Safe drinking water has a high priority in Europe according to the Water Framework Directive and the Directive on Quality of Water intended for Human Consumption. Concern has been raised regarding the adverse birth outcomes (e.g. small for gestational age, still birth, spontaneous abortion and congenital anomalies) and cancer (mainly bladder and colon cancer) in relation to disinfection by-products, particular for those countries where chlorination is commonly used. In the USA and Canada there has been considerable progress in the assessment health risks and policy development in relation to the disinfection by-products, including a research program on the occurrence and health risks relation to the by-products by the USEPA’s office on Water and National Health and Environmental Effects Research Laboratory. For example, considerable work has been carried out measuring a range of different disinfection by-products, animal testing of a list of high priority by-products and epidemiological studies. However, results may not be extended to Europe because mixtures of DBPs may be different. In Europe there has been a much slower response to the recent findings. Disinfection is used in many countries in Europe and is therefore of European concern and requests a European approach and solution. The proposed project makes use of the expected differences in disinfection practices and related disinfection by-product levels and mixtures. Furthermore, it aims to bring together scientists, policy makers, industry and consumer representatives to provide European guidelines in this area.

Relatively little research has been carried out on disinfection by-products in relation to adverse birth outcomes and cancer in Europe. Where work has been carried out, this has been carried out in isolation. This proposed work brings together a number of leading researchers in Europe in this area to carry out the research. A concerted European research effort has so far been lacking in this area, resulting in a widening gap of knowledge compared to North America and Japan. A larger number of people including scientists, policy makers, industry and consumer representatives will meet during the proposed open workshop at the end of the project to produce European guidelines and recommendations and set a research agenda for further work. We will identify these people at the beginning of the project, set up a stakeholder forum, and provide them with relevant information during the project (e.g. specific web pages and emails) and will ask their input where necessary. The researchers have complimentary expertise and considerable experience in relevant areas, including exposure assessment, epidemiological and risk/benefit studies of disinfection by-products and microbial contamination. They will be able to input their recent experience of similar studies into the proposed project. The proposed work addresses an important European issue that has lacked the attention and interest it deserves.

The proposed work is likely to lead to a considerable improvement of the quality of life, particularly if it shows associations between particular disinfection by-products and adverse birth outcomes and/or cancer, since this may lead to measures to reduce the disinfection by-product levels and therefore the number of adverse birth outcomes and cancers. The proposed work would not only improve the life of those who would have suffered, but also for family and friends, who often go through traumatic and guilt-ridden experiences. Furthermore, the detailed characterisation of with respect to DBPs will likely benefit other epidemiological studies and prevention of any adverse health effects will lead to an improvement of the quality of life for many people. The risk benefit component includes both risk estimation for DBP and microbial risks and produce robust evidence based estimates, which will lead to an improved risk assessment. The study may lead to a further improvement in the quality of drinking water from the public drinking water supply and therefore reduce the need for, often costly, bottled water, saving money to spend on other needs in life and improving the quality of life. A successful and well conducted study is also likely to lead to an improved perception of science, particularly since a safe drinking water supply is very close to and important for the general public.