Project #4530

Evidence for Association of Human Bladder Cancer with Chlorination Disinfection By-Products

Principal Investigator
Research Manager
Dr. Djanette Khiari
Steve E. Hrudey & Associates


The Water Research Foundation and the American Water Works Association commissioned this project to address three fundamental questions regarding disinfection by-products (DBPs):

  1. What are the qualitative strengths and limitations of the evidence for known and/or unidentified chlorination disinfection by-products (CxDBPs) that inform causality of human urinary bladder cancer?
  2. What critical knowledge gaps exist for explaining human urinary bladder cancer risk in relation to drinking water chlorine and/or chloramine-based disinfection practice(s) in the United States?
  3. Does the available evidence support a quantitative and qualitative analysis of CxDBP risk management strategies that will be more accurate and informative for guiding risk management than previously possible with evidence available for developing the current Stage 2 DBP Rule?

Research partner: American Water Works Association. Published in 2015.