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Chlorination by-products in drinking water and risk of bladder cancer: A population-based cohort study
Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Science Division, Swedish Food Agency, Uppsala, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Urology.ORCID iD: 0000-0002-0098-5300
Örebro University, School of Medical Sciences. Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden. (Clinical Epidemiology and Biostatistics)ORCID iD: 0000-0002-3649-2639
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2022 (English)In: Water Research, ISSN 0043-1354, E-ISSN 1879-2448, Vol. 214, article id 118202Article in journal (Refereed) Published
Abstract [en]

Chlorination by-products have been consistently associated with risk of bladder cancer in case-control studies, but confirmation from large-scale cohort studies is lacking. We assessed the association of drinking water trihalomethanes (THM), a proxy for chlorination by-products, with risk of bladder cancer in 58,672 men and women. Data came from two population-based cohorts, parts of the Swedish Infrastructure for Medical Population-Based Life-Course and Environmental Research (SIMPLER). Individual exposure to THM was assessed by combining residential information with tap water monitoring data. Participants were categorized into non-exposed, low (<15 µg/L) or high (≥15 µg/L) THM exposure. Incident cases were ascertained from 1998 through 2019 via register linkage. During 16 years of follow-up (965,590 person-years), 831 bladder cancer cases were ascertained. We observed no overall association of THM with risk of bladder cancer, hazard ratio for the highest exposed compared to the non-exposed 0.90 (95% confidence interval: 0.73 - 1.11). The null association remained after restricting the analysis to long-term residents and across strata of smoking status and cancer stage. Our results indicate that chlorination by-product exposure at THM concentrations representative of chlorinated drinking waters in most European countries, is not associated with an increased risk of bladder cancer.

Place, publisher, year, edition, pages
Elsevier, 2022. Vol. 214, article id 118202
Keywords [en]
Bladder cancer, Chlorination by-products, Cohort, Disinfection by-products, Population-based, Trihalomethanes
National Category
Occupational Health and Environmental Health Cancer and Oncology
Identifiers
URN: urn:nbn:se:oru:diva-97705DOI: 10.1016/j.watres.2022.118202ISI: 000787890000002PubMedID: 35220066Scopus ID: 2-s2.0-85125114607OAI: oai:DiVA.org:oru-97705DiVA, id: diva2:1641571
Funder
Swedish Research Council Formas, 2020-01630Swedish Cancer Society, CAN2018/584Available from: 2022-03-02 Created: 2022-03-02 Last updated: 2025-01-24Bibliographically approved

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Ugge, HenrikFall, Katja

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