Blood transcriptional and microRNA responses to short-term exposure to disinfection by-products in a swimming pool

Almudena Espin-Perez*, Laia Font-Ribera, Karin van Veldhoven, Julian Krauskopf, Lutzen Portengen, Marc Chadeau-Hyam, Roel Vermeulen, Joan O. Grimalt, Cristina M. Villanueva, Paolo Vineis, Manolis Kogevinas, Jos C. Kleinjans, Theo M. de Kok

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: Swimming in a chlorinated pool results in high exposure levels to disinfection by-products (DBPs), which have been associated with an increased risk of bladder cancer. Objectives: By studying molecular responses at the blood transcriptome level we examined the biological processes associated with exposure to these compounds. Methods: Whole-genome gene expression and microRNA analysis was performed on blood samples collected from 43 volunteers before and 2 h after 40 min swimming in an indoor chlorinated pool (PISCINAII study). Exposure to THMs was measured in exhaled breath. Heart rate and kcal expenditure were measured as proxies for physical activity. Associations between exposure levels and gene expression were assessed using multivariate normal models (MVN), correcting for age, body mass index and sex. A Bonferroni threshold at 5% was applied. Results: MVN-models for the individual exposures identified 1778 genes and 23 microRNAs that were significantly associated with exposure to at least one DBP. Due to co-linearity it was not possible to statistically disentangle responses to DBP exposure from those related to physical activity. However, after eliminating previously reported transcripts associated with physical activity a large number of hits remained associated with DBP exposure. Among those, 9 were linked with bladder and 31 with colon cancer. Concordant microRNA/mRNA expressions were identified in association with DBP exposure for hsa-mir-22-3p and hsa-miR-146a-5p and their targets RCOR1 and TLR4, both related to colon cancer in association with DBP exposure. Conclusions: Short-term exposure to low levels of DBPs shows genomics responses that may be indicative of increased cancer risk.
Original languageEnglish
Pages (from-to)42-50
Number of pages9
JournalEnvironment International
Publication statusPublished - 1 Jan 2018


  • Disinfection by-products
  • Transcriptomics
  • microRNA
  • Multivariate normal models
  • RISK


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