Young T B, Wolf D A, Kanarek M S
Int J Epidemiol. 1987 Jun;16(2):190-7. doi: 10.1093/ije/16.2.190.
A case-control study was conducted to test the hypothesis that chronic ingestion of trihalomethanes (THMs), occurring as chlorination byproducts in drinking water, carries a risk of colon cancer. Lifetime residential and water source histories and information on water-drinking habits, diet, sociodemographics, medical and occupation histories, lifestyle and other factors were obtained by questionnaire from a statewide sample of newly-diagnosed colon cancer cases (N = 347), controls with cancer of other sites (N = 639) and general population controls (N = 611). Since no data on past THM levels exists, it was necessary to devise a scheme to generate THM estimates for all Wisconsin water sources. For this, a statistical model based on quantitative THM measures and routinely-recorded data taken at 81 municipal water facilities was used in conjunction with individual residential histories to estimate lifetime and period-specific THM exposure for each case and control. Logistic regression was used to estimate odds ratios adjusted for age, sex and urban living, for colon cancer and THM exposure. The study results indicate that THM in Wisconsin drinking water does not pose a significant colon cancer risk. Odds ratios for exposure to the middle and highest category of lifetime cumulative THM were 1.05 (95% Cl = 0.66-1.68) and 0.93(95%Cl = 0.55-1.57) respectively, relative to the cancer control group, and 1.10 (95%Cl = 0.68-1.78) and 0.73 (95% Cl = 0.44-1.21) respectively, relative to the general population controls.(ABSTRACT TRUNCATED AT 250 WORDS)
开展了一项病例对照研究,以检验以下假设:长期摄入作为饮用水氯化副产物的三卤甲烷(THM)会带来患结肠癌的风险。通过问卷调查,从全州范围内新诊断出的结肠癌病例样本(N = 347)、其他部位癌症对照样本(N = 639)和普通人群对照样本(N = 611)中获取了终生居住和水源历史信息,以及饮水习惯、饮食、社会人口统计学、医疗和职业历史、生活方式及其他因素的信息。由于不存在过去THM水平的数据,因此有必要设计一个方案来估算威斯康星州所有水源的THM含量。为此,将基于81个市政供水设施定量THM测量值和常规记录数据的统计模型与个人居住历史相结合,以估算每个病例和对照的终生及特定时期THM暴露量。采用逻辑回归来估算经年龄、性别和城市居住情况调整后的结肠癌与THM暴露的比值比。研究结果表明,威斯康星州饮用水中的THM不会带来显著的结肠癌风险。相对于癌症对照组,终生累积THM暴露处于中等和最高类别的比值比分别为1.05(95%可信区间 = 0.66 - 1.68)和0.93(95%可信区间 = 0.55 - 1.57);相对于普通人群对照组,比值比分别为1.10(95%可信区间 = 0.68 - 1.78)和0.73(95%可信区间 = 0.44 - 1.21)。(摘要截短于250词)