Gottlieb M S, Carr J K, Clarkson J R
Am J Epidemiol. 1982 Oct;116(4):652-67. doi: 10.1093/oxfordjournals.aje.a113448.
Thirteen Louisiana parishes (counties) using the Mississippi river as a source of potable water have the highest mortality rates (1950-1969) in the drinking water source, a comparison of cancer deaths and noncancer deaths from 1960-1975 in selected southern Louisiana parishes was conducted. Parishes were grouped for similarities in industrialization and approximately equal exposure of the population to surface water and ground water. Cancers were studied in groups by hypothesized risk: high for bladder, colon, kidney, liver, lymphoma, rectum, and stomach; low for Hodgkin's lymphoma, leukemia, lung, malignant melanoma, multiple myeloma, and prostate; and questionable for breast, brain, esophagus, and pancreas. Noncancer deaths were randomly selected and matched 1:1 to cancer deaths on age, race, sex, and year and parish group of death. Water source at death was based on residence at death, surface or ground water, and chlorinated or nonchlorinated water. The risk associated with using surface water least likely due solely to change occurred for cancer of the rectum. Other risks which were lower but still greater than 1.0 occurred for cancer of the kidney and breast. No risk was observed for other cancers of the gastrointestinal or urinary tract. Risk for multiple myeloma was associated with use of ground water.
13个以密西西比河作为饮用水源的路易斯安那州教区（县）在饮用水源方面的死亡率最高（1950 - 1969年），对路易斯安那州南部选定教区1960 - 1975年的癌症死亡和非癌症死亡情况进行了比较。教区按工业化程度的相似性以及人口对地表水和地下水的大致同等暴露程度进行分组。按假设风险对癌症进行分组研究：膀胱癌、结肠癌、肾癌、肝癌、淋巴瘤、直肠癌和胃癌风险高；霍奇金淋巴瘤、白血病、肺癌、恶性黑色素瘤、多发性骨髓瘤和前列腺癌风险低；乳腺癌、脑癌、食道癌和胰腺癌风险存疑。非癌症死亡病例随机选取，并在年龄、种族、性别、死亡年份和教区组方面与癌症死亡病例1:1匹配。死亡时的水源依据死亡时的居住地、地表水或地下水以及加氯或未加氯的水来确定。使用地表水与直肠癌发生风险相关，这一风险不太可能完全仅由变化导致。肾癌和乳腺癌也存在较低但仍大于1.0的其他风险。未观察到胃肠道或泌尿系统其他癌症的风险。多发性骨髓瘤的风险与使用地下水有关。
