1
|
Dėdelė A, Nikiforov N, Miškinytė A. Relationship of trihalomethane in drinking water with hypertension and arrhythmia among young and middle-aged adults in Petropavlovsk, Kazakhstan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:2463-2475. [PMID: 37669752 DOI: 10.1080/09603123.2023.2254251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 08/29/2023] [Indexed: 09/07/2023]
Abstract
There are no studies investigating the association of chlorinated drinking water with the risk of cardiovascular diseases (CVDs) among young and middle-aged adults. This study was aimed to assess the associations between trihalomethanes (THMs) in drinking water and the risk of CVDs in in the target group in Petropavlovsk, Kazakhstan. 448 dwellers of Petropavlovsk were asked about their demographic, socioeconomic, lifestyle, behavioural characteristics, and drinking water preferences. THMs exposure was assessed to each participant based on their residence address. We used multivariable logistic regression analysis to assess the risk of CVDs in young and middle-aged adults. The results showed that the risk of hypertension in the adjusted logistic regression model was increased by 68% and a 2.7-fold in the second and third THM tertiles, respectively. Participants in the second and third THM exposure tertiles had a 2.3-fold and a 4.8-fold increase in the risk of arrhythmia.
Collapse
Affiliation(s)
- Audrius Dėdelė
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Akademija, Lithuania
| | - Nazim Nikiforov
- Department of Science, Kozybayev University, Petropavl, Kazakhstan
| | - Auksė Miškinytė
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Akademija, Lithuania
| |
Collapse
|
2
|
Wastensson G, Eriksson K. Inorganic chloramines: a critical review of the toxicological and epidemiological evidence as a basis for occupational exposure limit setting. Crit Rev Toxicol 2020; 50:219-271. [PMID: 32484073 DOI: 10.1080/10408444.2020.1744514] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Inorganic chloramines are not commercially available, but monochloramine is produced in situ for disinfection or for use in chemical synthesis. Inorganic chloramines are also formed when free chlorine reacts with nitrogen containing substances, e.g. ammonia and urea, present in chlorinated water sources. Occupational exposure may, therefore, occur in e.g. swimming pool facilities and the food processing industry. Monochloramine is soluble and stable in water and the dominating inorganic chloramine in chlorinated water sources. No clinical effects were seen in healthy volunteers given monochloramine in drinking water during 4 or 12 weeks in doses of 0.043 or 0.034 mg/kg bw/day, respectively. Limited data indicate that monochloramine is weakly mutagenic in vitro but not genotoxic in vivo. One drinking water study indicated equivocal evidence of carcinogenicity in female rats but not in male rats and mice. No reproductive or developmental effects were shown in rodents in the few studies located. Dichloramine is soluble but unstable in water. In the only study located, mild histological effects in kidneys, thyroid and gastric cardia were observed in rats administered dichloramine in drinking water for 13 weeks. Trichloramine is immiscible with water and evaporates easily from water into air. Therefore, the primary exposure route of concern in the occupational setting is inhalation. Occupational exposure to trichloramine has been demonstrated in indoor swimming pool facilities and in the food processing industry where chlorinated water is used for disinfection. Exposure-response relationships between airborne levels and self-reported ocular and upper airway irritation have been shown in several studies. Exposure to trichloramine may aggravate asthma symptoms in individuals with existing asthma. The risk of developing asthma following long-term exposure to trichloramine cannot be evaluated at present. No data on genotoxic, carcinogenic, reproductive or developmental effects were located. The toxicological data for mono- and dichloramine are insufficient to recommend health-based occupational exposure limits (OELs).As regard trichloramine, the critical effect is judged to be irritation observed in several studies on pool workers, starting at approximately 0.4 mg/m3 (stationary sampling). Based on these data, a health-based OEL of 0.1 mg/m3 (8-h time-weighted average) is recommended. This corresponds to 0.2 mg/m3 for stationary measurements in swimming pool facilities. No short-term exposure limit (STEL) is recommended.
Collapse
Affiliation(s)
- Gunilla Wastensson
- Department of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kåre Eriksson
- Department of Sustainable Health, Umeå University, Umeå, Sweden
| |
Collapse
|
3
|
Font-Ribera L, Gràcia-Lavedan E, Aragonés N, Pérez-Gómez B, Pollán M, Amiano P, Jiménez-Zabala A, Castaño-Vinyals G, Roca-Barceló A, Ardanaz E, Burgui R, Molina AJ, Fernández-Villa T, Gómez-Acebo I, Dierssen-Sotos T, Moreno V, Fernandez-Tardon G, Peiró R, Kogevinas M, Villanueva CM. Long-term exposure to trihalomethanes in drinking water and breast cancer in the Spanish multicase-control study on cancer (MCC-SPAIN). ENVIRONMENT INTERNATIONAL 2018; 112:227-234. [PMID: 29289867 DOI: 10.1016/j.envint.2017.12.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 12/20/2017] [Accepted: 12/20/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Exposure to trihalomethanes (THMs) in drinking water has consistently been associated with an increased risk of bladder cancer, but evidence on other cancers including the breast is very limited. OBJECTIVES We assessed long-term exposure to THMs to evaluate the association with female breast cancer (BC) risk. METHODS A multi case-control study was conducted in Spain from 2008 to 2013. We included 1003 incident BC cases (women 20-85years old) recruited from 14 hospitals and 1458 population controls. Subjects were interviewed to ascertain residential histories and major recognized risk factors for BC. Mean residential levels of chloroform, brominated THMs (Br-THMs) and the sum of both as total THM (TTHMs) during the adult-lifetime were calculated. RESULTS Mean adult-lifetime residential levels ranged from 0.8 to 145.7μg/L for TTHM (median=30.8), from 0.2 to 62.4μg/L for chloroform (median=19.7) and from 0.3 to 126.0μg/L for Br-THMs (median=9.7). Adult-lifetime residential chloroform was associated with BC (adjusted OR=1.47; 95%CI=1.05, 2.06 for the highest (>24μg/L) vs. lowest (<8μg/L) quartile; p-trend=0.024). No association was detected for residential Br-THMs (OR=0.91; 95%CI=0.68, 1.23 for >31μg/L vs. <6μg/L) or TTHMs (OR=1.14; 95%CI=0.83, 1.57 for >48μg/L vs. <22μg/L). CONCLUSIONS At common levels in Europe, long-term residential total THMs were not related to female breast cancer. A moderate association with chloroform was suggested at the highest exposure category. This large epidemiological study with extensive exposure assessment overcomes several limitations of previous studies but further studies are needed to confirm these results.
Collapse
Affiliation(s)
- Laia Font-Ribera
- ISGlobal, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Esther Gràcia-Lavedan
- ISGlobal, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Nuria Aragonés
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Beatriz Pérez-Gómez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Marina Pollán
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta De Hierro, Madrid, Spain
| | - Pilar Amiano
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain
| | - Ana Jiménez-Zabala
- Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain
| | - Gemma Castaño-Vinyals
- ISGlobal, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Aina Roca-Barceló
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona, Spain
| | - Eva Ardanaz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain
| | - Rosana Burgui
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain
| | - Antonio José Molina
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud, Universidad de León, Spain
| | - Tania Fernández-Villa
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud, Universidad de León, Spain
| | - Inés Gómez-Acebo
- Department of Preventive Medicine and Public Health, University of Cantabria, Santander, Spain
| | - Trinidad Dierssen-Sotos
- Department of Preventive Medicine and Public Health, University of Cantabria, Santander, Spain
| | - Victor Moreno
- Unit of Biomarkers and Susceptibility, Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO), Hospitalet de Llobregat, Spain; Colorectal Cancer Group, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | | | - Rosana Peiró
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Centre for Research in Public Health, Valencia, Spain
| | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Cristina M Villanueva
- ISGlobal, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| |
Collapse
|
4
|
Thomas RD. Epidemiology and Toxicology of Volatile Organic Chemical Contaminants in Water Absorbed Through the Skin. ACTA ACUST UNITED AC 2016. [DOI: 10.3109/10915818909018036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This paper provides a general introduction to the occurrence, epidemiology, and toxicity of some of the most common contaminants of water supplies, the volatile organic chemicals (VOCs). The VOCs are formed from the reaction of chlorine during disinfection with naturally occurring carbon in the form of humic acids. The VOCs may also enter water supplies as a result of manufacturing, processing, distribution, and urban and agricultural run off. Their occurrence is summarized in this paper. No epidemiologic studies examine the health effects where skin is the sole route of exposure. However, in several studies skin is one of the routes of exposure for VOCs. These are summarized in this paper. Finally, the toxicity of some of the more important VOCs is summarized. Where possible, similarities in toxicity between individual members of this class of chemical contaminants are noted. There are striking similarities of toxicity of various VOCs in the liver, kidney, and hematopoietic system. These similarities should be considered as skin exposure models are being developed.
Collapse
Affiliation(s)
- Richard D. Thomas
- National Academy of Sciences 2101 Constitution Avenue NW Washington, D.C. 20418
| |
Collapse
|
5
|
Jović M, Cortés-Salazar F, Lesch A, Amstutz V, Bi H, Girault HH. Electrochemical detection of free chlorine at inkjet printed silver electrodes. J Electroanal Chem (Lausanne) 2015. [DOI: 10.1016/j.jelechem.2015.08.024] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
6
|
Parbery G, Tivey D, McArthur A. Epidemiological association between chlorinated water and overall risk of cancer: A systematic review. JBI LIBRARY OF SYSTEMATIC REVIEWS 2012; 10:1-14. [PMID: 27820291 DOI: 10.11124/01938924-201210561-00020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Gordon Parbery
- 1. Gordon Parbery, BSc, Post Graduate Diploma Human Nutrition and Dietetics, MSc Clinical Science Candidate, The Joanna Briggs Institute, Faculty of Health Sciences, The University of Adelaide, South Australia. Australia 5005. 2. The Joanna Briggs Institute, Faculty of Health Sciences, The University of Adelaide, SA5005
| | | | | |
Collapse
|
7
|
Guo TL, Germolec DR, Collins BJ, Luebke RW, Auttachoat W, Smith MJ, White KL. Immunotoxicological profile of chloramine in female B6C3F1mice when administered in the drinking water for 28 days. J Immunotoxicol 2011; 8:381-8. [DOI: 10.3109/1547691x.2011.622317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
8
|
Parvez S, Rivera-Núñez Z, Meyer A, Wright JM. Temporal variability in trihalomethane and haloacetic acid concentrations in Massachusetts public drinking water systems. ENVIRONMENTAL RESEARCH 2011; 111:499-509. [PMID: 21316653 DOI: 10.1016/j.envres.2010.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Revised: 12/20/2010] [Accepted: 12/22/2010] [Indexed: 05/30/2023]
Abstract
Previous epidemiological studies in Massachusetts have reported a risk of adverse health outcomes in relation to disinfection by-product (DBP) exposures. Measurement error due to the use of indirect exposure surrogates can lead to misclassification bias in epidemiological studies; therefore, it is important to characterize exposure variability in these populations to assess the potential for exposure misclassification. We used 19,944 trihalomethane (THM) samples and 9291 haloacetic acid (HAA) samples collected in 201 public water systems (PWSs) in Massachusetts to examine temporal variability under different drinking water sources and disinfection types. Annual and seasonal variability was also examined in 46 PWSs with complete quarterly THM4 (i.e., the sum of 4 individual THMs) data from 1995 to 2004 and 19 PWSs with complete HAA5 (i.e., the sum of 5 individual HAAs) data from 2001 to 2004. The quarterly ratio of THM4 and HAA5 and correlations between THM4, HAA5 and individual DBP species were examined to determine the adequacy of using different exposure surrogates in epidemiological studies. Individual PWSs were used to examine monthly variability in relation to quarterly averages. Based on all available matched samples (n=9003) from 1995 to 2004 data, we found a correlation of 0.52 for THM4 and HAA5. The correlation was stronger among the 62 ground water systems (r(s)=0.62) compared to the 81 surface water (r(s)=0.45) and 40 mixed water (r(s)=0.39) systems. Mean THM4 levels were fairly stable over the 10-year study period for 46 PWSs including 39 PWSs that did not change disinfection. Large reductions (∼40 μg/L) in mean THM4 data were found among seven systems that switched from chlorination to alternative disinfectants. As expected, the highest mean THM4 values were detected for Quarter 3, while the lowest values were found in Quarter 1. The highest HAA5 values were detected in Quarters 2 and 3 and the lowest was found in Quarter 4. Data from four systems showed mean differences up to 66 μg/L (67% change) in successive months and by 46 μg/L compared to quarterly mean concentrations. Although longer-term disinfection by-product temporality may be minimal in this study population, the use of monthly average concentrations for exposure assessment may be needed for some PWSs to minimize misclassification of narrow critical periods of exposure in epidemiological studies.
Collapse
Affiliation(s)
- Shahid Parvez
- Oak Ridge Institute for Science and Education, 1299 Bethel Valley Road, Oak Ridge, TN 37830, USA
| | | | | | | |
Collapse
|
9
|
Chiu HF, Tsai SS, Wu TN, Yang CY. Effect modification of the association between trihalomethanes and pancreatic cancer by drinking water hardness: evidence from an ecological study. ENVIRONMENTAL RESEARCH 2010; 110:513-518. [PMID: 20382379 DOI: 10.1016/j.envres.2010.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2009] [Revised: 02/26/2010] [Accepted: 03/17/2010] [Indexed: 05/29/2023]
Abstract
The objective of this study was to examine the relationship between total trihalomethanes (TTHM) levels in public water supplies and risk of pancreatic cancer and to determine whether calcium (Ca) and magnesium (Mg) levels in drinking water modify the effects of TTHM on risk to develop pancreatic cancer. A matched case-control study was used to investigate the relationship between the risk of death attributed to pancreatic cancer and exposure to TTHM in drinking water in 53 municipalities in Taiwan. All pancreatic cancer deaths in the 53 municipalities from 1998 through 2007 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair matched to the cancer cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each cancer case. Data on TTHM levels in drinking water were collected from Taiwan Environmental Protection Administration. Information on the levels of Ca and Mg in drinking water was obtained from the Taiwan Water Supply Corporation. The municipality of residence for cancer cases and controls was presumed to be the source of the subject's TTHM, Ca, and Mg exposure via drinking water. Relative to individuals whose TTHM exposure level < 4.9ppb, the adjusted OR (95% CI) for pancreatic cancer was 1.01 (0.85-1.21) for individuals who resided in municipalities served by drinking water with a TTHM exposure > 4.9ppb. There was no evidence of an interaction of drinking water TTHM levels with low Ca intake via drinking water. However, we observed evidence of an interaction between drinking water TTHM concentrations and Mg intake via drinking water. Our findings showed that the correlation between TTHM exposure and risk of pancreatic cancer is influenced by Mg in drinking water. Increased knowledge of the interaction between Mg and TTHM in reducing pancreatic cancer risk will aid in public policy making and standard setting.
Collapse
Affiliation(s)
- Hui-Fen Chiu
- Department of Pharmacology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | | | | |
Collapse
|
10
|
Rahman MB, Driscoll T, Cowie C, Armstrong BK. Disinfection by-products in drinking water and colorectal cancer: a meta-analysis. Int J Epidemiol 2010; 39:733-45. [PMID: 20139236 DOI: 10.1093/ije/dyp371] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND There is inconclusive evidence from observational studies that disinfection by-products (DBPs) in drinking water are associated with colorectal cancer. METHODS A literature search, without language or time limits, was performed to identify relevant case-control and cohort studies. Separate risk estimates for colon and rectal cancer were extracted from studies meeting the inclusion criteria. Relative risks (RRs) or odds ratios (ORs) comparing the highest exposure category with the lowest were pooled using random effects methods. RESULTS A total of 13 studies (3 cohort and 10 case-control) were analysed. For colon cancer, the pooled RR estimates were 1.11 [95% confidence interval (CI): 0.73-1.70] for cohort studies, 1.33 (95% CI: 1.12-1.57) for case-control studies and 1.27 (95% CI: 1.08-1.50) combining both study types. For rectal cancer, the corresponding RR estimates were 0.88 (0.57-1.35), 1.40 (1.15-1.70) and 1.30 (1.06-1.59). Sensitivity analysis showed these results were not importantly influenced by any single study. Publication bias was not evident for the colon cancer analysis but may have been a minor issue for the rectal cancer analysis. The results for rectal cancer may have been influenced by the quality of the studies. CONCLUSIONS The study findings provide limited evidence of a positive association between colorectal cancer and exposure to DBPs in drinking water. The small number of studies and limitations in study quality prevent causal inference.
Collapse
Affiliation(s)
- Md Bayzidur Rahman
- School of Public Health, The University of Sydney, Sydney, NSW, Australia.
| | | | | | | |
Collapse
|
11
|
Backer LC, Coss AM, Wolkin AF, Flanders WD, Reif JS. Evaluation of associations between lifetime exposure to drinking water disinfection by-products and bladder cancer in dogs. J Am Vet Med Assoc 2008; 232:1663-8. [PMID: 18518807 DOI: 10.2460/javma.232.11.1663] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the risk of bladder cancer in dogs from exposure to drinking water disinfection by-products and determine whether dogs could serve as sentinels for human bladder cancer associated with such exposures. DESIGN Case-control study. ANIMALS 100 dogs with cancer of the urinary bladder and 100 control dogs. PROCEDURES Case and control dogs were frequency-matched by age (within 2 years) and sex. Owners of dogs enrolled provided verbal informed consent and were interviewed by telephone. The telephone questionnaire included a complete residence history for each dog. Each dog's total exposure history to trihalomethanes was reconstructed from its residence history and corresponding drinking water utility company data. RESULTS No association was detected between increasing years of exposure to chlorinated drinking water and risk of bladder cancer. Dogs with bladder cancer were exposed to higher total trihalomethanes concentrations than control dogs; however, the difference was not significant. CONCLUSIONS AND CLINICAL RELEVANCE Although humans and their dogs live in the same household, the activity patterns of dogs may lead to lower exposures to household tap water. Thus, although exposure to disinfection by-products in tap water may be a risk factor for human bladder cancer, this may not be true for canine bladder cancer at the concentrations at which dogs are exposed.
Collapse
Affiliation(s)
- Lorraine C Backer
- National Center for Environmental Health, CDC, Atlanta, GA 30341, USA
| | | | | | | | | |
Collapse
|
12
|
Bove GE, Rogerson PA, Vena JE. Case control study of the geographic variability of exposure to disinfectant byproducts and risk for rectal cancer. Int J Health Geogr 2007; 6:18. [PMID: 17535441 PMCID: PMC1890278 DOI: 10.1186/1476-072x-6-18] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2007] [Accepted: 05/29/2007] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Levels of byproducts that result from the disinfection of drinking water vary within a water distribution system. This prompted us to question whether the risk for rectal cancer also varies, depending upon one's long term geographic location within the system. Such a geographic distribution in rectal cancer risk would follow naturally from an association between level of byproduct and rectal cancer risk. We assess the effects of estimated geographic variability in exposure to some of the components of the trihalomethane group of disinfectant byproducts (DBPs) on the odds ratios and probabilities for rectal cancer in white males in a case control study of 128 cases and 253 controls, conducted in Monroe County, Western New York State, U.S.A. The study was designed around health data initially collected at the University at Buffalo (Department of Social and Preventative Medicine) as part of the Upstate New York Diet Study, and trihalomethane (THM) data collected from a separate independent study of THMs conducted by Monroe County Department of Health. Case participants were chosen from hospital pathology records. The controls are disease-free white males between 35-90 years old, living in Monroe County, and chosen from control groups for studies from cancer of five other (unrelated) sites. Using a combination of case control methodology and spatial analysis, the spatial patterns of THMs and individual measures of tap water consumption provide estimates of the effects of ingestion of specific amounts of some DBPs on rectal cancer risk. Trihalomethane (THM) data were used to spatially interpolate levels at the taps of cases and controls, and odds ratios were estimated using logistic regression to assess the effects of estimated THM exposure dose on cancer risk, adjusting for alcohol, dietary beta carotene intake, tap water intake, and total caloric intake. RESULTS Trihalomethane levels varied spatially within the county; although risk for rectal cancer did not increase with total level of trihalomethanes, increasing levels of the component bromoform (measured in ug/day) did correspond with an increase in odds ratios (OR = 1.85; 95% CI = 1.25 - 2.74) for rectal cancer. The highest quartiles of estimated consumption of bromoform (1.69-15.43 ug/day) led to increased risk for rectal cancer (OR = 2.32; 95% CI = 1.22-4.39). Two other THMs were marginally associated with an increase in risk - chlorodibromomethane (OR = 1.78, 95% CI = 1.00-3.19) and bromodichloromethane (OR = 1.15; 95% CI = 1.00-1.32). CONCLUSION Levels of THMs in the water distribution system exhibited spatial variation that was partially due to variation in water age. We also observed a geographic pattern of increased risk of rectal cancer in areas with the highest levels of bromoform in the county.
Collapse
Affiliation(s)
- Gerald E Bove
- Department of Geography, University at Buffalo, Wilkeson Hall, Buffalo, NY 14261, USA
| | - Peter A Rogerson
- Department of Geography, University at Buffalo, Wilkeson Hall, Buffalo, NY 14261, USA
- Department of Biostatistics, University at Buffalo, Farber Hall, Buffalo, NY 14261, USA
| | - John E Vena
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Columbia, SC 29208, USA
| |
Collapse
|
13
|
Do MT, Birkett NJ, Johnson KC, Krewski D, Villeneuve P. Chlorination disinfection by-products and pancreatic cancer risk. ENVIRONMENTAL HEALTH PERSPECTIVES 2005; 113:418-424. [PMID: 15811832 PMCID: PMC1278481 DOI: 10.1289/ehp.7403] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2004] [Accepted: 01/10/2005] [Indexed: 05/24/2023]
Abstract
Chlorination disinfection by-products (CDBPs) are produced during the treatment of water with chlorine to remove bacterial contamination. CDBPs have been associated with an increased risk of bladder cancer. There is also some evidence that they may increase the risk of pancreatic cancer. We report results from a population-based case-control study of 486 incident cases of pancreatic cancer and 3,596 age- and sex-matched controls. Exposure to chlorination by-products was estimated by linking lifetime residential histories to two different databases containing information on CDBP levels in municipal water supplies. Logistic regression analysis found no evidence of increased pancreatic cancer risk at higher CDBP concentrations (all odds ratios < 1.3). Null findings were also obtained assuming a latency period for pancreatic cancer induction of 3, 8, or 13 years.
Collapse
Affiliation(s)
- Minh T Do
- Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | | |
Collapse
|
14
|
Altieri A, La Vecchia C, Negri E. Fluid intake and risk of bladder and other cancers. Eur J Clin Nutr 2003; 57 Suppl 2:S59-68. [PMID: 14681715 DOI: 10.1038/sj.ejcn.1601903] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
There are appreciable differences in total fluid intake at the individual and population level, and substantial difficulties in obtaining valid measures of fluid intake. Epidemiological studies have examined the association between fluid intake and different types of cancer. For bladder cancer, fluid consumption has been associated with a moderate increase of risk in some studies, including a multicentric case-control study from the United States, based on about 3000 cases, with a decrease in others, including the Health Professional Follow-up study, or with no material association. The evidence, therefore, is far from consistent. Sources and components of fluids were also different across different types studies. From a biological point of view, a decreased fluid intake could result in a greater concentration of carcinogens in the urine or in a prolonged time of contact with the bladder mucosa because of less frequent micturition. Carcinogenic or anticarcinogenic components of various beverages excreted in the urine may also play a role in the process. It has been suggested that fluid consumption has a favorable effect on colorectal cancer risk. Fluid intake may reduce colon cancer risk by decreasing bowel transit time and reducing mucosal contact with carcinogens. Low fluid intake may also compromise cellular concentration, affect enzyme activity in metabolic regulation, and inhibit carcinogen removal. However, epidemiological data are inadequate for evaluation. Data are sparse and inconsistent for other neoplasms, including breast cancer. The fluid constituent of foods, confounding, interactions and possible influences of specific types of beverages should be investigated further. In conclusion therefore the association between total fluid intake and cancer risk remains still open to debate.
Collapse
Affiliation(s)
- A Altieri
- Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | | | | |
Collapse
|
15
|
Villanueva CM, Fernández F, Malats N, Grimalt JO, Kogevinas M. Meta-analysis of studies on individual consumption of chlorinated drinking water and bladder cancer. J Epidemiol Community Health 2003; 57:166-73. [PMID: 12594192 PMCID: PMC1732410 DOI: 10.1136/jech.57.3.166] [Citation(s) in RCA: 121] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
STUDY OBJECTIVE To evaluate whether consumption of chlorinated drinking water is associated with bladder cancer. DESIGN A bibliographic search was conducted and the authors selected studies evaluating individual consumption of chlorinated drinking water and bladder cancer. The authors extracted from each study risk estimates for intermediate and long term (>40 years) consumption of chlorinated water, stratified by sex when possible, and performed meta-analysis for the two exposure levels. A meta-analysis was also performed of the dose-response regression slopes. SETTING Populations in Europe and North America. PARTICIPANTS Those included in six case-control studies (6084 incident bladder cancer cases, 10,816 controls) and two cohort studies (124 incident bladder cancer cases) fulfilling the inclusion criteria. MAIN RESULTS Ever consumption of chlorinated drinking water was associated with an increased risk of bladder cancer in men (combined OR=1.4, 95%CI 1.1 to 1.9) and women (combined OR=1.2, 95%CI 0.7 to 1.8). The combined OR for mid-term exposure in both genders was 1.1 (95% CI 1.0 to 1.2) and for long term exposure was 1.4 (95%CI 1.2 to 1.7). The combined estimate of the slope for a linear increase in risk was 1.13 (95% CI 1.08 to 1.20) for 20 years and 1.27 (95% CI 1.15 to 1.43) for 40 years of exposure in both sexes. CONCLUSIONS This meta-analysis of the best available epidemiological evidence indicates that long term consumption of chlorinated drinking water is associated with bladder cancer, particularly in men. The observed relative risk is only moderately high, but the population attributable risk could be important as the vast majority of the population of industrialised countries is potentially exposed to chlorination byproducts for long time periods.
Collapse
Affiliation(s)
- C M Villanueva
- Respiratory and Environmental Health Research Unit, Municipal Institute of Medical Research (IMIM), Barcelona, Spain
| | | | | | | | | |
Collapse
|
16
|
Villanueva CM, Kogevinas M, Grimalt JO. [Drinking water chlorination and adverse health effects: review of epidemiological studies]. Med Clin (Barc) 2001; 117:27-35. [PMID: 11440699 DOI: 10.1016/s0025-7753(01)72000-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- C M Villanueva
- Institut Municipal d'Investigació Mèdica (IMIM). Unitat de Recerca Respiratòria i Ambiental. Instituto de Investigaciones Químicas y Ambientales de Barcelona. Departamento de Química Ambiental. Barcelona.
| | | | | |
Collapse
|
17
|
|
18
|
Koivusalo M, Vartiainen T. Drinking water chlorination by-products and cancer. REVIEWS ON ENVIRONMENTAL HEALTH 1997; 12:81-90. [PMID: 9273924 DOI: 10.1515/reveh.1997.12.2.81] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This review discusses the relation between by-products of drinking water chlorination and cancer in the light of present toxicological and epidemiologic evidence. During the chlorination of drinking water, a complex mixture of by-products forms from chlorine and the organic and inorganic compounds present in raw water. The quality and quantity of such compounds depend on the specific nature of the organic material in raw waters, the inorganic material in raw water, pH, temperature, other water treatment practices, and the chlorine timing and dose added. Chlorination by-products are important mainly when surface water is used for drinking water as more organic compounds are present in surface waters than in ground waters. The gastrointestinal and urinary tract are the cancer sites that are most often associated with the use of chlorinated surface water or with the quantity of chlorination by-products in the water-supply network. Yet the microbial quality of drinking water should not be compromised by excessive caution over the potential long-term effects of disinfection by-products because the risk of illness and death resulting from exposure to pathogens in untreated drinking water may be several orders of magnitude greater than the cancer risks from chlorination by-products.
Collapse
|
19
|
Munger R, Isacson P, Hu S, Burns T, Hanson J, Lynch CF, Cherryholmes K, Van Dorpe P, Hausler WJ. Intrauterine growth retardation in Iowa communities with herbicide-contaminated drinking water supplies. ENVIRONMENTAL HEALTH PERSPECTIVES 1997. [PMID: 9171992 DOI: 10.2307/3433268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
In a statewide survey of 856 Iowa municipal drinking water supplies in 1986-1987 the Rathbun rural water system was found to contain elevated levels of triazine herbicides. Rates of low birth weight, prematurity, and intrauterine growth retardation (IUGR) in live singleton births during the period 1984-1990 by women living in 13 communities served by the Rathbun water system were compared to other communities of similar size in the same Iowa counties. The Rathbun communities had a greater risk of IUGR than southern Iowa communities with other surface sources of drinking water (relative risk = 1.8; 95% CI = 1.3, 2.7). Multiple linear regression analyses revealed that levels of the herbicides atrazine, metolachlor, and cyanzinc were each significant predictors of community IUGR rates in southern Iowa after controlling for several potentially confounding factors including maternal smoking and socioeconomic variables. The association with IUGR was strongest for atrazine, but all three herbicides were intercorrelated and the independent contributions of each to IUGR risk could not be determined. We conclude that communities in southern Iowa with drinking water supplies contaminated with herbicides have elevated rates of IUGR compared to neighboring communities with different water supplies. Because of the limitations of the ecologic design of this study, including aggregate rather than individual measures of exposure and limited ability to control for confounding factors related to source of drinking water and risk of IUGR, a strong causal relationship between any specific water contaminant and risk of IUGR cannot yet be inferred. The association between the water supplied to the Rathbun communities and the increased risk of IUGR should be considered a preliminary finding that needs to be verified by more detailed epidemiologic studies.
Collapse
Affiliation(s)
- R Munger
- Department of Preventive Medicine and Environmental Health, University of Iowa, Iowa City 52242, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Munger R, Isacson P, Hu S, Burns T, Hanson J, Lynch CF, Cherryholmes K, Van Dorpe P, Hausler WJ. Intrauterine growth retardation in Iowa communities with herbicide-contaminated drinking water supplies. ENVIRONMENTAL HEALTH PERSPECTIVES 1997; 105:308-14. [PMID: 9171992 PMCID: PMC1470002 DOI: 10.1289/ehp.97105308] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
In a statewide survey of 856 Iowa municipal drinking water supplies in 1986-1987 the Rathbun rural water system was found to contain elevated levels of triazine herbicides. Rates of low birth weight, prematurity, and intrauterine growth retardation (IUGR) in live singleton births during the period 1984-1990 by women living in 13 communities served by the Rathbun water system were compared to other communities of similar size in the same Iowa counties. The Rathbun communities had a greater risk of IUGR than southern Iowa communities with other surface sources of drinking water (relative risk = 1.8; 95% CI = 1.3, 2.7). Multiple linear regression analyses revealed that levels of the herbicides atrazine, metolachlor, and cyanzinc were each significant predictors of community IUGR rates in southern Iowa after controlling for several potentially confounding factors including maternal smoking and socioeconomic variables. The association with IUGR was strongest for atrazine, but all three herbicides were intercorrelated and the independent contributions of each to IUGR risk could not be determined. We conclude that communities in southern Iowa with drinking water supplies contaminated with herbicides have elevated rates of IUGR compared to neighboring communities with different water supplies. Because of the limitations of the ecologic design of this study, including aggregate rather than individual measures of exposure and limited ability to control for confounding factors related to source of drinking water and risk of IUGR, a strong causal relationship between any specific water contaminant and risk of IUGR cannot yet be inferred. The association between the water supplied to the Rathbun communities and the increased risk of IUGR should be considered a preliminary finding that needs to be verified by more detailed epidemiologic studies.
Collapse
Affiliation(s)
- R Munger
- Department of Preventive Medicine and Environmental Health, University of Iowa, Iowa City 52242, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Chapter 7: Drinking water and wastewaters. Regul Toxicol Pharmacol 1994. [DOI: 10.1016/s0273-2300(05)80023-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
22
|
Appendix B: Chlorinated alkanes. Regul Toxicol Pharmacol 1994. [DOI: 10.1016/s0273-2300(05)80027-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
23
|
Morris RD, Audet AM, Angelillo IF, Chalmers TC, Mosteller F. Chlorination, chlorination by-products, and cancer: a meta-analysis. Am J Public Health 1992; 82:955-63. [PMID: 1535181 PMCID: PMC1694065 DOI: 10.2105/ajph.82.7.955] [Citation(s) in RCA: 393] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Individual epidemiological investigations into the association between chlorination by-products in drinking water and cancer have been suggestive but inconclusive. Enough studies exist to provide the basis for a meaningful meta-analysis. METHODS An extensive literature search was performed to identify pertinent case-control studies and cohort studies. Consumption of chlorinated water, surface water, or water with high levels of chloroform was used as a surrogate for exposure to chlorination by-products. Relative risk estimates were abstracted from the individual studies and pooled. RESULTS A simple meta-analysis of all cancer sites yielded a relative risk estimate for exposure to chlorination by-products of 1.15 (95% CI: 1.09, 1.20). Pooled relative risk estimates for organ-specific neoplasms were 1.21 (95% CI: 1.09, 1.34) for bladder cancer and 1.38 (95% CI: 1.01, 1.87) for rectal cancer. When studies that adjusted for potential confounders were pooled separately, estimates of relative risks did not change substantially. CONCLUSIONS The results of this meta-analysis suggest a positive association between consumption of chlorination by-products in drinking water and bladder and rectal cancer in humans.
Collapse
Affiliation(s)
- R D Morris
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee 53226
| | | | | | | | | |
Collapse
|
24
|
Penn A, Lu MX, Parkes JL. Ingestion of chlorinated water has no effect upon indicators of cardiovascular disease in pigeons. Toxicology 1990; 63:301-13. [PMID: 2219128 DOI: 10.1016/0300-483x(90)90192-j] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Cardiovascular disease (CVD) accounts for nearly half the deaths, yearly, in the United States. The arterio(athero)sclerotic plaque is the principal lesion of CVD. The White Carneau (WC) pigeon is an animal model that has been employed extensively for studying CVD. Cholesterol (CHOL) feeding aggravates atherosclerosis in WC pigeons greater than 2 years old. In 1986, two reports appeared from a single laboratory claiming a direct effect of drinking chlorinated (Cl) water upon lipid levels and plaque development in young (less than 1 year) WC pigeons. These are the only reports of such direct effects, to date. Three months' exposure to 2 ppm or 15 ppm Cl in the drinking water, resulted in increased circulating CHOL levels in young male WC pigeons fed a normocholesterolemic (NC) diet in which Ca2+ levels were reduced. In addition, at both Cl concentrations there was a significant increase in plaque size, compared to controls. Pigeons in the 2 ppm group also exhibited elevated low density lipoprotein (LDL) levels after 3 months on the NC diet. These findings, if extrapolated to man, could have considerable public health consequences, since nearly 200 million people in the United States drink Cl water. We have carried out a similar set of studies but with strikingly different results. We used the same suppliers of pigeons and feed as did the authors of the 1986 reports and followed their approach where possible. Six month-old male WC pigeons drank water with 2 ppm or 15 ppm Cl (pH 8.5) and ate a NC diet with Ca2+ reduced to 80% of normal. At both 1 and 3 months, body weight, CHOL, triglyceride and LDL levels were unaffected by drinking Cl water. There was also no effect of Cl water on plaque size after 3 months. Thus, we found no evidence that drinking chlorinated water has any effect upon circulating lipid levels or upon the development of arteriosclerotic plaques, in this animal model.
Collapse
Affiliation(s)
- A Penn
- Institute of Environmental Medicine, New York University Medical Center, New York 10016
| | | | | |
Collapse
|
25
|
|