Critical review of major sources of human exposure to N-nitrosamines

Adam J. Gushgari, Rolf U. Halden

Research output: Contribution to journalReview articlepeer-review

86 Scopus citations


More than 24 N-nitrosamine compounds contribute to the total N-nitrosamine (TNA) burden monitored routinely to assess human exposure to this important group of known and suspected human carcinogens. A literature review (n = 122) identified multiple sources of human exposure to TNAs, including waters (40 ± 10.5 ng/L; average ± standard deviation), food and beverages (6.7 ± 0.8 ng/g), tobacco (16,100 ± 3650 ng/g) and personal care products (1500 ± 750 ng/g). Due to source control interventions, levels of TNAs in beer have dropped by about 96% between 1980 and 1990, whereas N-nitrosamine levels in other known sources have shown little to no change. Maximum daily TNA exposure in the U.S. in units of ng/d is estimated at 25,000 ± 4,950, driven by consumption of tobacco products (22,000 ± 4350), food (1900 ± 380), alcohol (1000 ± 200), and drinking water (120 ± 24). Behavioral choices of individuals in non-occupational settings were calculated to result in a spectrum of exposure values ranging from a lower bound of 1900 ± 380 ng/d to a higher bound of 25,000 ± 4950 ng/d, indicating opportunities for a possible 12-fold reduction in TNA exposure to 8% of the above maximum through deliberate choices in diet and lifestyle.

Original languageEnglish (US)
Pages (from-to)1124-1136
Number of pages13
StatePublished - Nov 2018


  • Attributable risk analysis
  • Dermal contact
  • Human exposure
  • Ingestion
  • Inhalation
  • N-nitrosamine

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Pollution
  • General Chemistry
  • Health, Toxicology and Mutagenesis
  • Environmental Engineering
  • Environmental Chemistry


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