Multi-route trihalomethane exposure in households using municipal tap water treated with chlorine or ozone-chlorine

In Korea, data for multi-route trihalomethane (THM) exposure in households using municipal tap water treated with ozone-chlorine or chlorine are unavailable or very limited. Accordingly, the present study was designed to obtain those data by measurements of the THM concentrations in the tap water and indoor and outdoor air in the two types of households, along with an estimation of THM exposure from water ingestion, showering, and the inhalation of indoor air. Chloroform was the most abundant THM in all three media, yet no bromoform was detected in any sample. Similar to previous findings, the winter chloroform concentration in tap water treated with chlorine (22.1 microg/l, median) was significantly higher than that in the tap water treated with ozone-chlorine (16.8 microg/l, median). However, the summer water chloroform concentrations and summer and winter water concentrations of the other two THMs (bromodichloromethane and dibromochloromethane) exhibited no significant difference between the chlorine and ozone-chlorine-treated water. It was suggested that the effects of the water parameters including biochemical oxygen demand of raw water entering water treatment plants should be considered when evaluating the advantage of ozone-chlorine disinfection for THM formation over chlorine disinfection. The indoor air THM concentration trend was also consistent with the water concentration trend. The indoor to outdoor air concentration ratios were comparable with previous studies. The THM exposure estimates from water ingestion, showering, and the inhalation of apartment indoor air when not in the shower suggested that, for residents living in the surveyed households, their exposure to THMs in the home was mostly associated with their household water uses. The THM exposure estimates from tap water ingestion were similar to those from showering.     

Seasonal variation in drinking water concentrations of disinfection by-products in IZMIR and associated human health risks

Seasonal variation in concentrations of two different disinfection by-product groups, trihalomethanes (THMs) and haloacetonitriles (HANs), was investigated in tap water samples collected from five sampling points (one groundwater and four surface water sources) in Izmir, Turkey. Estimates of previously published carcinogenic and non-carcinogenic risks through oral exposure to THMs were re-evaluated using a probabilistic approach that took the seasonal concentration variation into account. Chloroform, bromoform, dibromochloromethane and dichloroacetonitrile were the most frequently detected compounds. Among these, chloroform was detected with the highest concentrations ranging from 0.03 to 98.4 microg/L. In tap water, at the groundwater supplied sampling point, brominated species, bromoform and dibromoacetonitrile, were detected at the highest levels most probably due to bromide ion intrusion from seawater. The highest total THM and total HAN concentrations were detected in spring while the lowest in summer and fall. The annual average total THM concentration measured at one of the surface water supplied sampling points exceeded the USEPA's limit of 80 microg/L. While all non-carcinogenic risks due to exposure to THMs in Izmir drinking water were negligible, carcinogenic risk levels associated with bromodichloromethane and dibromochloromethane were higher than one in million.     

Inhalation exposure to THMs from drinking water in south Taiwan

Trihalomethanes (THMs) are important disinfection byproducts (DBPs) in drinking water. To understand the magnitude of exposure to THMs for the people in southern Taiwan, models are used to estimate the inhalation exposure associated with drinking water based on raw water quality. Two parts of models are used in this study, one for estimating THM concentration from raw water quality, and one for estimating inhalation exposure to people. Important raw water quality and operational parameters, including TOC, UV254, pH, temperature, chlorine dosage, and water residence time of a major water treatment plant in south Taiwan were collected. An empirical THM formation model was then employed to predict the THM concentration at consumers' dwellings based on the parameters collected. Differences between the predicted results and experimental data were found to be small, indicating that the model is appropriate. The predicted THM concentration distribution was served as input parameters for the exposure models. Three major scenarios associated with probable inhalation exposure of THMs, including shower, pre- and post-cooking activities, and cooking processes, were considered in the exposure models. The model results show that the mean inhalation exposure of THMs for shower, pre- and post-cooking activities, and cooking processes are 26.4, 1.56, 3.29 micrograms/day, respectively. The total inhalation exposure (summation of the three scenarios) was found to be comparable with that for direct ingestion, indicating that inhalation is an important pathway for THM exposure from drinking water.     

Trihalomethane exposures in indoor swimming pools: a level III fugacity model

The potential for generation of disinfection byproducts (DBPs) in swimming pools is high due to the concentrations of chlorine required to maintain adequate disinfection, and the presence of organics introduced by the swimmers. Health Canada set guidelines for trihalomethanes (THMs) in drinking water; however, no such guideline exists for swimming pool waters. Exposure occurs through ingestion, inhalation and dermal contact in swimming pools. In this research, a multimedia model is developed to evaluate exposure concentrations of THMs in the air and water of an indoor swimming pool. THM water concentration data were obtained from 15 indoor swimming pool facilities in Quebec (Canada). A level III fugacity model is used to estimate inhalation, dermal contact and ingestion exposure doses. The results of the proposed model will be useful to perform a human health risk assessment and develop risk management strategies including developing health-based guidelines for disinfection practices and the design of ventilation system for indoor swimming pools.     

Occurrence, oral exposure and risk assessment of volatile organic compounds in drinking water for Izmir

Concentrations of volatile organic compounds (VOCs) were measured in the drinking water in Province of Izmir, Turkey, and associated health risks due to ingestion of these compounds were investigated using population weighted random samples. A total of 100 houses were visited in different districts of Izmir and drinking water samples were collected from consumers' drinking water source. Questionnaires were administered to one participant in each house to determine demographics and drinking water consumption rates. Oral exposure and risks were estimated for each participant and Izmir population by deterministic and probabilistic approaches, respectively. The four trihalomethane (THM) species (i.e., chloroform, bromodichloromethane, dibromochloromethane, and bromoform), benzene, toluene, p-xylene, and naphthalene were the most frequently detected VOCs with concentrations ranging from below detection limit to 35 microg/l. The risk estimates were found to be less than the values reported in the literature with few exceptions. Noncarcinogenic risks attributable to ingestion of VOCs for Izmir population were negligible, whereas the mean carcinogenic risk estimates for bromodichloromethane and dibromochloromethane were above the de minimis level of one in a million (10(-6)). For all VOCs, the concentrations measured in metropolitan area were greater than those in other districts. All THM species were detected in higher concentrations in tap water, whereas nontap water contained more benzene, toluene, p-xylene, and naphthalene. Therefore, the concentrations of the latter four compounds and associated risks increased with increasing income and education level since bottled water was used in larger proportions within these subgroups. The results of this study showed that oral exposure to drinking water contaminants and associated risks may be higher than the acceptable levels even if the concentrations fall below the standards.     

Characteristics of trihalomethane (THM) production and associated health risk assessment in swimming pool waters treated with different disinfection methods

Swimming pool water must be treated to prevent infections caused by microbial pathogens. In Korea, the most commonly used disinfection methods include the application of chlorine, ozone/chlorine, and a technique that uses electrochemically generated mixed oxidants (EGMOs). The purpose of this study was to estimate the concentrations of total trihalomethanes (TTHMs) in indoor swimming pools adopting these disinfection methods, and to examine the correlations between the concentrations of THMs and TTHMs and other factors affecting the production of THMs. We also estimated the lifetime cancer risks associated with various exposure pathways by THMs in swimming pools. Water samples were collected from 183 indoor swimming pools in Seoul, Korea, and were analyzed for concentrations of each THM, TOC, and the amount of KMnO₄ consumption. The free chlorine residual and the pH of the pool water samples were also measured. The geometric mean concentrations of TTHMs in the swimming pool waters were 32.9 ± 2.4 µg/L for chlorine, 23.3 ± 2.2 µg/L for ozone/chlorine, and 58.2 ± 1.7 µg/L for EGMO. The concentrations of THMs differed significantly among the three treatment methods, and the correlation between THMs and TTHMs and the other factors influencing THMs varied. The lifetime cancer risk estimation showed that, while risks from oral ingestion and dermal exposure to THMs are mostly less than 10^− 6, which is the negligible risk level defined by the US EPA, however swimmers can be at the greater risk from inhalation exposure (7.77 × 10^− 4-1.36 × 10^− 3).     

Partition coefficients for the trihalomethanes among blood, urine, water, milk and air

Chloroform, bromodichloromethane, chlorodibromomethane, and bromoform comprise the trihalomethanes, a group of widespread and mildly lipophilic compounds that result from water chlorination and other sources. Many animal studies show the chronic toxicity and carcinogenicity of these compounds, and recent work has demonstrated the importance of both ingestion and inhalation exposure pathways. This study presents partition coefficients describing the equilibrium among biological compartments (air, water, blood, milk, urine) for the four THMs based on results of headspace gas chromatographic analyses performed under equilibrium conditions and at 37 degrees C. The calculated partition coefficients ranged from 2.92 to 4.14 for blood/water, 1.54-2.85 for milk/blood, and 3.41-4.93 for blood/urine, with the lowest being chloroform and the highest being bromoform. Both human and cow milk were tested, with similar results. The available samples of human milk may not fully account for differences in lipid content and possibly other factors that affect estimates of partition coefficients. Simultaneous measurements of milk and blood in exposed individuals are suggested to confirm laboratory results. Partition coefficients are predicted using the octanol-air partition coefficient, also measured in this study, and the octanol-water partition coefficient. Results are similar to literature estimates for liquid/air partitioning of chloroform and chlorodibromomethane, but they differ from predictions based on hydrophobicity and lipid content. High correlations between the derived partitioned coefficients and the molecular structure (number of Br atoms) and physical properties (molecular weight and boiling point) are found for these analogous chemicals. In humans, THMs are both stored and metabolized with relatively rapid clearance rates. The derived partition coefficients can help to interpret results of biological monitoring and predict the potential for the accumulation and transfer of chemicals, specifically by the application of physiologically-based pharmacokinetic models. THM exposures to potentially susceptible populations, e.g. nursing infants, can be predicted using either such models.     

Modeling of trihalomethane cometabolism in nitrifying biofilters

The computer program AQUASIM was used to model biofilter experiments seeded with Lake Austin, Texas mixed-culture nitrifiers. These biofilters degraded four trihalomethanes (THMs) (trichloromethane (TCM) or chloroform, bromodichloromethane (BDCM), dibromochloromethane (DBCM), tribromomethane (TBM) or bromoform) commonly found in treated drinking water. Apparent steady-state data from the biofilter experiments and supporting batch experiments were used to estimate kinetic parameters for TCM, DBCM and ammonia degradation. Subsequently, the model was verified against other experimental biofilter data. To allow for full-scale simulations, BDCM and TBM rate constants were estimated using data from batch kinetic studies. Finally, the model was used to simulate full-scale filter performance under different filter surface loading rates and THM speciation seen in practice. Overall, total THM removals ranged from 16% to 54% in these simulations with influent total THM concentrations of 75-82microg/L, which illustrates the potential of THM cometabolism to have a significant impact on treated water quality.     

Risk from exposure to trihalomethanes during shower: Probabilistic assessment and control

Exposure to trihalomethanes (THMs) through inhalation and dermal contact during showering and bathing may pose risks to human health. During showering and bathing, warm water (35 °C-45 °C) is generally used. Warming of chlorinated supply water may increase THMs formation through enhanced reactions between organics and residual chlorine. Exposure assessment using THMs concentrations in cold water may under-predict the possible risks to human health. In this study, THMs concentrations in warm water were estimated by developing a THMs formation rate model. Using THMs in warm water, cancer and non-cancer risks to human health were predicted for three major cities in Ontario (Canada). The parameters for risk assessments were characterized by statistical distributions. The total cancer risks from exposure to THMs during showering were predicted to be 7.6 × 10^− 6, 6.3 × 10^− 6 and 4.3 × 10^− 6 for Ottawa, Hamilton and Toronto respectively. The cancer risks exceedance probabilities were estimated to be highest in Ottawa at different risk levels. The risks through inhalation exposure were found to be comparable (2.1 × 10^− 6-3.7 × 10^− 6) to those of the dermal contact (2.2 × 10^− 6-3.9 × 10^− 6) for the cities. This study predicted 36 cancer incidents from exposure to THMs during showering for these three cities, while Toronto contributed the highest number of possible cancer incidents (22), followed by Ottawa (10) and Hamilton (4). The sensitivity analyses showed that health risks could be controlled by varying shower stall volume and/or shower duration following the power law relationship.     

Risk assessment of exposure to volatile organic compounds in groundwater in Taiwan

The purpose of this study is to assess the risks from exposure to 14 volatile organic compounds (VOCs) in selected groundwater sites in Taiwan. The study employs the multimedia environment pollutant assessment system (MEPAS) model to calculate the specific non-cancer and cancer risks at an exposure level of 1 μg/L of each VOC for a variety of exposure pathways. The results show that the highest specific non-cancer risk is associated with water ingestion of vinyl chloride (VC) and that the highest specific cancer risk is associated with indoor breathing of VC. The three most important exposure pathways for risk assessment for both non-cancer and cancer risks are identified as water ingestion, dermal absorption when showering, and indoor breathing. Excess tetrachloroethylene (PCE), trichloroethylene (TCE), dichloroethylene (DCE), and VC are detected in the groundwater aquifers of one dump site and one factory. However, the study suggests that the pollutants in the contaminated groundwater aquifers do not travel extensively with groundwater flow and that the resulting VOC concentrations are below detectable levels for most of the sampled drinking-water treatment plants. Nevertheless, the non-cancer and cancer risks resulting from use of the contaminated groundwater are found to be hundred times higher than the general risk guidance values. To ensure safe groundwater utilisation, remediation initiatives for soil and groundwater are required. Finally, the study suggests that the current criteria for VOCs in drinking water might not be capable of ensuring public safety when groundwater is used as the primary water supply; more stringent quality criteria for drinking water are proposed for selected VOCs.     

Health-risk assessment for workers exposed to polycyclic aromatic hydrocarbons (PAHs) in a carbon black manufacturing industry.

This study was established to assess workers' health-risks posed by PAHs exposures via both routes of inhalation and dermal contact. Personal inhalation exposure sampling was conducted on eight wet pelletizing workers and 22 packaging workers, by using a sampling train comprising an IOM personal inhalable aerosol sampler followed by an XAD-2 sorbent tube. Two workers were randomly selected from both exposure groups, and dermal exposures assessed by using soft polypropylene pads attached to the skin for nine different body surface areas for each selected worker. All personal inhalation and dermal samples were analyzed for 21 polycyclic aromatic hydrocarbon (PAH) species, and then converted to benzo[a]pyrene equivalent (BaPeq) concentrations by using the list of toxic equivalent factors (TEFs) suggested by Nisbet and LaGoy [Regul Toxicol Pharmocol 16 (1992) 290]. The resultant inhalation and dermal BaPeq exposure levels were used to estimate lifetime risks for lung cancer and skin cancer by using the BaP unit risks of 7.0 x 10(-2) (microg/m3)(-1) and 37.47(mg/kg bodyweight/day)(-1), respectively. Results show the personal inhalation BaPeq exposure levels for pelletizing and packaging workers were 622 and 774 ng/m3, respectively. The corresponding lifetime lung cancer risks estimated for both exposure groups were 4.35 x 10(-2) and 5.42 x 10(-2) respectively. For dermal exposures, results show personal dermal BaPeq exposure levels for both exposure groups were 0.664 and 0.847 microg/kg per day, respectively. The corresponding estimated lifetime skin cancer risks were 1.13 x 10(-3) and 1.56 x 10(-3), respectively. Although the estimated skin cancer risks were lower than the corresponding lung cancer risks for both exposure groups, however, both were higher than the designated significant risk level (= 10(-3)) which was defined by the US Supreme Court in 1980. Considering the bioavailability of particle-bound PAHs still remains unknown, the health risks obtained from this study could be overestimated and thus require further investigation.     

Cometabolism of trihalomethanes by mixed culture nitrifiers

Three mixed-culture nitrifier sources degraded low concentrations (25-450 microg/L) of four trihalomethanes (THMs) (trichloromethane (TCM) or chloroform, bromodichloromethane (BDCM), dibromochloromethane (DBCM), tribromomethane (TBM) or bromoform) commonly found in treated drinking water. Individual THM rate constants (k1THM) increased with increasing THM bromine-substitution with TBM>DBCM>BDCM>TCM and were comparable to previous studies with the pure culture nitrifier, Nitrosomonas europaea. A decrease in temperature resulted in a decrease in both ammonia and THM degradation rates with ammonia rates affected to a greater extent than THM degradation rates. The significant effect of temperature indicates that seasonal variations in water temperature should be a consideration for technology implementation. Product toxicity, measured by transformation capacity (T(c)), was similar to that observed with N. europaea. Because both rate constants and product toxicities increase with increasing THM bromine-substitution, a water's THM speciation is an important consideration for process implementation during drinking water treatment. Even though a given water is kinetically favored, the resulting THM product toxicity may not allow stable treatment process performance.     

Trihalomethanes formation in point of use surface water disinfection with chlorine or chlorine dioxide tablets

In remote or underdeveloped areas, natural disaster emergencies and armed conflict zones, point‐of‐use surface water disinfection with chlorine tablets provides microbiologically safe water, but disinfection by‐products such as trihalomethanes (THMs) are formed. While the health risks from THMs are much less than the risks from consuming microbiologically unsafe water, it is nonetheless desirable to understand and minimise THM formation. We show that THM concentrations in surface water samples from the Northern British Isles disinfected with chlorine tablets increased with contact time, in some cases to significantly exceed EU, US EPA and WHO drinking water guidance values after more than an hour. More stagnant water from ponds and lochs had higher THM formation than river water. Doubling the chlorine tablet dose slightly enhanced THM formation, and passing water through coffee filter paper reduced it. Chlorine dioxide tablets produced minimal amounts of THMs.     

Analysis of trihalomethanes in drinking water using headspace-SPME technique with gas chromatography

In many drinking water treatment plants, the chlorination process is one of the main techniques used for the disinfection of water. This disinfecting treatment leads to the formation of trihalomethanes (THMs) such as chloroform, dichlorobromomethane, chlorodibromomethane and bromoform. In this study, headspace-solid-phase microextraction (HS-SPME, 85 microm carboxen/polydimethylsiloxane fiber) technique was applied for the analysis of THMs in drinking water. The effects of experimental parameters such as kinds of SPME fiber, the volume ratio of sample to headspace, the addition of salts, magnetic stirring, extraction temperature, extraction time and desorption time on the analysis were investigated. Analytical parameters such as linearity, repeatability and limit of detection were also evaluated. The results of THMs from the survey of Seongnam (Korea) drinking water samples showed that the highest total trihalomethane and chloroform were 24.03 and 13.34 microg/l, which were well within the Korean drinking water quality standard of 100 and 80 microg/l, respectively.     

A risk assessment for acrylonitrile in consumer products

A carcinogenic risk assessment for acrylonitrile in consumer products was prepared as part of the Second Workshop on Pragmatics of Risk Assessment, Bethesda, MD. Data from one inhalation and two oral rat bioassays served as input into several high-to-low-dose mathematical risk extrapolation models. The final unit risk estimates for humans were based on maximum likelihood estimates from the Global83 implementation of the multistage model after adjustments for surface area differences, continuous versus intermittent exposures, and the proportion of lifetime exposed. The unit risk estimates for lifetime exposure to 1 mg kg-1 day-1 by inhalation and ingestion were 0.0531 and 0.2385, respectively. These risks are equivalent to risks of 3.3 x 10(-8) for inhalation of 1 ppt in air and 3.4 x 10(-9) for ingestion of 1 ng day.-1     

Investigating effects of bromide ions on trihalomethanes and developing model for predicting bromodichloromethane in drinking water

Chlorination for drinking water can form brominated trihalomethanes (THMs) in the presence of bromide ions. Recent studies have reported that bromodichloromethane (BDCM) has a stronger association with stillbirths and neural tube defects than other THMs species. In this paper, the results of an experimental investigation into the factors forming THMs in the presence of bromide ions are presented. The experiments were conducted using synthetic water samples with different characteristics (e.g., pH, temperature, dissolve organic content). Different combinations of these characteristics were considered in the experimental program. The results showed that increased bromide ion concentrations led to increases in the formation of total THMs, with higher BDCM and dibromochloromethane (DBCM), and lower chloroform formation. By increasing the pH from 6 to 8.5, increased chloroform and decreased BDCM and DBCM formation were observed. Higher bromide ions to chlorine ratios increased BDCM and DBCM and decreased chloroform formation, while higher temperatures increased BDCM, DBCM and chloroform formation. In most cases, bromoform (CHBr₃) concentrations were found to be below the detection limit. Significant factors influencing BDCM formation were identified using a statistical analysis. A model for BDCM formation was estimated from 44 experiments and statistical adequacy was assessed using appropriate diagnostics, including residual plots and an R² of 0.97. The model was validated using external data from 17 water supply systems in Newfoundland, Canada. The predictive performance of the model was found to be excellent, and the resulting model could be used to predict BDCM formation in drinking water and to perform risk-cost balance analyses for best management practices.     

Health risk assessment of personal inhalation exposure to volatile organic compounds in Tianjin, China

Volatile Organic Compounds (VOCs) exposure can induce a range of adverse human health effects. To date, however, personal VOCs exposure and residential indoor and outdoor VOCs levels have not been well characterized in the mainland of China, less is known about health risk of personal exposure to VOCs. In this study, personal exposures for 12 participants as well as residential indoor/outdoor, workplace and in vehicle VOCs concentrations were measured simultaneously in Tianjin, China. All VOCs samples were collected using passive samplers for 5 days and were analyzed using Thermal Desorption GC-MS method. U.S. Environmental Protect Agency's Inhalation Unit Risks were used to calculate the inhalation cancer health risk. To assess uncertainty of health risk estimate, Monte Carlo simulation and sensitivity analysis were implemented. Personal exposures were greater than residential indoor exposures as expected with the exception of carbon tetrachloride. Exposure assessment showed modeled and measured concentrations are statistically linearly correlated for all VOCs (P < 0.01) except chloroform, confirming that estimated personal exposure using time-weighted model can provide reasonable estimate of personal inhalation exposure to VOCs. Indoor smoking and recent renovation were identified as two major factors influencing personal exposure based on the time-activity pattern and factor analysis. According to the cancer risk analysis of personal exposure, benzene, chloroform, carbon tetrachloride and 1,3-butadiene had median upper-bound lifetime cancer risks that exceeded the U.S. EPA benchmark of 1 per one million, and benzene presented the highest median risks at about 22 per one million population. The median cumulative cancer risk of personal exposure to 5 VOCs was approximately 44 per million, followed by indoor exposure (37 per million) and in vehicle exposure (36 per million). Sensitivity analysis suggested that improving the accuracy of exposure measurement in further research would advance the health risk assessment.     

Haloacetic acids in drinking water in the United Kingdom

We measured concentrations of haloacetic acids (HAAs) in the water supply in regions covered by three water companies in the UK Approximately 30 samples in each region were obtained for analysis of both THMs and HAAs to assess the levels of HAAs and the relationship between HAAs and THMs, temperature, pH, free and total chlorine. We have found that there is a range of HAA levels in drinking water with the means ranging from 35-95mug/l and a maximum concentration of 244mug/l. In two out of the three regions there was a high correlation between total THMs and total HAAs, but whereas the HAA and THM levels in one of these companies were approximately equal, in another company the HAA levels were 3-4 times higher than the THM levels. In the third region there was no correlation between total THMs and total HAAs even though the average levels were approximately equal. The ratio of total THM and total HAAs levels was significantly correlated with temperature, pH, free and total chlorine. Overall total THM levels are therefore not considered to be a good indicator of HAA levels. Epidemiological studies using total THM levels should be taking this into account in the interpretation of their results, and regulatory authorities when setting water guidelines.     

Occupational exposure to trihalomethanes in indoor swimming pools

The study evaluated occupational exposure to trihalomethanes (THMs) in indoor swimming pools. Thirty-two subjects, representing the whole workforce employed in the five public indoor swimming pools in the city of Modena (Northern Italy) were enrolled. Both environmental and biological monitoring of THMs exposure were performed. Environmental concentrations of THMs in different areas inside the swimming pools (at the poolside, in the reception area and in the engine-room) were measured as external exposure index, while individual exposure of swimming pool employees was estimated by THMs concentration in alveolar air. The levels of THMs observed in swimming pool water ranged from 17.8 to 70.8 microg/l; the mean levels of THMs in ambient air were 25.6+/-24.5 microg/m3 in the engine room, 26.1+/-24.3 microg/m3 in the reception area and 58.0+/-22.1 microg/m3 at the poolside. Among THMs, only chloroform and bromodichloromethane were always measured in ambient air, while dibromochloromethane was detected in ambient air rarely and bromoform only once. Biological monitoring results showed a THMs mean value of 20.9+/-15.6 microg/m3. Statistically significant differences were observed according to the main job activity: in pool attendants, THMs alveolar air were approximately double those observed in employees working in other areas of the swimming pools (25.1+/-16.5 microg/m3 vs. 14.8+/-12.3 microg/m3, P < 0.01). THMs in alveolar air samples were significantly correlated with THMs concentrations in ambient air (r = 0.57; P < 0.001). Indoor swimming pool employees are exposed to THMs at ambient air levels higher than the general population. The different environmental exposure inside the swimming pool can induce a different internal dose in exposed workers. The correlation found between ambient and alveolar air samples confirms that breath analysis is a good biological index of occupational exposure to these substances at low environmental levels.