Estimating Potential Increased Bladder Cancer Risk Due to Increased Bromide Concentrations in Sources of Disinfected Drinking Waters

Environ Sci Technol. 2015 Nov 17;49(22):13094-102. doi: 10.1021/acs.est.5b03547. Epub 2015 Nov 5.


Public water systems are increasingly facing higher bromide levels in their source waters from anthropogenic contamination through coal-fired power plants, conventional oil and gas extraction, textile mills, and hydraulic fracturing. Climate change is likely to exacerbate this in coming years. We estimate bladder cancer risk from potential increased bromide levels in source waters of disinfecting public drinking water systems in the United States. Bladder cancer is the health end point used by the United States Environmental Protection Agency (EPA) in its benefits analysis for regulating disinfection byproducts in drinking water. We use estimated increases in the mass of the four regulated trihalomethanes (THM4) concentrations (due to increased bromide incorporation) as the surrogate disinfection byproduct (DBP) occurrence metric for informing potential bladder cancer risk. We estimate potential increased excess lifetime bladder cancer risk as a function of increased source water bromide levels. Results based on data from 201 drinking water treatment plants indicate that a bromide increase of 50 μg/L could result in a potential increase of between 10(-3) and 10(-4) excess lifetime bladder cancer risk in populations served by roughly 90% of these plants.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bromides / adverse effects*
  • Disinfectants / adverse effects*
  • Drinking Water / adverse effects*
  • Humans
  • Odds Ratio
  • Risk Factors
  • Trihalomethanes / adverse effects
  • United States
  • Urinary Bladder Neoplasms / epidemiology
  • Urinary Bladder Neoplasms / etiology*
  • Water Pollutants, Chemical / adverse effects*


  • Bromides
  • Disinfectants
  • Drinking Water
  • Trihalomethanes
  • Water Pollutants, Chemical