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Environ Health Perspect. 2007 Nov;115(11):1569-72.

Total fluid and water consumption and the joint effect of exposure to disinfection by-products on risk of bladder cancer.

Author information

  • 1Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts 02115, USA. dmichaud@hsph.harvard.edu

Abstract

BACKGROUND:

Findings on water and total fluid intake and bladder cancer are inconsistent; this may, in part, be due to different levels of carcinogens in drinking water. High levels of arsenic and chlorinated by-products in drinking water have been associated with elevated bladder cancer risk in most studies. A pooled analysis based on six case-control studies observed a positive association between tap water and bladder cancer but none for nontap fluid intake, suggesting that contaminants in tap water may be responsible for the excess risk.

OBJECTIVES:

We examined the association between total fluid and water consumption and bladder cancer risk, as well as the interaction between water intake and trihalomethane (THM) exposure, in a large case-control study in Spain.

METHODS:

A total of 397 bladder cancer cases and 664 matched controls were available for this analysis. Odds ratios (OR) were estimated using unconditional logistic regression, controlling for potential confounders.

RESULTS:

Total fluid intake was associated with a decrease in bladder cancer risk [OR = 0.62; 95% confidence interval (CI), 0.40-0.95 for highest vs. lowest quintile comparison]. A significant inverse association was observed for water intake (for > 1,399 vs. < 400 mL/day, OR = 0.47; 95% CI, 0.33-0.66; p for trend < 0.0001), but not for other individual beverages. The inverse association between water intake and bladder cancer persisted within each level of THM exposure; we found no statistical interaction (p for interaction = 0.13).

CONCLUSION:

Findings from this study suggest that water intake is inversely associated with bladder cancer risk, regardless of THM exposure level.

KEYWORDS:

bladder cancer; case–control study; chlorination by-products; fluid intake; water intake

PMID:
18007986
PMCID:
PMC2072844
DOI:
10.1289/ehp.10281
[PubMed - indexed for MEDLINE]
Free PMC Article
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