Chloramine, and Health: What Is Known – Confusion and Clarity

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Chloramine, and Health What Is Known Confusion
and Clarity

• Jeffrey K. Griffiths, MD MPHTM
• Professor of Public Health, Tufts Univ.
• Chair, US EPA Drinking Water Committee

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Some history

• Chloramines have been used as a secondary
  disinfectant since the early 1900s (gt90 years).
  During WWII, ammonia was needed for the war
  effort (explosives) so many utilities switched to
  chlorine from chloramine.
• gt 20 of US citizens drink water treated with
  chloramines.

Treatment Plant Filter Disinfect
Pipes the Distribution System
SOURCE WATER
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Chlorine

• Water has to be disinfected or else we get
  infections from the water system. Chlorine was
  the first disinfectant with wide use 1900
• Chlorine not only kills microbes, it reacts with
  organic matter in water and creates disinfection
  byproducts (DBPs) which cause bladder cancer.
  There are strong suggestions (but not proof) that
  DBPs can cause fetal nervous system problems, and
  miscarriages.
• Led to changes in drinking water standards.

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Why use chloramine?

• Chloramine leads to much less formation of DBPs
  with a different spectrum than chlorine. It
  should thus cause less cancer.
• It is less reactive than chlorine, yet remains
  active in water for a longer period of time.
  These two factors balance out for disinfection
  (around longer, less reactive similar result).
• Chloramine technically monochloramine has
  little if any adverse taste or smell.

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Chlorine versus Chloramine

• Top arrow chlorine inactivated, no power to kill
  microbes at end of water delivery pipe.
  Cancer-causing DBPs increase over time.
• Bottom arrow chloramine still present, killing
  microbes at end of water delivery pipe

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Mono, di, and tri-chloramine

• Chloramine results from the combination of
  chlorine and ammonia. If you use a lot of
  ammonia, you get monochloramine.
• HOCl plus NH3 NH2Cl and H2O
• If you use a little ammonia and a lot of
  chlorine, you get dichloramine trichloramine.
  Trichloramine is the chlorine smell at swimming
  pool often a lot of chlorine is added and a
  little ammonia is present (pee).

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pH and Monochloramine

• If the pH of water is above 7 (neutral) then you
  naturally have monochloramine the chloramine
  as used by water industry
• If pH is lower, get bi- and tri-chloramines.
• Drinking water is pH adjusted.

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Health impacts monochloramine

• There is no evidence of skin problems because of
  monochloramines. Public health officials
  investigated in San Francisco and in Vermont
  where complaints were made could find no
  evidence this was the case.
• Chloramine-T (N-chloro tosylamide sodium salt) is
  a sulfonamide - not monochloramine. It is used to
  treat diseases in fish, and has been rarely
  reported to cause eczema.

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Health impacts monochloramine

• Chlorine and monochloramine can react with your
  blood if you are on hemodialysis. They can harm
  fish as they enter their blood through their
  gills. Chlorine or chloramine should be removed
  from dialysis water or aquarium water.
• Trichloramine, not monochloramine, can irritate
  the lungs cause asthma-like symptoms.
• Monochloramine may allow more leaching of lead
  into water than chlorine if you have lead pipes.

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Washington DC , Lead, and Chloramine

• In Washington DC, use of chloramine dropped DBPs
  from 75 ppb to 40 ppb on average (good).
• Water Authority did not optimize the use of
  orthophosphate, a corrosion inhibitor.
  Ortho-phosphate forms a protective coating inside
  pipes and decreases the leaching of lead. They
  were warned they had to pay attention to this but
  they did not pay attention.
• Lower DBPs high levels of lead in water (bad)

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Once corrosion control in place, lead levels
dropped in Wash. DC water
Washington DC Water and Sewer Authority, Drinking
Water Quality Report 1999-2006
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Chloramine Summary

• Does not cause asthma cause skin disease cause
  cancer harm plants or soil watered with it have
  a nasty smell make you lose your hair.
• Does lower cancer-causing DBPs (decreases it
  significantly) mobilize lead from lead solder or
  pipes more than chlorine unless lead corrosion
  control in place.
• Unknowns What residual risk exists from the DBPs
  which are made? (similar to chlorine where we
  still have unanswered questions)