Source of drinking water at home and site-specific cancer incidence in Washington County, Maryland.

A nonconcurrent prospective study was conducted to investigate the postulated relationship between organic chemical by-products of water chlorination and risk of human cancer. Vital records and nonofficial census data available for each of nearly 31,000 study subjects were used to compute selected sex- and site-specific cancer incidence rates in a well-defined county population. Age, socioeconomic status, smoking history, source of drinking water at home, and other individual characteristics of the study population were examined in relation to the cancer rates. The drinking water source variable consisted of three historical cohorts, each distinguished by a different degree of exposure to chloroform and other chlorination byproducts. Incidence rates for cancer of the bladder among men and for cancer of the liver among women were nearly twofold higher in the drinking water cohort that had been supplied chlorinated surface water at home when compared to the cohort with a history of consumption of unchlorinated ground water. The differences, however, were not statistically significant. A complementary mortality study also suggested an association of chlorinated water with cancer of the liver and urinary tract. The findings in Washington County indicate the need for further studies of individuals with different histories of exposure to chlorinated and unchlorinated drinking water.