Trihalomethane concentrations in tap water as determinant of bottled water use in the city of Barcelona

Bottled water consumption is increasing worldwide, despite its huge economic and environmental cost. We aim to describe personal and tap water quality determinants of bottled water use in the city of Barcelona. This cross-sectional study used data from the Health Survey of Barcelona in 2006 (N=5417 adults). The use of bottled water to drink and to cook was evaluated in relation to age, gender, educational level, district and levels of trihalomethanes (THMs), free chlorine, conductivity, chloride, sodium, pH, nitrate and aluminium in municipal tap water using Robust Poisson Regression. The prevalence of bottled water use to drink and cook was 53.9% and 6.7%, respectively. Chemical parameters in water had a large variability (interquartile range of THMs concentrations: 83.2-200.8μg/L) and were correlated between them, except aluminium. Drinking bottled water increased with educational level, while cooking with bottled water was higher among men than among women and decreased with age. After adjusting by these personal determinants, a dose-response relationship was found between concentrations of all chemicals except aluminium in tap water and bottled water use. The highest association was found for THMs, with a Prevalence Ratio of 2.00 (95%CI=1.86, 2.15) for drinking bottled water and 2.80 (95%CI=1.72, 4.58) for cooking with bottled water, among those with >150μg/L vs.