Trihalomethanes in Drinking Water and Bladder Cancer Burden in the European Union.


Journal

Environmental health perspectives
ISSN: 1552-9924
Titre abrégé: Environ Health Perspect
Pays: United States
ID NLM: 0330411

Informations de publication

Date de publication:
01 2020
Historique:
entrez: 16 1 2020
pubmed: 16 1 2020
medline: 29 7 2020
Statut: ppublish

Résumé

Trihalomethanes (THMs) are widespread disinfection by-products (DBPs) in drinking water, and long-term exposure has been consistently associated with increased bladder cancer risk. We assessed THM levels in drinking water in the European Union as a marker of DBP exposure and estimated the attributable burden of bladder cancer. We collected recent annual mean THM levels in municipal drinking water in 28 European countries (EU28) from routine monitoring records. We estimated a linear exposure-response function for average residential THM levels and bladder cancer by pooling data from studies included in the largest international pooled analysis published to date in order to estimate odds ratios (ORs) for bladder cancer associated with the mean THM level in each country (relative to no exposure), population-attributable fraction (PAF), and number of attributable bladder cancer cases in different scenarios using incidence rates and population from the Global Burden of Disease study of 2016. We obtained 2005-2018 THM data from EU26, covering 75% of the population. Data coverage and accuracy were heterogeneous among countries. The estimated population-weighted mean THM level was Efforts have been made to reduce THM levels in the European Union. However, assuming a causal association, current levels in certain countries still could lead to a considerable burden of bladder cancer that could potentially be avoided by optimizing water treatment, disinfection, and distribution practices, among other possible measures. https://doi.org/10.1289/EHP4495.

Sections du résumé

BACKGROUND
Trihalomethanes (THMs) are widespread disinfection by-products (DBPs) in drinking water, and long-term exposure has been consistently associated with increased bladder cancer risk.
OBJECTIVE
We assessed THM levels in drinking water in the European Union as a marker of DBP exposure and estimated the attributable burden of bladder cancer.
METHODS
We collected recent annual mean THM levels in municipal drinking water in 28 European countries (EU28) from routine monitoring records. We estimated a linear exposure-response function for average residential THM levels and bladder cancer by pooling data from studies included in the largest international pooled analysis published to date in order to estimate odds ratios (ORs) for bladder cancer associated with the mean THM level in each country (relative to no exposure), population-attributable fraction (PAF), and number of attributable bladder cancer cases in different scenarios using incidence rates and population from the Global Burden of Disease study of 2016.
RESULTS
We obtained 2005-2018 THM data from EU26, covering 75% of the population. Data coverage and accuracy were heterogeneous among countries. The estimated population-weighted mean THM level was
DISCUSSION
Efforts have been made to reduce THM levels in the European Union. However, assuming a causal association, current levels in certain countries still could lead to a considerable burden of bladder cancer that could potentially be avoided by optimizing water treatment, disinfection, and distribution practices, among other possible measures. https://doi.org/10.1289/EHP4495.

Identifiants

pubmed: 31939704
doi: 10.1289/EHP4495
pmc: PMC7015561
doi:

Substances chimiques

Drinking Water 0
Trihalomethanes 0
Water Pollutants, Chemical 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

17001

Subventions

Organisme : Medical Research Council
ID : MR/S019669/1
Pays : United Kingdom

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Auteurs

Iro Evlampidou (I)

ISGlobal, Barcelona, Spain.
Universitat Pompeu Fabra (UPF), Barcelona, Spain.
CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.

Laia Font-Ribera (L)

ISGlobal, Barcelona, Spain.
Universitat Pompeu Fabra (UPF), Barcelona, Spain.
CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.
Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.

David Rojas-Rueda (D)

ISGlobal, Barcelona, Spain.
Universitat Pompeu Fabra (UPF), Barcelona, Spain.
CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.

Esther Gracia-Lavedan (E)

ISGlobal, Barcelona, Spain.
Universitat Pompeu Fabra (UPF), Barcelona, Spain.
CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.

Nathalie Costet (N)

Université de Rennes, Institut national de la santé et de la recherche médicale (Inserm), École des hautes études en santé publique (EHESP), Rennes, France.

Neil Pearce (N)

London School of Hygiene & Tropical Medicine, London, UK.

Paolo Vineis (P)

Imperial College of London, London, UK.

Jouni J K Jaakkola (JJK)

Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland.

Francis Delloye (F)

Service Public de Wallonie, Direction générale de l'Agriculture, des Ressources naturelles et de l'Environnement, Département de l'Environnement et de l'Eau, Jambes, Belgium.

Konstantinos C Makris (KC)

Water and Health Laboratory, Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus.

Euripides G Stephanou (EG)

Environmental Chemical Processes Laboratory (ECPL), Department of Chemistry, University of Crete, Heraklion, Greece.
The Cyprus Institute, Aglantzia-Nicosia, Cyprus.

Sophia Kargaki (S)

Environmental Chemical Processes Laboratory (ECPL), Department of Chemistry, University of Crete, Heraklion, Greece.

Frantisek Kozisek (F)

National Institute of Public Health, Prague, Czech Republic.

Torben Sigsgaard (T)

Department of Public Health, Section for Environment, Occupation & Health, Aarhus University, Aarhus, Denmark.

Birgitte Hansen (B)

Geological Survey of Denmark and Greenland (GEUS), Aarhus, Denmark.

Jörg Schullehner (J)

Geological Survey of Denmark and Greenland (GEUS), Aarhus, Denmark.
National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.

Ramon Nahkur (R)

Public Health Department, Estonian Ministry of Social Affairs, Tallinn, Estonia.

Catherine Galey (C)

Santé Publique France (French National Public Health Agency), Saint-Maurice, France.

Christian Zwiener (C)

Environmental Analytical Chemistry, Center for Applied Geosciences (ZAG), Eberhard-Karls-University Tuebingen, Tuebingen, Germany.

Marta Vargha (M)

National Public Health Center, Budapest, Hungary.

Elena Righi (E)

Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Gabriella Aggazzotti (G)

Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Gunda Kalnina (G)

Public Health Division, Ministry of Health of the Republic Latvia, Health Inspectorate, Riga, Latvia.

Regina Grazuleviciene (R)

Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Kaunas, Lithuania.

Kinga Polanska (K)

Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland.

Dasa Gubkova (D)

Public Health Authority of the Slovak Republic, Bratislava, Slovak Republic.

Katarina Bitenc (K)

National Institute of Public Health, Ljubljana, Slovenia.

Emma H Goslan (EH)

Cranfield Water Science Institute, Cranfield University, Cranfield, Bedford, UK.

Manolis Kogevinas (M)

ISGlobal, Barcelona, Spain.
Universitat Pompeu Fabra (UPF), Barcelona, Spain.
CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.
Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.

Cristina M Villanueva (CM)

ISGlobal, Barcelona, Spain.
Universitat Pompeu Fabra (UPF), Barcelona, Spain.
CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.
Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.

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