Effects of exposure to trihalomethanes in swimming pool waters on metabolomics profile: a randomized parallel design trial

Biological mechanisms of exposure to Trihalomethanes (THMs) in swimming pools remain unclear. Investigation of short-term changes in metabolomic profiles due to exposure to THMs during swimming can help to understand the health effects-related mechanisms. With this in view, we aimed to assess exposure of swimmers to THMs in chlorine and ozone-chlorine swimming pools using the metabolomics approach from September 2020 to January 2021 in Tehran.

Two parallel panels of 29 healthy adult subjects swam over 60 min in either of swimming pools. Blood samples were collected before and 2 h after swimming to assess metabolomic profile using Hydrogen-Nuclear Magnetic Resonance Spectroscopy (H-NMR). Differential metabolites between the two groups were identified by multivariate analysis methods such as Orthogonal Partial Least-Squares Discriminant Analysis (OPLS-DA) and Random Forest (RF).

The levels of THMs in exhaled air as a biomarker of exposure and the metabolic profile as a biomarker of the effect changed significantly between two participants of swimming pools. Based on the significant metabolites, the biochemical pathways were identified by the method of Metabolite Setts Enrichment Analysis (MSEA) and by using the Metaboanalyst platform. The pathways of tryptophan metabolism, galactose metabolism and fructose and mannose metabolism were the most important biochemically significant pathways in individuals after exposure to THMs.

Finally, findings from metabolic changes in our study indicate that exposure to THMs in swimming pools can activate the mechanisms of central nervous system disorders, increased uric acid, increased risk of bladder cancer and oxidative stress.