Drinking water source and chlorination byproducts in Iowa. III. Risk of brain cancer

Exposure to disinfection by-products and risk of cancer: A systematic review and dose-response meta-analysis

Disinfection by-products (DBPs), including trihalomethanes (THMs) and haloacetic acids (HAAs), have attracted attention due to their carcinogenic properties, leading to varying conclusions. This meta-analysis aimed to evaluate the dose-response relationship and the dose-dependent effect of DBPs on cancer risk. We performed a selective search in PubMed, Web of Science, and Embase databases for articles published up to September 15th, 2023. Our meta-analysis eventually included 25 articles, encompassing 8 cohort studies with 6038,525 participants and 10,668 cases, and 17 case-control studies with 10,847 cases and 20,702 controls. We observed a positive correlation between increased cancer risk and higher concentrations of total trihalomethanes (TTHM) in water, longer exposure durations, and higher cumulative TTHM intake. These associations showed a linear trend, with relative risks (RRs) and 95 % confidence intervals (CIs) being 1.02 (1.01-1.03), 1.04 (1.02-1.06), and 1.02 (1.00-1.03), respectively. Gender-specific analyses revealed slightly U-shaped relationships in both males and females, with males exhibiting higher risks. The threshold dose for TTHM in relation to cancer risk was determined to be 55 µg/L for females and 40 µg/L for males. A linear association was also identified between bladder cancer risk and TTHM exposure, with an RR and 95 % CI of 1.08 (1.05-1.11). Positive linear associations were observed between cancer risk and exposure to chloroform, bromodichloromethane (BDCM), and HAA5, with RRs and 95 % CIs of 1.02 (1.01-1.03), 1.33 (1.18-1.50), and 1.07 (1.03-1.12), respectively. Positive dose-dependent effects were noted for brominated THMs above 35 µg/L and chloroform above 75 µg/L. While heterogeneity was observed in the studies for quantitative synthesis, no publication bias was detected. Exposure to TTHM, chloroform, BDCM, or HAA5 may contribute to carcinogenesis, and the risk of cancer appears to be dose-dependent on DBP exposure levels. A cumulative effect is suggested by the positive correlation between TTHM exposure and cancer risk. Bladder cancer and endocrine-related cancers show dose-dependent and positive associations with TTHM exposure. Males may be more susceptible to TTHM compared to females.

Evaluation and strategy for improving the quality of desalinated water

Seawater desalination is practiced in many coastal countries, which is accepted as clean water by the general populations. The untreated seawater reported high concentrations of bromide (50,000 - 80,000 µg/L) and iodide (21 - 60 µg/L) ions, which are reduced to non-detectable levels during thermal desalination while the concentrations of bromide and iodide ions were reduced to 250-600 µg/L and < 4-16 µg/L, respectively during reverse osmosis processes. During the treatment and/or disinfection, many brominated and iodinated disinfection byproducts (Br-DBPs and I-DBPs) are formed in desalinated water, some of which are genotoxic and cytotoxic to the mammalian cells and possible/probable human carcinogens. In this paper, DBPs' formation in desalinated and blended water from source to tap, toxicity to the mammalian cells, their risks to humans and the strategies to control DBPs were investigated. The lifetime excess cancer risks from groundwater, and desalinated and blended water sourced DBPs were 4.15 × 10^-6 (4.72 × 10^-7 - 1.30 × 10^-5), 1.75 × 10^-5 (2.58 × 10^-6 - 5.25 × 10^-5) and 2.59 × 10^-5 (4.02 × 10^-6 - 8.35 × 10^-5) respectively, indicating higher risks from desalinated and blended water (2.56 and 4.51 times respectively) than groundwater systems. Few emerging DBPs in desalinated/blended water showed higher cyto- and genotoxicity in the mammalian cells. The findings were compared with safe drinking water standards and strategies to produce cleaner desalinated water were demonstrated.

Drinking water sources and water quality in a prospective agricultural cohort

We describe drinking water sources and water quality for a large agricultural cohort. We used questionnaire data from the Agricultural Health Study (N = 89,655), a cohort of licensed pesticide applicators and their spouses in Iowa (IA) and North Carolina (NC), to ascertain drinking water source at enrollment (1993-1997). For users of public water supplies (PWS), we linked participants' geocoded addresses to contaminant monitoring data [five haloacetic acids (HAA5), total trihalomethanes (TTHM), and nitrate-nitrogen (NO3-N)]. We estimated private well nitrate levels using random forest models accounting for well depth, soil characteristics, nitrogen inputs, and other predictors. We assigned drinking water source for 84% (N = 74,919) of participants. Among these, 69% of IA and 75% of NC participants used private wells; 27% in IA and 21% in NC used PWS. Median PWS nitrate concentrations (NO3-N) were higher in IA [0.9 mg/L, interquartile range (IQR): 0.4-3.1 mg/L] than NC (0.1 mg/L, IQR: 0.1-0.2 mg/L), while median HAA5 and TTHM concentrations were higher in NC (HAA5: 11.9 µg/L, IQR: 5.5-33.4 µg/L; TTHM: 37.7 µg/L, IQR: 10.7-54.7 µg/L) than IA (HAA5: 5.0 µg/L, IQR: 3.7-10.7 µg/L; TTHM: 13.0 µg/L, IQR: 4.2-32.4 µg/L). Private well nitrate concentrations in IA (1.5 mg/L, IQR: 0.8-4.9 mg/L) and NC (1.9 mg/L, IQR: 1.4-2.5 mg/L) were higher than PWS. More private wells in IA (12%) exceeded 10 mg/L NO3-N (regulatory limit for PWS) than NC (<1%). Due to the proximity of their drinking water sources to farms, agricultural communities may be exposed to elevated nitrate levels.

Exposure to drinking water trihalomethanes and nitrate and the risk of brain tumours in young people

Brain tumours (BTs) are one of the most frequent tumour types in young people. We explored the association between tap water, exposure to trihalomethanes (THM) and nitrate and neuroepithelial BT risk in young people. Analysis of tap water consumption were based on 321 cases and 919 appendicitis controls (10-24 years old) from 6 of the 14 participating countries in the international MOBI-Kids case-control study (2010-2016). Available historical residential tap water concentrations of THMs and nitrate, available from 3 countries for 86 cases and 352 controls and 85 cases and 343 for nitrate, respectively, were modelled and combined with the study subjects' personal consumption patterns to estimate ingestion and residential exposure levels in the study population (both pre- and postnatal). The mean age of participants was 16.6 years old and 56% were male. The highest levels and widest ranges for THMs were found in Spain (residential and ingested) and Italy and in Korea for nitrate. There was no association between BT and the amount of tap water consumed and the showering/bathing frequency. Odds Ratios (ORs) for BT in relation to both pre- and postnatal residential and ingestion levels of THMs were systematically below 1 (OR = 0.37 (0.08-1.73)) for postnatal average residential THMs higher than 66 μg/L. For nitrate, all ORs were above 1 (OR = 1.80 (0.91-3.55)) for postnatal average residential nitrate levels higher than 8.5 mg/L, with a suggestion of a trend of increased risk of neuroepithelial BTs with increasing residential nitrate levels in tap water, which appeared stronger in early in life. This, to our knowledge, is the first study on this topic in young people. Further research is required to clarify the observed associations.

Cumulative health risk assessment of disinfection by-products in drinking water by different disinfection methods in typical regions of China

Disinfection was essential to keep human healthy from microorganisms in drinking water. Meanwhile, disinfection by-products (DBPs) have been proved to be associated with some adverse health effects. The DBP levels were different in drinking water disinfected by different methods and may cause diverse health risks. However, studies in this field and systematic analysis about risk characteristics are limited. We estimated the health risks of DBPs exposure in drinking water through multi-pathways, and systematically analyzed the characteristics of different disinfection methods and influence factors of health risk of DBPs in China. Drinking water samples were collected and analyzed for DBPs from some representative water treatment plants in several typical regions in China. We adopted the additive method to estimate the health risks of DBPs exposure in drinking water through multi-pathways, and used descriptive and hierarchical analysis to understand their characteristics and influence factors. The concentrations of the six DBPs in drinking water ranged from 1.6 μg/L to 13.3 μg/L. The cumulative cancer risk of DBPs exposure through multi-pathways was 8.63 × 10^-5. The total HI of DBPs exposure was 1.70 × 10^-1. The health risks of DBPs in drinking water disinfected by chlorine dioxide and sodium hypochlorite were lower than by other disinfection methods. The health risk of DBPs in drinking water was dominated by risk through oral and inhalation route. The health risks in wet season were higher than that in dry season. There is no significant difference in health risk for males and females, but children experienced higher health risks than adults. Our study suggested the situation of that a large population experienced the high cancer risk of DBPs in drinking water in typical regions of China. It was suggested that potential higher risk should be concerned, and possible measures could be considered to decrease the health risks.

Predicting risk and loss of disability-adjusted life years (DALY) from selected disinfection byproducts in multiple water supply sources in Saudi Arabia

Disinfection byproducts (DBPs) in drinking water is an issue in many countries. Many DBPs are possible or probable human carcinogens while few DBPs pose cyto- and genotoxic effects to the mammalian cells. The populations are likely to consume DBPs with drinking water throughout their lifetimes. A number of DBPs are regulated in many countries to protect humans. In this study, human exposure, risk and disability-adjusted life years (DALY) were predicted from DBPs in multiple water supply systems, including groundwater (GW), desalinated water (DW) and blend water (BW). The averages of lifetime excess cancer risks from GW, DW and BW were 4.15 × 10^-6, 1.75 × 10^-5 and 2.59 × 10^-5 respectively. The populations in age groups of 0 - <2, 2-16 and >16 years contributed 25.4-25.7%, 28.6-29.6% and 45.0-45.7% to the total risks respectively. The DALY from GW, DW and BW were estimated to be 5.8, 27.0 and 39.9 years, respectively while the corresponding financial burdens were US$ 0.63, 2.93 and 4.34 million respectively. The findings are likely to assist in selecting the supply water sources to better control human exposure and risk from DBPs.

Disinfection by-products in desalinated and blend water: formation and control strategy

Desalinated seawater is the major source of drinking water in many countries. During desalination, several activities including pretreatment, desalination, stabilization, mixing, storage and distribution are performed. Few disinfectants are used during these activities to control the biofouling agents and microbiological regrowth. The reactions between the disinfectants and natural organic matter (NOM), bromide and iodide form disinfection by-products (DBPs) in product water. The product water is stabilized and mixed with treated freshwater (e.g., groundwater) to meet the domestic water demands. The DBPs in desalinated and blend water are an issue due to their possible cancer and non-cancer risks to humans. In this paper, formation and distribution of DBPs in different steps of desalination and water distribution systems prior to reaching the consumer tap were reviewed. The variability of DBPs among different sources and desalination processes was explained. The toxicities of DBPs were compared and the strategies to control DBPs in desalinated water were proposed. Several research directions were identified to achieve comprehensive control on DBPs in desalinated water, which are likely to protect humans from the adverse consequences of DBPs.

The drinking water contaminant dibromoacetonitrile delays G1-S transition and suppresses Chk1 activation at broken replication forks

Chlorination of drinking water protects humans from water-born pathogens, but it also produces low concentrations of dibromoacetonitrile (DBAN), a common disinfectant by-product found in many water supply systems. DBAN is not mutagenic but causes DNA breaks and elevates sister chromatid exchange in mammalian cells. The WHO issued guidelines for DBAN after it was linked with cancer of the liver and stomach in rodents. How this haloacetonitrile promotes malignant cell transformation is unknown. Using fission yeast as a model, we report here that DBAN delays G1-S transition. DBAN does not hinder ongoing DNA replication, but specifically blocks the serine 345 phosphorylation of the DNA damage checkpoint kinase Chk1 by Rad3 (ATR) at broken replication forks. DBAN is particularly damaging for cells with defects in the lagging-strand DNA polymerase delta. This sensitivity can be explained by the dependency of pol delta mutants on Chk1 activation for survival. We conclude that DBAN targets a process or protein that acts at the start of S phase and is required for Chk1 phosphorylation. Taken together, DBAN may precipitate cancer by perturbing S phase and by blocking the Chk1-dependent response to replication fork damage.

F344/NTac Rats Chronically Exposed to Bromodichloroacetic Acid Develop Mammary Adenocarcinomas With Mixed Luminal/Basal Phenotype and Tgfβ Dysregulation

Breast cancer is the most common cancer and the second-leading cause of cancer mortality in women in the United States. A recent 2-year National Toxicology Program carcinogenicity study showed an increased incidence of proliferative mammary lesions (hyperplasia, fibroadenoma, adenocarcinoma) in F344/NTac rats exposed to bromodichloroacetic acid (BDCA), a disinfection by-product in finished drinking water with widespread human exposure. We hypothesized that the increase in mammary tumors observed in BDCA-exposed F344/NTac rats may be due to underlying molecular changes relevant for human breast cancer. The objective of the study was to compare (1) gene and protein expression and (2) mutation spectra of relevant human breast cancer genes between normal untreated mammary gland and mammary tumors from control and BDCA-exposed animals to identify molecular changes relevant for human cancer. Histologically, adenocarcinomas from control and BDCA-exposed animals were morphologically very similar, were estrogen/progesterone receptor positive, and displayed a mixed luminal/basal phenotype. Gene expression analysis showed a positive trend in the number of genes associated with human breast cancer, with proportionally more genes represented in the BDCA-treated tumor group. Additionally, a 5-gene signature representing possible Tgfβ pathway activation in BDCA-treated adenocarcinomas was observed, suggesting that this pathway may be involved in the increased incidence of mammary tumors in BDCA-exposed animals.

Improving Brain Tumor Research in Resource-Limited Countries: A Review of the Literature Focusing on West Africa

Neoplasms of the brain are often overlooked in resource-limited countries. Our literature search via AJOL and PubMed demonstrated that brain tumor research is still a rarity in these regions. We highlight the current status, importance, challenges, and methods of improving brain tumor research in West Africa. We suggest that more attention be given to basic, clinical, and epidemiological brain tumor research by national governments, private organizations, international organizations, non-governmental organizations (NGOs), and individuals in this region.

Multipathways human health risk assessment of trihalomethane exposure through drinking water

Life-time human health risk of cancer attributed to trihalomethanes in drinking water in an urban-industrialized area of Karachi (Pakistan) was conducted through multiple pathways of exposure. The extent of cancer risk was compared with USEPA guidelines. Human health cancer risk for total trihalomethanes (TTHMs) through ingestion and dermal routes were estimated in "acceptable-low risk" (≥1.0E-06; ≤5.10E-05), whereas through inhalation route it was estimated under "acceptable-high risk" (≥5.10E-05; ≤1.0E-04) category. However, at some industrial-urban areas cancer risk for CHCl3 were estimated under "unacceptable risk" (≥1.0E-04) through inhalation route.

Rapid quantitative estimation of chlorinated methane utilizing bacteria in drinking water and the effect of nanosilver on biodegradation of the trichloromethane in the environment

Background:

Halomethanes are toxic and carcinogenic chemicals, which are widely used in industry. Also they can be formed during water disinfection by chlorine. Biodegradation by methylotrophs is the most important way to remove these pollutants from the environment.

Objectives:

This study aimed to represent a simple and rapid method for quantitative study of halomethanes utilizing bacteria in drinking water and also a method to facilitate the biodegradation of these compounds in the environment compared to cometabolism.

Materials and Methods:

Enumeration of chlorinated methane utilizing bacteria in drinking water was carried out by most probable number (MPN) method in two steps. First, the presence and the number of methylotroph bacteria were confirmed on methanol-containing medium. Then, utilization of dichloromethane was determined by measuring the released chloride after the addition of 0.04 mol/L of it to the growth medium. Also, the effect of nanosilver particles on biodegradation of multiple chlorinated methanes was studied by bacterial growth on Bushnell-Haas Broth containing chloroform (trichloromethane) that was treated with 0.2 ppm nanosilver.

Results:

Most probable number of methylotrophs and chlorinated methane utilizing bacteria in tested drinking water were 10 and 4 MPN Index/L, respectively. Chloroform treatment by nanosilver leads to dechlorination and the production of formaldehyde. The highest growth of bacteria and formic acid production were observed in the tubes containing 1% chloroform treated with nanosilver.

Conclusions:

By combining the two tests, a rapid approach to estimation of most probable number of chlorinated methane utilizing bacteria is introduced. Treatment by nanosilver particles was resulted in the easier and faster biodegradation of chloroform by bacteria. Thus, degradation of these chlorinated compounds is more efficient compared to cometabolism.

Spatial Analysis of Human Health Risk Associated with Trihalomethanes in Drinking Water: A Case Study of Karachi, Pakistan

The objective of this study was to spatially analyze total trihalomethanes (TTHMs) and health risk associated with TTHMs in drinking water of different densely populated towns of Karachi city. Lifetime cancer risk and hazard index of THMs through oral ingestion and dermal absorption were calculated and mapped using kriging as an interpolation method to evaluate the carcinogenic and noncarcinogenic risk to human health in the study area. Lifetime cancer risk value due to the oral ingestion of TTHMs in different towns of the city was exceeded from1.0×10−6, showing that residents of these towns were expected to be at higher cancer risk. The hazard index for different towns was found to be lower than unity, indicating that no adverse health effects are expected as a result of exposure to THMs.

Multi-route risk assessment from trihalomethanes in drinking water supplies

The main objectives of this study were to investigate the concentration and lifetime cancer risk and hazard index of trihalomethanes (THMs) through multiple routes like oral ingestion, dermal absorption, and inhalation exposure in the water samples collected at water treatment plant endpoints. Bromoform has been found in highest concentration followed by chloroform. A lesser concentration of dibromochloromethane has been found than dichlorobromomethane in most of the studied water, which is an unusual scenario, in spite of the high concentration of bromide in the water which can be attributed to the formation, speciation, and distribution of THMs in the breakpoint chlorination curve. Among the three pathways studied, inhalation contributed 80-90% of the total risk followed by oral exposure and dermal contact. Chloroform was found to be the major THM which is having cancer risk in its gaseous form whereas bromoform contributed highest cancer risk through oral ingestion. The average hazard index of total THMs through oral route was higher than unity, indicating high noncarcinogenic risk. The discrepancy between the three exposure pathways may be attributed to different concentration and speciation of THMs present in the waters. The sensitivity analysis by tornado diagram confirmed the highest positive impact of chloroform to the total cancer risk and, indirectly, confirmed inhalation as the major pathway of exposure. This study suggests the modification of the regulatory issues related to THMs based on the health risk associated with each THM and exposure pathway.

Development of a multi-pathway probabilistic health risk assessment model for swimmers exposed to chloroform in indoor swimming pools

For swimmers, exposure to chloroform, a probable carcinogen, in indoor swimming pools can be through different pathways such as ingestion, dermal absorption, inhalation during swimming, and inhalation during resting. In order to evaluate health risk results from excessive exposure to chloroform, concentrations of chloroform in pool water were first collected and analyzed. Then, a two-layer model is used, which is capable of estimating the concentrations of chloroform in the boundary layer adjacent to the water surface and the concentrations of chloroform in indoor swimming pool air. The use of stratification model is important for estimating the risks for swimmers since they are exposed to these kinds of situations while performing swimming and resting in indoor swimming pools environment. The incremental lifetime cancer risk (ILCR) was then estimated using the multi-pathway exposure model. The results showed that the 95th percentile of ILCRs calculated for male and female swimmers were 2.80 × 10(-4) and 2.47 × 10(-4), respectively. The major exposure routes were found to be inhalation during swimming which contributes to more than 99% of the total health risk. Our study suggested that to protect swimmers from excessive exposure to chloroform, alternative methods or processes of disinfection should be considered for swimming pool managers.

[Epidemiology of primary brain tumor]

Two main approaches are generally used to study the epidemiology of primary brain tumors. The first approach is to identify risk factors, which may be intrinsic or related to external causes. The second main approach is descriptive. Intrinsic factors potentially affecting risk include genetic predisposition and susceptibility, gender, race, birth weight and allergy. Radiation exposure is the main extrinsic factor affecting risk. A large body of work devoted, among others, to electromagnetic fields and especially cellular phones, substitutive hormonal therapy, pesticides, and diet have been published. To date, results have been discordant. Descriptive epidemiological studies have reported an increasing annual incidence of primary brain tumors in industrialized countries. The main reasons are the increasing age of the population and better access to diagnostic imaging. Comparing incidences from one registry to another is difficult. Spatial and temporal variations constitute one explanation and evolutions in coding methods another. In all registries, weak incidence of primary brain tumors constitute a very important limiting factor. Renewed interest from the neuro-oncological community is needed to obtain pertinent and essential data which could facilitate improved knowledge on this topic.

Groundwater contamination by microbiological and chemical substances released from hospital wastewater: health risk assessment for drinking water consumers

Contamination of natural aquatic ecosystems by hospital wastewater is a major environmental and human health issue. Disinfectants, pharmaceuticals, radionuclides and solvents are widely used in hospitals for medical purposes and research. After application, some of these substances combine with hospital effluents and, in industrialised countries, reach the municipal sewer network. In certain developing countries, hospitals usually discharge their wastewater into septic tanks equipped with diffusion wells. The discharge of chemical compounds from hospital activities into the natural environment can lead to the pollution of water resources and risks for human health. The aim of this article is to present: (i) the steps of a procedure intended to evaluate risks to human health linked to hospital effluents discharged into a septic tank equipped with a diffusion well; and (ii) the results of its application on the effluents of a hospital in Port-au-Prince. The procedure is based on a scenario that describes the discharge of hospital effluents, via septic tanks, into a karstic formation where water resources are used for human consumption. COD, Chloroform, dichlomethane, dibromochloromethane, dichlorobromomethane and bromoform contents were measured. Furthermore, the presence of heavy metals (chrome, nickel and lead) and faecal coliforms were studied. Maximum concentrations were 700 NPP/100 ml for faecal coliforms and 112 mg/L for COD. A risk of infection of 10(-5) infection per year was calculated. Major chemical risks, particularly for children, relating to Pb(II), Cr(III), Cr(VI) and Ni(II) contained in the ground water were also characterised. Certain aspects of the scenario studied require improvement, especially those relating to the characterisation of drugs in groundwater and the detection of other microbiological indicators such as protozoa, enterococcus and viruses.

Brain tumor epidemiology: consensus from the Brain Tumor Epidemiology Consortium

Epidemiologists in the Brain Tumor Epidemiology Consortium (BTEC) have prioritized areas for further research. Although many risk factors have been examined over the past several decades, there are few consistent findings, possibly because of small sample sizes in individual studies and differences between studies in patients, tumor types, and methods of classification. Individual studies generally have lacked samples of sufficient size to examine interactions. A major priority based on available evidence and technologies includes expanding research in genetics and molecular epidemiology of brain tumors. BTEC has taken an active role in promoting understudied groups, such as pediatric brain tumors; the etiology of rare glioma subtypes, such as oligodendroglioma; and meningioma, which, although it is not uncommon, has only recently been registered systematically in the United States. There also is a pressing need for more researchers, especially junior investigators, to study brain tumor epidemiology. However, relatively poor funding for brain tumor research has made it difficult to encourage careers in this area. In this report, BTEC epidemiologists reviewed the group's consensus on the current state of scientific findings, and they present a consensus on research priorities to identify which important areas the science should move to address.

Toxicity and carcinogenicity of the water disinfection byproduct, dibromoacetic acid, in rats and mice

Dibromoacetic acid (DBA) is a water disinfection byproduct formed by the reaction of chlorine oxidizing compounds with natural organic matter in water containing bromide. Male and female F344/N rats and B6C3F(1) mice were exposed to DBA in drinking water for 2 weeks (N=5), 3 months (N=10), or 2 years (N=50). Concentrations of DBA in drinking water were 0, 125, 250, 500, 1000, and 2000mg/L in the 2-week and 3-month studies, and 0, 50, 500, and 1000mg/L in the 2-year studies. Toxic effects of DBA in the prechronic studies were detected in the liver (hepatocellular cytoplasmic vacuolization in rats and mice) and testes (delayed spermiation and atypical residual bodies in male rats and mice, and atrophy of the germinal epithelium in rats). In the 2-year studies, neoplasms were induced at multiple sites in rats and mice exposed to DBA; these included mononuclear cell leukemia and abdominal cavity mesothliomas in rats, and neoplasms of the liver (hepatocellular adenoma or carcinoma and hepatoblastoma) and lung (alveolar adenoma or carcinoma) in mice. The increase in incidence of hepatocellular neoplasms in male mice was significant even at the lowest exposure concentration of 50mg/L, which is equivalent to an average daily dose of approximately 4mg/kg. These studies provide critical information for future re-evaluations of health-based drinking water standards for haloacetic acids.

Modulation of the cytotoxicity and genotoxicity of the drinking water disinfection byproduct lodoacetic acid by suppressors of oxidative stress

Drinking water disinfection byproducts (DBPs) are generated by the chemical disinfection of water and may pose a hazard to the public health. Previously we demonstrated that iodoacetic acid was the most cytotoxic and genotoxic DBP analyzed in a mammalian cell system. Little is known of the mechanisms of its genotoxicity. The involvement of oxidative stress in the toxicity of iodoacetic acid was analyzed with the antioxidants catalase and butylated hydroxyanisole (BHA). lodoacetic acid toxicity was quantitatively measured with and without antioxidants in Salmonella typhimurium strain TA100 and with Chinese hamster ovary (CHO) cells. The endpoints included cytotoxicity in S. typhimurium or in CHO cells, mutagenicity in S. typhimurium, and genotoxicity in CHO cells. Neither catalase nor BHA reduced the level of iodoacetic acid induced cytotoxicity in S. typhimurium. In CHO cells neither antioxidant caused a significant reduction in iodoacetic acid induced cytotoxicity. However, in S. typhimurium, BHA or catalase reduced the mutagenicity of iodoacetic acid by 33.5 and 26.8%, respectively. Likewise, BHA or catalase reduced iodoacetic acid induced genomic DNA damage by 86.5 and 42%, respectively. These results support the hypothesis that oxidative stress is involved in the induction of genotoxicity and mutagenicity by iodoacetic acid.

Chlorination disinfection by-products in drinking water and the risk of adult leukemia in Canada

The authors conducted a population-based case-control study of 1,068 incident leukemia cases and 5,039 controls aged 20-74 years during 1994-1997 to examine the association between exposure to drinking water chlorination disinfection by-products and adult leukemia risk in Canada. Residence and drinking water source histories and data from municipal water supplies were used to estimate individual chlorination disinfection by-product exposure according to water source, chlorination status, and chlorination disinfection by-product levels during the 40-year period before the interview. The analysis included 686 cases and 3,420 controls for whom water quality information was available for at least 30 of these years. Increased risk of chronic myeloid leukemia was associated with increasing years of exposure to different chlorination disinfection by-product indexes, with an adjusted odds ratio of 1.72 (95% confidence interval: 1.01, 3.08) for the highest exposure duration to total trihalomethanes of more than 40 microg/liter. In contrast, the risk of the other studied leukemia subtypes was found to decrease with increasing years of exposure to chlorination disinfection by-products. A protective effect was noted for chronic lymphoid leukemia (odds ratio = 0.60, 95 percent confidence interval: 0.41, 0.87) associated with the highest exposure duration to total trihalomethanes of more than 40 microg/liter. More studies with long-term exposure measures and large enough to evaluate leukemia subtypes are needed to further understanding of the issue.

Gliomas and Farm Pesticide Exposure in Men: The Upper Midwest Health Study

The National Institute for Occupational Safety and Health evaluated farm pesticide exposure and glioma risk in a study that included 457 glioma cases and 648 population-based controls, all adult men (18-80 yr old) and nonmetropolitan residents of Iowa, Michigan, Minnesota, and Wisconsin. Multiple logistic regressions were used to control for farm residence, age, age group, education, and exposure to other pesticides. No associations were found between glioma and 12 specific pesticides. We estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) and found reduced glioma risk for insecticides (OR = 0.53, CI = 0.37-0.77), fumigants (OR = 0.57, CI = 0.34-0.95), and organochlorines (OR = 0.66, CI = 0.47-0.94). In analyses excluding proxy respondents (47% of cases) most CIs included 1.0. No positive association of farm pesticide exposure and glioma was found. Other farm exposures may explain the excess brain cancer risk seen in previous studies.

Nitrate in public water supplies and the risk of colon and rectum cancers

BACKGROUND

Nitrate is a widespread contaminant of drinking water, but its potential health effects are unclear. In the body, nitrate is reduced to nitrite, which can react with amines and amides by nitrosation to form N-nitroso compounds, known animal carcinogens. N-nitroso compound formation is inhibited by certain nutrients, such as vitamin C, and increased by meat intake.

METHODS

We investigated the association of nitrate in public water supplies with incident colon and rectum cancers in a case-control study conducted in Iowa from 1986 to 1989. Nitrate levels in Iowa towns were linked to the participants' water source histories. We focused our analyses on the period from 1960 onward, during which nitrate measurements were more frequent, and we restricted analyses to those persons with public water supplies that had nitrate data (actual or imputed) for greater than 70% of this time period (376 colon cancer cases, 338 rectum cancer cases, and 1244 controls).

RESULTS

There were negligible overall associations of colon or rectum cancers with measures of nitrate in public water supplies, including average nitrate and the number of years with elevated average nitrate levels. For more than 10 years with average nitrate greater than 5 mg/L, the odds ratio (OR) for colon cancer was 1.2 (95% confidence interval [CI] = 0.9-1.6) and for rectum the OR was 1.1 (CI = 0.7-1.5). However, nitrate exposure (>10 years with average nitrate >5 mg/L) was associated with increased colon cancer risk among subgroups with low vitamin C intake (OR = 2.0; CI = 1.2-3.3) and high meat intake (OR = 2.2; CI = 1.4-3.6). These patterns were not observed for rectum cancer.

CONCLUSIONS

Our analyses suggest that any increased risk of colon cancer associated with nitrate in public water supplies might occur only among susceptible subpopulations.

Intracranial Neoplasms

This chapter begins with a discussion of the taxonomy of primary brain tumors, with a focus on gliomas, meningiomas, and grading systems for these tumors. It discusses methodological challenges for studies of brain tumor incidence including variations in diagnostic practices. It summarizes descriptive epidemiology studies of brain tumor incidence and mortality by age, sex, histologic type, and ethnicity. Factors associated with survival are discussed including histologic grade, tumor location, and extent of surgical resection. Much work remains to discover the causes of the majority of human brain tumors, as established risk factors account for only a small proportion of these tumors. The chapter critiques evidence regarding possible risk factors for brain tumors, including genetic predisposition, ionizing radiation, chemical carcinogen exposure, electromagnetic fields, infections, head trauma, smoking, and diet.

Different frames, different fears: communicating about chlorinated drinking water and cancer in the Canadian media

Risk issues become complicated when scientific evidence concerning a potential environmental exposure is equivocal; particularly when many argue that the public health benefits of a policy action outweigh any potential negative health effects. Chlorinated drinking water, and chlorinated disinfection byproducts (CDBPs) that are formed during the disinfection process, represent a useful case-study for examining these complications. We conduct a media analysis of chlorinated drinking water stories in the Canadian print media from 1977 to 2000. We examine media presentations of science compared to framings by scientists, regulators, the chlorine industry, water utility representatives, and non-governmental organizations of the CDBP issue based on key informant interviews. We argue that there are two main framings of the debate, each of which are powerful in constructing risk perceptions. On the one hand, many frame the debate as a 'voluntary' risk: we choose chlorine disinfection to protect against microbial risks with a possible adverse consequence of that protection. On the other hand, others frame the issue as an 'involuntary' risk: chlorine disinfection was a 'choice' imposed by public health and water utility officials; a choice that carries a potential cancer risk, and alternative disinfection technologies are advocated. We demonstrate these different frames by examining metaphorical constructs of water, chlorine and cancer contained within them.

Analysis of the cytotoxicity and mutagenicity of drinking water disinfection by-products in Salmonella typhimurium

We analyzed the cytotoxicity and mutagenicity of the drinking water disinfection by-products (DBPs) bromoform (BF), bromoacetic acid (BA), dibromoacetic acid (DBA), tribromoacetic acid (TCA), chloroform (CF), chloroacetic acid (CA), dichloroacetic acid (DCA), trichloroacetic acid (TCA), 3-chloro-4-(dichloromethyl)-5-hydroxy-2[5H]-furanone (MX), and potassium bromate (KBrO3) in Salmonella typhimurium strains TA98, TA100, and RSJ100 +/- S9. Solvent controls of DMSO and ethanol and a positive control of ethylmethanesulfonate (EMS) were also analyzed. We developed a rapid microplate-based method to determine the cytotoxicity of the DBPs and we determined their mutagenic potencies. The distributions of the rank order for the cytotoxicity and mutagenicity of these DBPs were compared and the structure-function relationships were identified. TA100 -S9 was the most sensitive strain for these DBPs. The rank order of the mutagenic potency adjusted with a cytoxicity factor was MX > BA > EMS > DBA > DCA > CA with TBA, TCA, BF, and CF not mutagenic. From a structure-function perspective, the brominated acetic acids were more cytotoxic and mutagenic than their chlorinated analogs. BA was 150x more mutagenic than CA. The mutagenic potency of the haloacetic acids was inversely related to the number of halogen atoms of the molecule. BA was 36x more mutagenic than DBA. The differential cytotoxicity expressed by the DBPs indicated that a cytotoxicity analysis enhanced the sensitivity of the mutagenicity data, which resulted in an enhanced precision for comparing their relative mutagenic strengths. This information is critical when conducting quantitative structure-function analysis of these hazardous agents.

Associação entre fatores da dieta e tumores de cérebro em adultos: uma revisão da literatura

Desenvolveu-se uma revisão da literatura científica publicada entre 1986 e 1999, sobre a associação entre fatores da dieta e os tumores de cérebro em adultos, com o objetivo de descrever as associações observadas e discutir os aspectos metodológicos que possam influenciar os resultados observados. De um modo geral, os estudos revisados parecem apontar na direção de uma associação moderada entre os fatores da dieta e os tumores de cérebro; há evidências de que o consumo de compostos N-nitroso possa favorecer o desenvolvimento desses tumores, e de que o consumo de vegetais e frutas pode ter papel na sua inibição. A participação dos respondentes substitutos nos estudos analisados, pode ter introduzido viés de memória nas informações levantadas e contribuído para a inconsistência dos achados. As investigações epidemiológicas sobre a associação da dieta com estes tumores devem considerar a análise de outros fatores alimentares, além dos compostos N-nitroso. É necessário precisar os períodos de exposição que devem ser investigados e contar com criteriosa metodologia, de modo a prevenir a ocorrência de tendenciosidades relacionadas com a seleção dos controles e minimizar os efeitos do viés de memória.

Occupational risk factors for brain cancer: a population-based case-control study in Iowa

A number of occupations and industries have been inconsistently associated with the risk of brain cancer. To further explore possible relationships, we conducted a population-based case-control study of brain glioma in the state of Iowa, involving 375 histologically confirmed incident cases and 2434 population-based controls. Among men, the industries and/or occupations that had a significantly increased risk for employment of more than 10 years included roofing, siding, and sheet metalworking; newspaper work; rubber and plastics products, particularly tires and inner tubes; miscellaneous manufacturing industries; wholesale trade of durable goods, grain, and field beans; cleaning and building service occupations; miscellaneous mechanics and repairers; and janitors and cleaners. Subjects who worked in plumbing, heating, and air conditioning; electrical services; gasoline service stations; and military occupations also experienced a significantly increased risk. Among women, significant excess risk was observed for occupations in agricultural services and farming, apparel and textile products, electrical and electronic equipment manufacturing, various retail sales, record-keeping, and restaurant service. Workers in industries with a potential for gasoline or motor exhaust exposures experienced a non-significant excess risk of brain glioma.

Estimation of potential lifetime cancer risks for trihalomethanes from consuming chlorinated drinking water in Taiwan

Data on concentrations of trihalomethanes (THMs) in raw and chlorinated water collected from three water treatment plants in Taiwan and estimates of the lifetime cancer risk for THMs from drinking water, using age-adjusted factors and volatilization terms, are presented. Data on THM levels in drinking water were obtained from the annual reports of the Environmental Protection Administration (EPA) of Taiwan. The methodology for estimation of lifetime cancer risks was taken from the USEPA. Chloroform was the major species of THMs, especially in the water plant of south Taiwan. Chloroform contributed the majority of the lifetime cancer risks (range: 87.5-92.5%) of total risks from the three water supply areas. All lifetime cancer risks for CHCl(3), CHBrCl(2), CHBr2Cl, and CHBr3 from consuming tap water in the three water supply areas were higher than 10(-6). The sum of lifetime cancer risks for CHCl(3), CHBrCl(3), CHBr2Cl, and CHBr3 was highest (total risk for total THMs<1.94x10(-4)) for tap water from south Taiwan.