Probabilistic health risk assessment of nitrosamines in drinking water of Shaoxing, Zhejiang, China

Nitrosamines (NAms) are potent genotoxic and carcinogenic but widely detected in drinking water. This study aimed to investigate the occurrence of major types of NAms in drinking water in Shaoxing, China, and to conduct multi-pathway probabilistic cancer risk (CR) assessment to residents based on age-dependent adjustment Chinese exposure factors. Results showed that concentrations of NAms in water varied from not detected (ND) to dozens of nanograms per liter level. N-Nitrosodimethylamine (NDMA) was detected most frequently (93.06%), followed by N-nitrosodiethylamine (NDEA) (64.08%)—with the highest cancer risk among NAms. The CR of NAms came mainly through the oral exposure pathway. The 95th percentile of the total CR of five major NAms was 1.06 × 10−4, exceeding the maximum acceptable lifetime CR (1 × 10−4) recommended by US EPA. Exposure to NDEA contributed the highest to the total CR. The CR of the five NAms through ingestion was 2.5 times higher using the Chinese exposure factors than that of the Americans. The most important variables related to CRs were concentrations of NAms in drinking water, exposure duration, drinking water ingestion rate, and exposure time during bathing. Our findings suggest the urgent need to develop and enforce effective regulatory policies to control the contamination of NAms in drinking water in China.