Drinking water disinfection has been viewed as one of the major advances in public health protection in history. However, while it has been very successful in assuring microbiological safety, disinfection also brought relevant concerns about chemical safety and the potential unintended health hazards associated with disinfection byproduct (DBP) exposure. DBPs represent one of the most important groups of chemical compounds to which humans are exposed through drinking water, as epidemiological studies have consistently associated long-term exposure with multiple adverse health effects. It is established that disinfection is an essential component of providing microbiologically safe drinking water and shall never be compromised. Yet, chemical safety regarding DBP exposure remains a largely uncovered and highly discussed topic. Several DBPs have been reported in the past few decades, yet research on formation, toxicity and occurrence remains scarce for most compounds. Also, for each identified DBP, many remain undiscovered. In view of an ever-growing list of DBPs and the existing gaps in available research, identifying overall driving agents of toxicity is still a major challenge for public health protection. This review attempts to provide an insight on contemporary issues regarding the overall safety of drinking water and the trade-off between microbiological and chemical risks, considering current challenges in water and sanitation access and existing regulations.
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