02/24/2009 US EPA COMMON HEALTH QUESTIONS RELATED TO MONOCHLORAMINE 28) Can my doctor tell if my health problems are caused by monochloramine or any other disinfectant in drinking water? A doctor would have difficulty making a direct link between a health problem and monochloramine or any other disinfectant in drinking water. • People are exposed to many chemicals and other irritants in their daily lives and their sensitivity to these agents varies. • EPA's drinking water regulations limit the use of chloramines to levels where no adverse health effects are anticipated. • EPA's regulatory standard for chloramines in drinking water provides a wide margin of safety1 to offset any uncertainties in risk assessments. EPA believes that drinking water disinfected with monochloramine that meets regulatory standards poses no known or anticipated adverse health problems. • Isolated cases of health problems thought to be related to drinking water have been reported and were investigated by CDC.2 • Trichloramine, a chemical that may be formed in swimming pools3, has been linked to skin irritation and breathing problems. • CDC's investigation2 of reports of monochloramine-related breathing problems related to drinking water was unable to draw any conclusions about monochloramine and health effects. Contact your doctor if you think you have a health problem related to drinking water use. • It is important for your doctor to know where and how you believe you were exposed to chloramines (e.g., via drinking water or a swimming pool).4 • Health problems are typically highly diverse in origin, making it difficult for doctors to specify exact causes. • Your doctor should discuss health problems that he/she believes may be related to chloramines in drinking water with the local health department. Additional Supporting Information: 1. For additional information regarding how uncertainty factors (also known as safety factors) are applied to risk assessments to provide a wide margin of safety see: http://epa.gov/risk/dose-response.htm. 2. CDC and EPA conducted a preliminary investigation of reports of monochloramine- related health problems associated with drinking water. The investigation consisted of a questionnaire filled out by complainants. The information collected can be used to help design future epidemiologic studies. CDC's trip report can be found at: http://healthvermont.gov/enviro/water/documents/CDC Chloramines report 011608.pdf. 3. Improper pool maintenance can often lead to trichloramine formation: Some examples include: www.cdc.gov/niosh/hhe/reports/pdfs/2007-0163-3062.pdf and www.cdc.gov/mmwR/PDF/wk/mm5636.pdf. 4.. See question 1 for a discussion of the different types of chloramines. ------- |