Long-term exposure to trihalomethanes in drinking water and breast cancer in the Spanish multicase-control study on cancer (MCC-SPAIN).

Rosana Burgui, Cristina M Villanueva, Manolis Kogevinas, Rosana Peiró, Guillermo Fernandez-Tardon, Victor Moreno, Trinidad Dierssen-Sotos, Inés Gómez-Acebo, Tania Fernández-Villa, Antonio José Molina, Laia Font-Ribera, Eva Ardanaz, Aina Roca-Barceló, Gemma Castaño-Vinyals, Ana Jiménez-Zabala, Pilar Amiano, Marina Pollán, Beatriz Pérez-Gómez, Nuria Aragonés, Esther Gràcia-Lavedan

Journal: Environment international 2018;112():227-234

PMID: 29289867

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND

Exposure to trihalomethanes (THMs) in drinking water has consistently been associated with an increased risk of bladder cancer, but evidence on other cancers including the breast is very limited.

OBJECTIVES

We assessed long-term exposure to THMs to evaluate the association with female breast cancer (BC) risk.

METHODS

A multi case-control study was conducted in Spain from 2008 to 2013. We included 1003 incident BC cases (women 20-85years old) recruited from 14 hospitals and 1458 population controls. Subjects were interviewed to ascertain residential histories and major recognized risk factors for BC. Mean residential levels of chloroform, brominated THMs (Br-THMs) and the sum of both as total THM (TTHMs) during the adult-lifetime were calculated.

RESULTS

Mean adult-lifetime residential levels ranged from 0.8 to 145.7μg/L for TTHM (median=30.8), from 0.2 to 62.4μg/L for chloroform (median=19.7) and from 0.3 to 126.0μg/L for Br-THMs (median=9.7). Adult-lifetime residential chloroform was associated with BC (adjusted OR=1.47; 95%CI=1.05, 2.06 for the highest (>24μg/L) vs. lowest (<8μg/L) quartile; p-trend=0.024). No association was detected for residential Br-THMs (OR=0.91; 95%CI=0.68, 1.23 for >31μg/L vs. <6μg/L) or TTHMs (OR=1.14; 95%CI=0.83, 1.57 for >48μg/L vs. <22μg/L).

CONCLUSIONS

At common levels in Europe, long-term residential total THMs were not related to female breast cancer. A moderate association with chloroform was suggested at the highest exposure category. This large epidemiological study with extensive exposure assessment overcomes several limitations of previous studies but further studies are needed to confirm these results.

Address: ISGlobal, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.; ISGlobal, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta De Hierro, Madrid, Spain.; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain.; Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain.; Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona, Spain.; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain.; Grupo de Investigación en Interacciones Gen-Ambiente y Salud, Universidad de León, Spain.; Department of Preventive Medicine and Public Health, University of Cantabria, Santander, Spain.; Unit of Biomarkers and Susceptibility, Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO), Hospitalet de Llobregat, Spain; Colorectal Cancer Group, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain.; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; University of Oviedo, Asturias, Spain.; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Centre for Research in Public Health, Valencia, Spain.; ISGlobal, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Electronic address: [email protected].

DOI: 10.1016/j.envint.2017.12.031

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MeSH Terms: Adult, Aged, Aged, 80 and over, Breast Neoplasms, Case-Control Studies, Drinking Water, Environmental Exposure, Female, Humans, Middle Aged, Spain, Trihalomethanes, Water Pollutants, Chemical, Young Adult