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Controlled clinical evaluations of chlorine dioxide, chlorite and chlorate in man.
Open accessAbstract
To assess the relative safety of chronically administered chlorine water disinfectants in man, a controlled study was undertaken. The clinical evaluation was conducted in the three phases common to investigational drug studies. Phase I, a rising dose tolerance investigation, examined the acute effects of progressively increasing single doses of chlorine disinfectants to normal healthy adult male volunteers. Phase II considered the impact on normal subjects of daily ingestion of the disinfectants at a concentration of 5 mg/l. for twelve consecutive weeks. Persons with a low level of glucose-6-phosphate dehydrogenase may be expected to be especially susceptible to oxidative stress; therefore, in Phase III, chlorite at a concentration of 5 mg/l. was administered daily for twelve consecutive weeks to a small group of potentially at-risk glucose-6-phosphate dehydrogenase-deficient subjects. Physiological impact was assessed by evaluation of a battery of qualitative and quantitative tests. The three phases of this controlled double-blind clinical evaluation of chlorine dioxide and its potential metabolites in human male volunteer subjects were completed uneventfully. There were no obvious undesirable clinical sequellae noted by any of the participating subjects or by the observing medical team. In several cases, statistically significant trends in certain biochemical or physiological parameters were associated with treatment; however, none of these trends was judged to have physiological consequence. One cannot rule out the possibility that, over a longer treatment period, these trends might indeed achieve proportions of clinical importance. However, by the absence of detrimental physiological responses within the limits of the study, the relative safety of oral ingestion of chlorine dioxide and its metabolites, chlorite and chlorate, was demonstrated.
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“No effects were shown in 10 healthy male volunteers administered monochloramine in water daily for 12 weeks (corresponding to 0.036 mg/kg bw/day assuming a body weight of 70 kg) or every third day for 13 days at increasing concentrations corresponding to 0.034 mg/kg bw/day as evaluated by an extensive battery of measures including serum chemistry, blood count, urine analysis and physical exami”
From Inorganic chloramines: a critical review of the toxicological and epidemiological evidence as a basis for occupational exposure limit setting (2020) · cites this paper as Lubbers et al. 1982
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“The authors concluded that no definitive finding of detrimental physiological impact was identified in any of the experiments (Lubbers et al. 1982).”
From Inorganic chloramines: a critical review of the toxicological and epidemiological evidence as a basis for occupational exposure limit setting (2020) · cites this paper as Lubbers et al. 1982
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“No clinical effects were seen among male healthy volunteers ingesting monochloramine in drinking water daily during 4 or 12 weeks in doses corresponding to 0.043 mg/kg bw/day (Wones et al. 1993) or 0.034 mg/kg bw/day (Lubbers et al. 1982), respectively.”
From Inorganic chloramines: a critical review of the toxicological and epidemiological evidence as a basis for occupational exposure limit setting (2020) · cites this paper as Lubbers et al. 1982
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Inorganic chloramines as drinking water disinfectants: a review
Wolfe, R. L., Ward, N. R., & Olson, B. H. (1984) · Journal AWWA · doi:10.1002/j.1551-8833.1984.tb05337.x · Cited by 162
Wastensson, G., & Eriksson, K. (2020) · Critical Reviews in Toxicology · doi:10.1080/10408444.2020.1744514 · Cited by 30
Metadata
- Authors
- Lubbers, J. R., Chauan, S., & Bianchine, J. R.
- Venue
- Environmental Health Perspectives
- Publisher
- American Chemical Society (ACS)
- Published
- 1982-12
- Volume
- 46
- Pages
- 57-62
- ISSN
- 0091-6765 (ISSN-L)
- 1552-9924
- PMC
- PMC1569027
- OpenAlex
- W2004545577
- Cited by
- 58
- References
- 0
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 4 · 2022: 3 · 2021: 6 · 2020: 6 · 2019: 1 · 2016: 1 · 2013: 4 · 2012: 1
- FWCI
- 1.33
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- public-domain
- Locations
- Environmental Health Perspectives (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Water Treatment and Disinfection
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Carcinogens and Genotoxicity Assessment
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Environmental Toxicology and Ecotoxicology
- Keywords
- chlorine dioxide, chlorite, chlorate, oral toxicity, human safety assessment, glucose-6-phosphate dehydrogenase deficiency, oxidative stress, dose tolerance, chronic ingestion, human volunteers
- MeSH terms
- Blood, Chlorates, Chlorides, Chlorine, Disinfectants, Double-Blind Method, Drug Evaluation, Glycogen Storage Disease Type I, Humans, Male, Oxides, Taste, Chlorine Compounds
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