Shy C M
Environ Health Perspect. 1985 Oct;62:399-406. doi: 10.1289/ehp.8562399.
Man-made organic chemicals have been found in drinking water for many years. Their numbers and varieties increase as our analytical capabilities improve. The identified chemicals comprise 10 to 20% of the total organic matter present. These are volatile or low molecular weight compounds which are easily identified. Many of them are carcinogenic or mutagenic. Chlorinated compounds have been found in untreated well water at levels up to 21,300 micrograms/L and are generally present at higher levels in chlorine-treated water than in untreated water. Aggregate risk studies for cancer are summarized. The most common sites are: bladder, stomach, colon, and rectum. Such studies cannot be linked to individual cases. However, they are useful for identifying exposed populations for epidemiologic studies. Five case-control studies were reviewed, and significant associations with water quality were found for: bladder cancer in two studies, colon cancer in three and rectal cancer in four. A large study by the National Cancer Institute found that there had been a change in the source of raw water for 50% of the persons in one area between the years 1955 and 1975. Such flaws in the data may preclude finding a causal relation between cancer and contaminants in drinking water. Large case-control and cohort studies are needed because of the low frequency of the marker diseases, bladder and rectal cancer. Cohort studies may be precluded by variations in the kinds of water contaminants. Definitive questions about these issues are posed for cooperative effort and resolution by water chemists, engineers, and epidemiologists.
多年来,饮用水中一直存在人造有机化学物质。随着我们分析能力的提高,其数量和种类不断增加。已鉴定出的化学物质占总有机物质的10%至20%。这些是挥发性或低分子量化合物,很容易识别。其中许多具有致癌性或致突变性。在未经处理的井水中发现的氯化化合物含量高达21300微克/升,通常在经过氯处理的水中的含量高于未经处理的水。总结了癌症的总体风险研究。最常见的发病部位是:膀胱、胃、结肠和直肠。此类研究无法与个别病例相关联。然而,它们对于识别用于流行病学研究的暴露人群很有用。审查了五项病例对照研究,发现了与水质的显著关联:两项研究中与膀胱癌有关,三项研究中与结肠癌有关,四项研究中与直肠癌有关。美国国家癌症研究所的一项大型研究发现,在1955年至1975年期间,一个地区50%的人的原水水源发生了变化。数据中的此类缺陷可能妨碍发现癌症与饮用水中的污染物之间的因果关系。由于标记疾病(膀胱癌和直肠癌)的发生率较低,因此需要进行大型病例对照研究和队列研究。由于水污染物种类的差异,队列研究可能无法进行。水化学家、工程师和流行病学家提出了关于这些问题的明确问题,以供共同努力和解决。