也需要全社会的共同参与,男性要重视自身的生殖健康,从社会与家庭的位置中真正认识到男性是人类的一半。     

次氯酸钠与液氯消毒效果及消毒副产物对比分析

目的 研究水厂消毒方式由液氯转变为次氯酸钠后对出厂水消毒效果与消毒副产物的影响.方法 采集6家水厂转变消毒方式前后出厂水水样共22份,检测消毒效果与13种消毒副产物的指标水平.结果 两种消毒方式出厂水消毒效果与13项消毒副产物指标均合格;次氯酸钠消毒出厂水中游离余氯、一氯二溴甲烷、二氯一溴甲烷、三溴甲烷、三卤甲烷、三氯...     

860例男性生殖健康状况和需求调查

目的为了解男性生殖健康状况和服务需求,探讨男性生殖健康最佳咨询和服务模式。方法从增城市随机抽取城区、乡镇、农村共860名成年男性进行问卷调查。结果成年男性普遍缺乏生殖健康知识和必备的保健意识,存在不同的生殖健康问题,希望获得更多的生殖健康知识和有效的咨询服务。结论通过多途径大力宣传生殖健康保健知识,发挥计生服务网络和妇幼保健网络优势,为不同年龄段男性提供满意安全的生殖健康咨询服务。     

Genotoxic Effects in Swimmers Exposed to Disinfection By-products in Indoor Swimming Pools

Background

Exposure to disinfection by-products (DBPs) in drinking water has been associated with cancer risk. A recent study (Villanueva et al. 2007; Am J Epidemiol 165:148–156) found an increased bladder cancer risk among subjects attending swimming pools relative to those not attending.

Objectives

We evaluated adults who swam in chlorinated pools to determine whether exposure to DBPs in pool water is associated with biomarkers of genotoxicity.

Methods

We collected blood, urine, and exhaled air samples from 49 nonsmoking adult volunteers before and after they swam for 40 min in an indoor chlorinated pool. We estimated associations between the concentrations of four trihalomethanes (THMs) in exhaled breath and changes in micronuclei (MN) and DNA damage (comet assay) in peripheral blood lymphocytes before and 1 hr after swimming; urine mutagenicity (Ames assay) before and 2 hr after swimming; and MN in exfoliated urothelial cells before and 2 weeks after swimming. We also estimated associations and interactions with polymorphisms in genes related to DNA repair or to DBP metabolism.

Results

After swimming, the total concentration of the four THMs in exhaled breath was seven times higher than before swimming. The change in the frequency of micronucleated lymphocytes after swimming increased in association with higher exhaled concentrations of the brominated THMs (p = 0.03 for bromodichloromethane, p = 0.05 for chlorodibromomethane, p = 0.01 for bromoform) but not chloroform. Swimming was not associated with DNA damage detectable by the comet assay. Urine mutagenicity increased significantly after swimming, in association with the higher concentration of exhaled bromoform (p = 0.004). We found no significant associations with changes in micronucleated urothelial cells.

Conclusions

Our findings support potential genotoxic effects of exposure to DBPs from swimming pools. The positive health effects gained by swimming could be increased by reducing the potential health risks of pool water.     

增城市男性生殖健康现状调查研究

目的了解男性生殖健康状况和服务需求,探讨男性生殖健康适宜咨询和服务模式。方法从增城市随机抽取城区、乡镇、农村共860名成年男性进行问卷调查。结果成年男性普遍缺乏生殖健康知识,不同文化程度组间有显著性差异(P<0.05);存在不同的生殖健康问题;勃起功能国际问卷-5(IIEF-5)评分结果得出,男性勃起功能障碍(ED)患病率为36.5%,不同年龄组间ED的患病率及ED程度有显著性差异(P<0.05),且随着年龄的增大ED患病率增高,程度也愈严重;希望获得更多的生殖健康知识和有效的咨询服务。结论全社会应关注男性生殖健康,向他们提供适宜的生殖健康咨询和服务模式。     

Polymorphisms in GSTT1, GSTZ1, and CYP2E1, Disinfection By-products,and Risk of Bladder Cancer in Spain

Background

Bladder cancer has been linked with long-term exposure to disinfection by-products (DBPs) in drinking water.

Objectives

In this study we investigated the combined influence of DBP exposure and polymorphisms in glutathione S-transferase (GSTT1, GSTZ1) and cytochrome P450 (CYP2E1) genes in the metabolic pathways of selected by-products on bladder cancer in a hospital-based case–control study in Spain.

Methods

Average exposures to trihalomethanes (THMs; a surrogate for DBPs) from 15 years of age were estimated for each subject based on residential history and information on municipal water sources among 680 cases and 714 controls. We estimated effects of THMs and GSTT1, GSTZ1, and CYP2E1 polymorphisms on bladder cancer using adjusted logistic regression models with and without interaction terms.

Results

THM exposure was positively associated with bladder cancer: adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were 1.2 (0.8–1.8), 1.8 (1.1–2.9), and 1.8 (0.9–3.5) for THM quartiles 2, 3, and 4, respectively, relative to quartile 1. Associations between THMs and bladder cancer were stronger among subjects who were GSTT1 +/+ or +/− versus GSTT1 null (p_interaction = 0.021), GSTZ1 rs1046428 CT/TT versus CC (p_interaction = 0.018), or CYP2E1 rs2031920 CC versus CT/TT (p_interaction = 0.035). Among the 195 cases and 192 controls with high-risk forms of GSTT1 and GSTZ1, the ORs for quartiles 2, 3, and 4 of THMs were 1.5 (0.7–3.5), 3.4 (1.4–8.2), and 5.9 (1.8–19.0), respectively.

Conclusions

Polymorphisms in key metabolizing enzymes modified DBP-associated bladder cancer risk. The consistency of these findings with experimental observations of GSTT1, GSTZ1, and CYP2E1 activity strengthens the hypothesis that DBPs cause bladder cancer and suggests possible mechanisms as well as the classes of compounds likely to be implicated.     

Thyroid Function of Newborns and Exposure to Chlorine Dioxide By-products

In this study, the authors compared thyroid function of newborns from 11 municipalities where drinking water was disinfected by chlorine dioxide (ClO₂) with that of newborns from 15 municipalities using chlorine disinfection. They estimated the mean neonatal blood thyroid stimulating hormone (TSH) levels and proportion of congenital hypothyroidism cases using the results of the Québec neonatal screening for congenital hypothyroidism for 32,978 newborns over the period 1993–1999. There was no significant increase in the TSH level and no excess of congenital hypothyroidism when all newborns exposed to ClO₂ were considered. However, for newborns with low birth weight, mean TSH level was significantly higher among those exposed to ClO₂ than for those in the reference group.     

Health impacts of long-term exposure to disinfection by-products in drinking water in Europe: HIWATE

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.     

妇女基本生育健康需求评估的两类方法

通过对妇女基本生育健康需求评估的两种方法,即传统的流行病学方法和参与性农村评估(Participatoryrural appraisal,PRA)方法的比较,对两种方法的性质、优缺点进行了评价,认为用流行病学方法评估妇女生育健康的需求只提供了测量需求的一个维度,而PRA方法则提供了另一个维度,只有两种方法结合才能对妇女的需求有客观全面的了解。