Journal article
Long-term cancer and overall mortality associated with drinking water nitrate in the United States
Public health (London), Vol.228, pp.82-84
03/2024
DOI: 10.1016/j.puhe.2024.01.001
PMCID: PMC11626709
PMID: 38330736
Abstract
Nitrate is a probable carcinogen regulated in drinking water by the US Environmental Protection Agency (EPA) to a maximum contaminant level (MCL) of 10 mg/L nitrate-nitrogen (NO3-N; equivalent to 44.3 mg/L NO3). We aimed to determine the association of US drinking water nitrate levels with overall as well as cardiovascular, cancer, and other cause mortality.
This study used a population-based retrospective cohort design.
We analyzed data from 2029 participants of the 2005–2006 National Health and Nutrition Examination Survey followed for mortality until 2019 for a median of 13.9 years. We used Cox proportional hazards regression to estimate the hazard ratio (HR) and 95% confidence interval (CI) for mortality associated with drinking water nitrate, adjusting for covariates that included socio-economic factors and pack-years of cigarette smoking.
Drinking water nitrate was detected in 50.8 % of the samples, had a median concentration of 0.77 mg/L NO3, and was above US EPA MCL in 0.4 % of participants. In adjusted analysis, drinking water nitrate detection was associated with 73 % higher cancer mortality (HR: 1.73, 95% CI: 1.19–2.51), whereas a 10-fold increase in drinking water nitrate levels was associated with 69 % higher cancer mortality (HR: 1.69, 95% CI: 1.24–2.31) and 21 % higher overall mortality (HR: 1.21, 95% CI: 1.00–1.46). Drinking water nitrate below EPA MCL was still associated with higher cancer mortality (HR: 1.61, 95% CI: 1.07–2.43 per 10-fold increase and HR: 1.61, 95% CI: 1.08–2.42 for detection).
Levels of drinking water nitrate may be an overlooked contributor to cancer mortality in the United States.
Details
- Title: Subtitle
- Long-term cancer and overall mortality associated with drinking water nitrate in the United States
- Creators
- Angelico Mendy - University of CincinnatiPeter S. Thorne - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Public health (London), Vol.228, pp.82-84
- DOI
- 10.1016/j.puhe.2024.01.001
- PMID
- 38330736
- PMCID
- PMC11626709
- NLM abbreviation
- Public Health
- ISSN
- 0033-3506
- eISSN
- 1476-5616
- Publisher
- Elsevier Ltd
- Grant note
- DOI: 10.13039/100014452, name: University of Cincinnati College of Medicine, award: P30ES005605; DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/100000066, name: National Institute of Environmental Health Sciences, award: R01ES034049
- Language
- English
- Date published
- 03/2024
- Academic Unit
- Civil and Environmental Engineering; Occupational and Environmental Health
- Record Identifier
- 9984557947502771
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