Immune System Problems

• Chloramine cannot kill the pathogens in the water as well as chlorine.
• As a result, people with suppressed immune systems must have their water boiled over TEN minutes BEFORE use to kill pathogens, or they risk becoming ill.
• Those at risk include children under 6 months of age, the elderly, those on or who have had chemotherapy, people with HIV or AIDS, organ transplant patients, and others with a weakened immune system.

Respiratory Problems

• Chloramine can cause and/or aggravate respiratory problems.
• Chloramine fumes can cause an individual to become congested and cause sneezing, sinus congestion, coughing, choking, wheezing, shortness of breath, and asthma by the New Jersey Department of Health and Senior Services).
• An increase in asthma due to exposure from chloramine in indoor swimming pool areas was shown in a Belgium study from the Catholic University of Louvain.
• Chloramine damages mucous membranes. The lung damage in those exposed to chloramine in indoor pool air is similar to that seen in regular smokers.
• Chloraminated vapour from showers, baths, hot tubs, dishwashers, and other household appliances contains volatilized chemicals that can be inhaled and cause irritation to the respiratory tract.
• Inhaled chloraminated vapour can enter the bloodstream directly through the lungs. It bypasses the digestive tract where the SFPUC says it is broken down and excreted.
• The SFPUC says that "if monochloramine enters the bloodstream directly, it combines with hemoglobin (red blood cells) so it can no longer carry oxygen"
• The toxic exposure to chemicals (like chloramine) in water is greater from taking a shower than from drinking the same water (see Toxic Showers and Baths).

An individual can experience long-term effects from repeated exposures to a chemical (like chloramine) at levels not high enough to make them immediately sick (see the Hazardous Substances Fact Sheet for Chloramine, page 3, PDF, 98 KB).

In a study by Zierler, et al, it was found that there was an increase in deaths from influenza and pneumonia in the communities that used chloramine. (Communities in Massachusetts that used chlorine for disinfection were compared to those that used chloramine).

1) Chloramine exposure damages lung mucosa, making the lungs more susceptible to allergens and infections.

2) Chloramine is a less effective disinfectant and therefore people are exposed to more pathogens.

Skin Problems

Rashes, dry skin, itching, flaking, welting, blistering, chapping, burning sensation, cracking, scarring, bleeding, pigmentation. 

• Chloramine can aggravate other skin conditions such as eczema and psoriasis.
• Chloramine can cause bleeding lips, dry mouth, and dry throat.
• Chloramine can cause burning, red, and dry eyes.
• Skin exposure to ammonia "breaks down cell structural proteins, extracts water from the cells and initiates an inflammatory response, which further damages the surrounding tissues."

Digestive and Gastric Problems

• Chloramine damages digestive mucosa.
• Chloramine can aggravate digestive disorders.

It is suggested that monochloramine is responsible for gastric cancer. (Journal of Gastroenterology, 1997, "Enhancement by Monochloramine of the Development of Gastric Cancers in Rats; a possible mechanism of Helicobacter, pylori-associated gastric carcinogenesis.

Kidney And Blood Problems

• Persons with liver or kidney disease and those with hereditary urea cycle disorders are at increased risk for ammonia toxicity from the consumption of chloraminated water.
• Kidney dialysis patients cannot use chloraminated water in their dialysis machines because it will cause hemolytic anemia.
• Chloramine must be completely removed from the water in dialysis treatment using extensive carbon filtration and a reverse osmosis or Cation filtering system to remove both chlorine and ammonia from the water.
• There are populations that are unusually susceptible to ammonia reactivity or toxicity due to factors such as genetic makeup, age, health status, etc.