Potential health effects of chlorine dioxide as a disinfectant in potable water supplies

Chlorination of potable water supplies high in organics may yield carcinogenic compounds such as trihalomethanes. Chlorine dioxide has been proposed as an alternative disinfectant to chlorine. However, chlorine dioxide is a strong oxidant that forms significant amounts of chlorite when added to potable water supplies, and chlorite is similar to nitrite in its molecular structure and may be similar in its mechanism of methemoglobin production. Nitrites and chlorites are thought to act synergistically to produce MetHb. Neonates and persons with G-*-PD deficiency are likely to be unusually susceptible to MetHb formation from these compounds because their red cells lack the metabolic machinery to adequately protect against oxidant stress. Since male blacks represent the largest population in the U.S. to be G-6PD deficient, Black male neonates may represent the group at highest risk to the use of chlorine dioxide as a disinfectant in the nations water supplies.