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Disinfection byproducts and bladder cancer: a pooled analysis
Journal article   Peer reviewed

Disinfection byproducts and bladder cancer: a pooled analysis

Cristina M Villanueva, Kenneth P Cantor, Sylvaine Cordier, Jouni J K Jaakkola, Will D King, Charles F Lynch, Stefano Porru and Manolis Kogevinas
Epidemiology (Cambridge, Mass.), Vol.15(3), pp.357-367
05/2004
DOI: 10.1097/01.ede.0000121380.02594.fc
PMID: 15097021

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Abstract

Exposure to disinfection byproducts in drinking water has been associated with an increased risk of bladder cancer. We pooled the primary data from 6 case-control studies of bladder cancer that used trihalomethanes as a marker of disinfection byproducts. Two studies were included from the United States and one each from Canada, France, Italy, and Finland. Inclusion criteria were availability of detailed data on trihalomethane exposure and individual water consumption. The analysis included 2806 cases and 5254 controls, all of whom had measures of known exposure for at least 70% of the exposure window of 40 years before the interview. Cumulative exposure to trihalomethanes was estimated by combining individual year-by-year average trihalomethane level and daily tap water consumption. There was an adjusted odds ratio (OR) of 1.24 in men exposed to an average of more than 1 microg/L (ppb) trihalomethanes compared with those who had lower or no exposure (95% confidence interval [CI] = 1.09-1.41). Estimated relative risks increased with increasing exposure, with an OR of 1.44 (1.20-1.73) for exposure higher than 50 microg/L (ppb). Similar results were found with other indices of trihalomethane exposure. Among women, trihalomethane exposure was not associated with bladder cancer risk (0.95; 0.76-1.20). These findings strengthen the hypothesis that the risk of bladder cancer is increased with long-term exposure to disinfection byproducts at levels currently observed in many industrialized countries.
Confidence Intervals Age Distribution Global Health Risk Assessment Humans Middle Aged Urinary Bladder Neoplasms - etiology Male Disinfectants - adverse effects Water Purification Disinfectants - chemistry Case-Control Studies Incidence Trihalomethanes - adverse effects Survival Analysis Aged, 80 and over Sex Distribution Female Aged Water Supply Odds Ratio Urinary Bladder Neoplasms - epidemiology

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