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

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Additional Information
    • Affiliation:
      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
      Université de Rennes, Institut national de la santé et de la recherche médicale (Inserm), (Ecole des hautes études en santé publique (EHESP), Rennes, France
      London School of Hygiene & Tropical Medicine, London, UK
      Imperial College of London, London, UK
      Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
      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
      Water and Health Laboratory, Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
      Environmental Chemical Processes Laboratory (ECPL), Department of Chemistry, University of Crete, Heraklion, Greece
      The Cyprus Institute, Aglantzia-Nicosia, Cyprus
      National Institute of Public Health, Prague, Czech Republic
      Department of Public Health, Section for Environment, Occupation & Health, Aarhus University, Aarhus, Denmark
      Geological Survey of Denmark and Greenland (GEUS), Aarhus, Denmark
      National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
      Public Health Department, Estonian Ministry of Social Affairs, Tallinn, Estonia
      Santé Publique France (French National Public Health Agency), Saint-Maurice, France
      Environmental Analytical Chemistry, Center for Applied Geosciences (ZAG), Eberhard-Karls-University Tuebingen, Tuebingen, Germany
      National Public Health Center, Budapest, Hungary
      Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      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 11.7 μg/L [standard deviation (SD) of 11.2]. The estimated bladder cancer PAF was 4.9% [95% confidence interval (CI): 2.5, 7.1] overall (range: 0-23%), accounting for 6,561 (95% CI: 3,389, 9,537) bladder cancer cases per year. Denmark and the Netherlands had the lowest PAF (0.0% each), while Cyprus (23.2%), Malta (17.9%), and Ireland (17.2%) had the highest among EU26. In the scenario where no country would exceed the current EU mean, 2,868 (95% CI: 1,522, 4,060; 43%) annual attributable bladder cancer cases could potentially be avoided. 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.
    • Journal Subset:
      Blind Peer Reviewed; Editorial Board Reviewed; Peer Reviewed; Public Health; USA
    • ISSN:
      0091-6765
    • MEDLINE Info:
      NLM UID: 0330411
    • Publication Date:
      20200213
    • Publication Date:
      20200220
    • DOI:
      http://dx.doi.org/10.1289/EHP4495
    • Accession Number:
      141659245
  • Citations
    • ABNT:
      EVLAMPIDOU, I. et al. Trihalomethanes in Drinking Water and Bladder Cancer Burden in the European Union. Environmental Health Perspectives, [s. l.], v. 128, n. 1, p. 017001-1-017001-14, 2020. DOI 10.1289/EHP4495. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=141659245. Acesso em: 8 jul. 2020.
    • AMA:
      Evlampidou I, Font-Ribera L, Rojas-Rueda D, et al. Trihalomethanes in Drinking Water and Bladder Cancer Burden in the European Union. Environmental Health Perspectives. 2020;128(1):017001-1-017001-14. doi:10.1289/EHP4495.
    • AMA11:
      Evlampidou I, Font-Ribera L, Rojas-Rueda D, et al. Trihalomethanes in Drinking Water and Bladder Cancer Burden in the European Union. Environmental Health Perspectives. 2020;128(1):017001-1-017001-14. doi:10.1289/EHP4495
    • APA:
      Evlampidou, I., Font-Ribera, L., Rojas-Rueda, D., Gracia-Lavedan, E., Costet, N., Pearce, N., Vineis, P., Jaakkola, J. J. K., Delloye, F., Makris, K. C., Stephanou, E. G., Kozisek, F., Sigsgaard, T., Hansen, B., Schullehner, J., Nahkur, R., Galey, C., Zwiener, C., Vargha, M., & Righi, E. (2020). Trihalomethanes in Drinking Water and Bladder Cancer Burden in the European Union. Environmental Health Perspectives, 128(1), 017001-1-017001-14. https://doi.org/10.1289/EHP4495
    • Chicago/Turabian: Author-Date:
      Evlampidou, Iro, Laia Font-Ribera, David Rojas-Rueda, Esther Gracia-Lavedan, Nathalie Costet, Neil Pearce, Paolo Vineis, et al. 2020. “Trihalomethanes in Drinking Water and Bladder Cancer Burden in the European Union.” Environmental Health Perspectives 128 (1): 017001-1-017001-14. doi:10.1289/EHP4495.
    • Harvard:
      Evlampidou, I. et al. (2020) ‘Trihalomethanes in Drinking Water and Bladder Cancer Burden in the European Union’, Environmental Health Perspectives, 128(1), pp. 017001-1-017001-14. doi: 10.1289/EHP4495.
    • Harvard: Australian:
      Evlampidou, I, Font-Ribera, L, Rojas-Rueda, D, Gracia-Lavedan, E, Costet, N, Pearce, N, Vineis, P, Jaakkola, JJK, Delloye, F, Makris, KC, Stephanou, EG, Kozisek, F, Sigsgaard, T, Hansen, B, Schullehner, J, Nahkur, R, Galey, C, Zwiener, C, Vargha, M & Righi, E 2020, ‘Trihalomethanes in Drinking Water and Bladder Cancer Burden in the European Union’, Environmental Health Perspectives, vol. 128, no. 1, pp. 017001-1-017001-14, viewed 8 July 2020, .
    • MLA:
      Evlampidou, Iro, et al. “Trihalomethanes in Drinking Water and Bladder Cancer Burden in the European Union.” Environmental Health Perspectives, vol. 128, no. 1, Jan. 2020, pp. 017001-1-017001-14. EBSCOhost, doi:10.1289/EHP4495.
    • Chicago/Turabian: Humanities:
      Evlampidou, Iro, Laia Font-Ribera, David Rojas-Rueda, Esther Gracia-Lavedan, Nathalie Costet, Neil Pearce, Paolo Vineis, et al. “Trihalomethanes in Drinking Water and Bladder Cancer Burden in the European Union.” Environmental Health Perspectives 128, no. 1 (January 2020): 017001-1-017001-14. doi:10.1289/EHP4495.
    • Vancouver/ICMJE:
      Evlampidou I, Font-Ribera L, Rojas-Rueda D, Gracia-Lavedan E, Costet N, Pearce N, et al. Trihalomethanes in Drinking Water and Bladder Cancer Burden in the European Union. Environmental Health Perspectives [Internet]. 2020 Jan [cited 2020 Jul 8];128(1):017001-1-017001-14. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=141659245