Long-term exposure to nitrate and trihalomethanes in drinking water and prostate cancer: a multicase–control study in Spain (MCC-Spain)

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• dc.contributor.author Donat-Vargas, Carolina
• dc.contributor.author Kogevinas, Manolis
• dc.contributor.author Castaño Vinyals, Gemma
• dc.contributor.author Pérez-Gómez, Beatriz
• dc.contributor.author Llorca, Javier
• dc.contributor.author Vanaclocha-Espi, Mercedes
• dc.contributor.author Fernandez-Tardon, Guillermo
• dc.contributor.author Costas, Laura
• dc.contributor.author Aragonés, Núria
• dc.contributor.author Gómez-Acebo, Inés
• dc.contributor.author Moreno, Víctor
• dc.contributor.author Pollan, Marina
• dc.contributor.author Villanueva, Cristina M.
• dc.date.accessioned 2023-06-19T05:59:36Z
• dc.date.available 2023-06-19T05:59:36Z
• dc.date.issued 2023
• dc.description.abstract Nitrate and trihalomethanes (THMs) in drinking water are widespread and are potential human carcinogens. We evaluated the association between drinking-water exposure to nitrate and THMs and prostate cancer. During the period 2008–2013, 697 hospital-based incident prostate cancer cases (97 aggressive tumors) and 927 population-based controls were recruited in Spain, providing information on residential histories and type of water consumed. Average nitrate and THMs levels in drinking water were linked with lifetime water consumption to calculate waterborne ingestion. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using mixed models with recruitment area as random effect. Effect modification by tumor grade (Gleason score), age, education, lifestyle, and dietary factors was explored. Mean (plus or minus standard deviation±standard deviation) adult lifetime waterborne ingested nitrate (milligrams per day), brominated (Br)-THMs (micrograms per day), and chloroform (micrograms per day) were 11.5 (plus or minus 9.0±9.0), 20.7 (plus or minus 32.4±32.4), and 15.1 (plus or minus 14.7±14.7) in controls. Waterborne ingested nitrate greater than 13.8>13.8 vs. less than 5.5 milligrams per day<5.5mg/d was associated with an OR of 1.74 (95% CI: 1.19, 2.54) overall, and 2.78 (95% CI: 1.23, 6.27) for tumors with Gleason scores greater than or equal to 8≥8. Associations were higher in the youngest and those with lower intakes of fiber, fruit/vegetables, and vitamin C. Waterborne ingested THMs were not associated with prostate cancer. Residential tap water levels of Br-THMs and chloroform showed, respectively, inverse and positive associations with prostate cancer. Findings suggest long-term waterborne ingested nitrate could be a risk factor of prostate cancer, particularly for aggressive tumors. High intakes of fiber, fruit/vegetables and vitamin C may lower this risk. Association with residential levels but not ingested chloroform/Br-THM may suggest inhalation and dermal routes could be relevant for prostate cancer. https://doi.org/10.1289/EHP11391
• dc.description.sponsorship The authors would like to acknowledge all the research assistants and interviewers in the study centers, the staff of all participating hospitals, and, most of all, the study participants. The study was partially funded by the “Accion Transversal del Cancer,” approved on the Spanish Ministry Council on 11 October 2007, by the Instituto de Salud Carlos III-FEDER (PI08/1770, PI08/0533, PI08/1359, PS09/00773, PS09/01286, PS09/01903, PS09/02078, PS09/01662, PI11/01889, PI11/00226, PI12/01270, PI12/00715, PI14/0613, PI15/00914, PI17CIII/00034), by the Fundación Marqués de Valdecilla (API 10/09), by the Conselleria de Sanitat of the Generalitat Valenciana (AP_061/10), by the European Commission grants FOOD-CT-2006-036224-HIWATE, by the Spanish Association Against Cancer (AECC) Scientific Foundation, by the Catalan Government-Agency for Management of University and Research Grants (AGAUR) grants 2017SGR723 and 2014SGR850, by the Fundación Caja de Ahorros de Asturias, and by the University of Oviedo. ISGlobal acknowledges support from the Spanish Ministry of Science and Innovation through the “Centro de Excelencia Severo Ochoa 2019–2023” Program (CEX2018-000806-S) and support from the Generalitat de Catalunya through the CERCA Program.
• dc.format.mimetype application/pdf
• dc.identifier.citation Donat-Vargas C, Kogevinas M, Castaño-Vinyals G, Pérez-Gómez B, Llorca J, Vanaclocha-Espí M, et al. Long-term exposure to nitrate and trihalomethanes in drinking water and prostate cancer: a multicase–control study in Spain (MCC-Spain). Environ Health Perspect. 2023 Mar;131(3):037004. DOI: 10.1289/ehp11391
• dc.identifier.doi http://dx.doi.org/10.1289/ehp11391
• dc.identifier.issn 0091-6765
• dc.identifier.uri http://hdl.handle.net/10230/57217
• dc.language.iso eng
• dc.publisher National Institute of Environmental Health Sciences
• dc.relation.ispartof Environmental Health Perspectives. 2023 Mar;131(3):037004
• dc.relation.projectID info:eu-repo/grantAgreement/2PE/CEX2018-000806-S
• dc.rights Reproduced from Environmental Health Perspectives https://doi.org/10.1289/EHP11391
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.other Pròstata -- Càncer
• dc.subject.other Aigua potable -- Anàlisi
• dc.subject.other Espanya -- Població
• dc.title Long-term exposure to nitrate and trihalomethanes in drinking water and prostate cancer: a multicase–control study in Spain (MCC-Spain)
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion