Introduction: Experimental data suggest that disinfection by-products (DBPs) are possible colorectal carcinogens, but epidemiological evidence is inconclusive. Objectives: To evaluate colorectal cancer risk in relation to long-term DBP exposure. Methods: A case-control study is ongoing in the greater Milan area and the provinces of Pordenone and Udine, Italy, and the metropolitan area of Barcelona, Spain. Cases are incident, histollogically confirmed colon and rectal patients, aged 20-85 years and resident in the study areas. Controls are hospital-based (Italy) or population-based patients (Spain) matched to cases by age and sex. Besides data on known or potential risk factors of colorectal cancer, information is collected on residential and water source history, water consumption and use, including ingestion, showering, bathing, dishwashing and swimming pool attendance. Retrospective data on DPB (mainly trihalomethane, THM) levels in the study areas is collected through local water companies. Results: Based on 400 cases and 363 controls from Italy, and 500 cases and 436 controls from Spain, 46% of Italian subjects and 56% of Spanish subjects drunk water from public water at the longest residence (mean duration 37 years in Italy and 35 years in Spain); the remaining consumed water from bottles or other sources. The multivariate odds ratio (OR) for subjects drinking water from public supplies as compared to those drinking bottled water was 1.17 (95% confidence interval, CI, 0.87-1.58) in Italy and 1.18 (95% CI, 0.79-1.77) in Spain. Taking long compared to short shower yield an OR of 1.16 (95% CI, 0.83-1.63) in Italy and of 1.04 (95% CI, 0.80-1.40) in Spain. Mean THM levels in Italy were <10 ug/l, and ranged between 17.6 and 134 ug/l in Spain. No clear dose-risk relations between residential THM exposure and colorectal cancer risk were observed. Conclusions: Preliminary results suggest a weak – if any – association between colorectal cancer and DBPs.

Colorectal cancer and disinfection by-products in Italy and Spain / Bosetti, C; Villanueva, Cm; Righi, Elena; Moreno, V; Aggazzotti, Gabriella; Castaño Vinyals, G; Carrasco, G; Tavani, A; Bustamante, M; Talamini, R; Pisa, F; Rantakokko, P; Kogevinas, M; Nieuwenhuijsen, M; La Vecchia, C.. - In: EPIDEMIOLOGIA E PREVENZIONE. - ISSN 1120-9763. - STAMPA. - 5-6 (suppl.1):(2010), pp. 44-45. (Intervento presentato al convegno EUROEPI 2010 Epidemiology and public health in an evolving Europe tenutosi a Firenze nel 6-9 November 2010).

Colorectal cancer and disinfection by-products in Italy and Spain.

RIGHI, Elena;AGGAZZOTTI, Gabriella;
2010

Abstract

Introduction: Experimental data suggest that disinfection by-products (DBPs) are possible colorectal carcinogens, but epidemiological evidence is inconclusive. Objectives: To evaluate colorectal cancer risk in relation to long-term DBP exposure. Methods: A case-control study is ongoing in the greater Milan area and the provinces of Pordenone and Udine, Italy, and the metropolitan area of Barcelona, Spain. Cases are incident, histollogically confirmed colon and rectal patients, aged 20-85 years and resident in the study areas. Controls are hospital-based (Italy) or population-based patients (Spain) matched to cases by age and sex. Besides data on known or potential risk factors of colorectal cancer, information is collected on residential and water source history, water consumption and use, including ingestion, showering, bathing, dishwashing and swimming pool attendance. Retrospective data on DPB (mainly trihalomethane, THM) levels in the study areas is collected through local water companies. Results: Based on 400 cases and 363 controls from Italy, and 500 cases and 436 controls from Spain, 46% of Italian subjects and 56% of Spanish subjects drunk water from public water at the longest residence (mean duration 37 years in Italy and 35 years in Spain); the remaining consumed water from bottles or other sources. The multivariate odds ratio (OR) for subjects drinking water from public supplies as compared to those drinking bottled water was 1.17 (95% confidence interval, CI, 0.87-1.58) in Italy and 1.18 (95% CI, 0.79-1.77) in Spain. Taking long compared to short shower yield an OR of 1.16 (95% CI, 0.83-1.63) in Italy and of 1.04 (95% CI, 0.80-1.40) in Spain. Mean THM levels in Italy were <10 ug/l, and ranged between 17.6 and 134 ug/l in Spain. No clear dose-risk relations between residential THM exposure and colorectal cancer risk were observed. Conclusions: Preliminary results suggest a weak – if any – association between colorectal cancer and DBPs.
2010
5-6 (suppl.1)
44
45
Bosetti, C; Villanueva, Cm; Righi, Elena; Moreno, V; Aggazzotti, Gabriella; Castaño Vinyals, G; Carrasco, G; Tavani, A; Bustamante, M; Talamini, R; Pisa, F; Rantakokko, P; Kogevinas, M; Nieuwenhuijsen, M; La Vecchia, C.
Colorectal cancer and disinfection by-products in Italy and Spain / Bosetti, C; Villanueva, Cm; Righi, Elena; Moreno, V; Aggazzotti, Gabriella; Castaño Vinyals, G; Carrasco, G; Tavani, A; Bustamante, M; Talamini, R; Pisa, F; Rantakokko, P; Kogevinas, M; Nieuwenhuijsen, M; La Vecchia, C.. - In: EPIDEMIOLOGIA E PREVENZIONE. - ISSN 1120-9763. - STAMPA. - 5-6 (suppl.1):(2010), pp. 44-45. (Intervento presentato al convegno EUROEPI 2010 Epidemiology and public health in an evolving Europe tenutosi a Firenze nel 6-9 November 2010).
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