2026· Journal of Health Development· Vol 61, pp. jhd077-jhd077· 0 citations
TL;DR
A comparative analysis of international experience in assessing the carcinogenic risks associated with trihalomethanes in drinking water revealed several gaps in research that could affect the assessment of risks associated with exposure to disinfection products.
Abstract
Ensuring the safety of drinking water supply for the population is an important area of modern public health worldwide. In recent years, the risk of potential exposure to chemical compounds in water has increased, which may subsequently have a negative impact on human health in the long term.
The aim of this review: to conduct a comparative analysis of international experience in assessing the carcinogenic risks associated with trihalomethanes in drinking water.
Methods. The review was prepared based on the recommendations of PRISMA. We searched in databases, including Scopus, PubMed, and the WoS, to find scientific articles published from 2015 to 2025 for the following keywords. The selection process included identification, screening, compliance assessment, and inclusion steps. In total, 412 records were checked after the duplicates were removed, of which 298 were excluded, and 26 articles were selected for analysis. The selected publications were subjected to a thorough content analysis, thematic and comparative analysis, with particular attention to regional differences in impact assessment methodologies, regulatory frameworks and monitoring practices, where several thematic groups were identified: impact assessment methods, dose-effect relationship, and comparative analysis of the regulatory framework.
Results. The analysis revealed several gaps in research that could affect the assessment of risks associated with exposure to disinfection products. There is still a need for longitudinal epidemiological studies with long follow-up periods to better characterize long-term risks such as carcinogenic. Epidemiological data from some countries in Central Asia and Eastern Europe remain limited, underscoring need for regional research initiatives and improved monitoring systems. Differences in regulatory standards, monitoring systems, and impact assessment methodologies lead to different approaches to risk management strategies.
Conclusions. Effective risk reduction is achieved through improved water treatment technologies, the introduction of comprehensive monitoring programs and the integration of environmental and human health data. For Central Asian countries, including Kazakhstan, the development of standardized monitoring systems and the strengthening of environmental surveillance systems are important steps towards improving drinking water safety and reducing potential carcinogenic risks.
Keywords: trihalomethanes, drinking water, environmental exposure, water pollutants, malignant neoplasms, carcinogenic risk.
BACKGROUND
Vanadium is a metal naturally occurring in various ecosystems. Both natural and anthropogenic sources contribute to high concentrations in the air, soil, and water. Several experimental and epidemiological studies have linked this exposure to multiple adverse health effects.
OBJECTIVE
To analytically synthesize the available evidence to establish the effects of vanadium exposure on human health and to determine whether this metal is an epidemiological risk.
METHODS
The study protocol was registered in PROSPERO (ID CRD42023447293). A systematic review was conducted following the PRISMA 2020 methodology. A search for cross-sectional, case-control, and cohort studies was performed in six databases (PubMed, Scopus, ScienceDirect, LILACS, Web of Science, SciELO) up to May 5, 2025. The search terms used were: "human, vanadium, pollution, exposure, diseases, damage".
RESULTS
8,397 articles were identified, of which 27 were ultimately selected. The prevalent adverse effects reported were on pregnancy, fetal development, reproductive health, and the cardiovascular system, in addition to findings in different organs.
CONCLUSIONS
Evidence regarding the effects of vanadium in human populations is limited; nevertheless, the available reports substantiate its potential harmful effects on fetal development and various human systems. The oxidation state and concentration of vanadium are determining factors in these effects, and controversy persists regarding its etiological role in certain pathologies.
Thalía O Macías-Camacho, M. Sánchez-Rodríguez· Critical Reviews in Toxicolo...· 0 citations
Background and objectives India ranks third in global cancer incidence. Groundwater often carries undetectable contaminants such as arsenic, a highly toxic element, and chromium, a probable carcinogen. This systematic review aims to identify patterns of arsenic and chromium exposure in Indian population through groundwater and surface water, and the resulting health effects, including cancer and other non-communicable diseases. Methods A comprehensive search was conducted in PubMed, Embase, and Scopus for English-language studies from inception to January 8, 2025. Studies assessing health effects of arsenic or chromium in groundwater or surface were included. After screening the articles, data on key health risk indices: hazard quotient (HQ) and carcinogenic risk, were extracted and categorised by standard thresholds. Heat maps and violin plots were used to represent health risk levels across studies and regions. Joanna Briggs Institute (JBI) critical appraisal tool was used for quality assessment. Results A total of 1259 articles were identified, with 63 included studies. All reported studies presented a low risk of bias. Arsenic ingestion indicated non-carcinogenic risks in 49% of adult and 60% of child-focused studies. Chromium ingestion risks were lower, reported in 12% and 14% of adult and children-focused studies, respectively. Carcinogenic risk was higher for both metals, particularly through ingestion. Higher non-carcinogenic risk was reported from groundwater than surface water, especially via dermal exposure in children. Affected regions were Punjab, West Bengal, Haryana, Delhi, Uttarakhand, and Jammu and Kashmir. Interpretation and conclusions Groundwater arsenic contamination poses a major public health threat in India, while evidence on chromium ingestion risks are limited.
Vartika Sakalkar, Shipra Singh, Ekta Gupta et al.· The Indian journal of medica...· 0 citations
The proliferation of pharmaceutical residues as emerging contaminants presents growing concerns for environmental and human health worldwide. These pollutants originate from diverse sources and persist across environmental matrices. This systematic review aims to synthesize current evidence on pharmaceutical contamination and its implications for human and ecosystem health within a One Health framework. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar. Out of 500 records screened, 46 peer-reviewed studies met the eligibility criteria following PRISMA guidelines. Study quality was assessed using the CASP checklist and Newcastle–Ottawa Scale. Studies were thematically categorized into occupational exposure (n = 4), adverse drug reactions/antimicrobial resistance (n = 7), waste disposal (n = 14), environmental contamination (n = 6), and epidemiological trends (n = 15). Pharmaceutical residues including antibiotics, analgesics, antidepressants, and hormones were detected in surface waters, groundwater, soils, and biota at concentrations capable of disrupting physiological processes. Documented effects include endocrine disruption, neurotoxicity, reproductive toxicity, and propagation of antimicrobial resistance (AMR). This review confirms that pharmaceutical pollutants represent a multidimensional One Health challenge. Primary recommendations include: (1) strengthening pharmaceutical waste management systems and medication take-back programs; (2) implementing advanced wastewater treatment technologies (ozonation, activated carbon); (3) expanding environmental monitoring programs in low- and middle-income countries; and (4) prioritizing research on chronic, low-dose, and mixture exposures.
Benjamin Oritsemuelebi, E. O. Chidebe, G. Udom et al.· Discover Environment· 0 citations
This study systematically reviewed research on heavy metal contamination in environmental and food systems in Uganda using the PRISMA 2020 data reporting method and the PICOS framework. An extensive literature search of published papers on heavy metal contamination in Uganda's environment and food systems was conducted in PubMed, Web of Science, and Scopus databases up to May 21, 2024. Boolean operators (AND/OR/NOT) were applied to develop search strategies tailored to each database. Following duplicate removal, title and abstract screening, and full-text assessment using the Rayyan platform, 39 articles were included in the final review. Data were extracted from each study using a standardized template that captured metal type, contamination source, concentration levels, affected food or environmental matrix, geographic location, and toxicological impact. Data were synthesized using a descriptive and narrative approach. Key sources of contamination include industrial and municipal waste, agricultural practices, and emissions from transport and manufacturing. Among the metals, lead was the most mentioned across studies. Regional analysis revealed that Central Uganda had the highest reports on heavy metals, while Northern Uganda remains critically understudied. Ecologically, heavy metals threaten soil fertility, aquatic biodiversity, and agricultural sustainability. Contamination of staple foods with lead, cadmium, and mercury poses significant public health risks, particularly for children and pregnant women. Strengthened environmental monitoring, targeted regional investigations, and improved food safety surveillance within a One Health framework are urgently recommended.
Sandra Etumah Ifie, B. A. Ale, I. Fasogbon et al.· Discover Environment· 0 citations
Pharmaceutical contaminants are increasingly recognized as emerging pollutants of concern due to their persistence in the environment and potential impacts on ecosystems and human health. This review aimed to synthesize evidence on the occurrence, pathways, health effects, interventions, and regulatory frameworks related to pharmaceutical pollution.
We conducted a systematic review in accordance with PRISMA 2020 guidelines. Eligible studies (2018–2025) included peer‐reviewed research and reviews assessing pharmaceutical contaminants in water, soil, food, as well as their health impacts, treatment technologies, and regulatory measures. Databases searched included PubMed, Scopus, Web of Science, and Google Scholar.
A total of 20 studies from 6 countries were included. Antibiotics, Non‐Steroidal Anti‐inflammatory drugs (NSAID), hormones, and psychiatric drugs were the most frequently reported contaminants. Geographic hotspots were identified in Asia, particularly India and China, showing intense pharmaceutical manufacturing and inadequate wastewater treatment. Conventional treatment processes were consistently ineffective at removing persistent compounds such as diclofenac and carbamazepine. Health evidence, though limited, highlighted risks of chronic exposure, endocrine disruption, and contribution to Antimicrobial Resistance (AMR). Intervention studies included advanced oxidation processes, membrane filtration, and nanotechnology.
The evidence indicates widespread and persistent pharmaceutical pollution with significant implications for One Health. Limitations include geographic bias, lack of long‐term epidemiological data, and reliance on laboratory‐scale intervention studies. Standardized monitoring protocols, stricter industrial effluent regulations, and integration of environmental surveillance with AMR monitoring are urgently required. Future research should prioritize longitudinal studies, field validation of advanced treatment systems, and socio‐economic evaluations of interventions.
Aflatoxins are food contaminants that cause exposure and adverse health effects and are detected using modern analytical methods. This review summarizes global aflatoxin exposure levels, exposure routes, associated health effects, and detection technologies. This narrative review was guided by the Scale for the Assessment of Narrative Review Articles (SANRA) framework. Relevant literature was retrieved from PubMed, Scopus, Web of Science, and Google Scholar. Studies addressing aflatoxin exposure, health effects, and detection technologies were included and qualitatively synthesized. This review showed that in Côte d’Ivoire, peanut paste had 100% AFB1 contamination, with levels of 4535 µg/kg (AFB1) and 8094 µg/kg (total aflatoxins), and 99% of samples exceeded European Union limits. Dietary intake is the main route of exposure (0.3–180 ng/kg/day), with additional exposure via prenatal transfer, breastfeeding (0.01–0.55 ng/mL AFM1), and complementary feeding. Biomarkers show high aflatoxin exposure: 97% (Malaysia) and 94% (pregnant women in Nepal; 0.45–2939.30 pg/mg). Aflatoxin exposure is responsible for 4.6–28.2% of global hepatocellular carcinoma cases, contributes to approximately 250,000 deaths annually, and is associated with a 2–4-fold higher risk of cancer in children. High-performance liquid chromatography coupled with fluorescence detection (HPLC-FLD) is widely used, while Liquid chromatography–tandem mass spectrometry (LC–MS/MS) is the gold standard (< 1 ng/mL). Electrochemical immunosensors reach 0.3 pg/mL, and lateral flow assays provide rapid but less sensitive screening. Aflatoxin exposure is a major global public health concern. Improved detection methods and food safety measures are essential to reduce exposure and disease burden.