Chloramines are all respiratory irritants with trichloramine being the most toxic (order of toxicity: monochloramine < dichloramine < trichloramine-most severe.) 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. Chloramine vapors and its disinfection byproducts can accumulate in indoor air and concentrate in an enclosed area such as a shower stall, small bathroom, kitchen, or apartment. Chloraminated vapor from showers, baths, hot tubs, dishwashers, and other household appliances contains volatilized chemicals that can be inhaled and cause irritation to the respiratory tract. The toxic exposure to chemicals (like chloramine) in water is greater from taking a shower than from drinking the same water. Chloramine does not dissipate easily compared to chlorine. Chloramine stays in the water distribution system longer than chlorine. Chloramine is difficult to remove. Chloramine cannot be removed by boiling, distilling, or by standing uncovered. Both trihalomethanes and chloramines are possible causes of cancer and heart disease and therefore considered carcinogens.
