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dc.contributor.authorBrody, Julia Greenen_US
dc.contributor.authorAschengrau, Annen_US
dc.contributor.authorMcKelvey, Wendyen_US
dc.contributor.authorSwartz, Christopher Hen_US
dc.contributor.authorKennedy, Theresaen_US
dc.contributor.authorRudel, Ruthann Aen_US
dc.date.accessioned2011-12-29T22:41:33Z
dc.date.available2011-12-29T22:41:33Z
dc.date.copyright2006en_US
dc.date.issued2006-10-6en_US
dc.identifier.citationBrody, Julia Green, Ann Aschengrau, Wendy McKelvey, Christopher H Swartz, Theresa Kennedy, Ruthann A Rudel. "Breast cancer risk and drinking water contaminated by wastewater: a case control study" Environmental Health 5:28. (2006)en_US
dc.identifier.issn1476-069Xen_US
dc.identifier.urihttp://hdl.handle.net/2144/2598
dc.description.abstractBACKGROUND: Drinking water contaminated by wastewater is a potential source of exposure to mammary carcinogens and endocrine disrupting compounds from commercial products and excreted natural and pharmaceutical hormones. These contaminants are hypothesized to increase breast cancer risk. Cape Cod, Massachusetts, has a history of wastewater contamination in many, but not all, of its public water supplies; and the region has a history of higher breast cancer incidence that is unexplained by the population's age, in-migration, mammography use, or established breast cancer risk factors. We conducted a case-control study to investigate whether exposure to drinking water contaminated by wastewater increases the risk of breast cancer. METHODS: Participants were 824 Cape Cod women diagnosed with breast cancer in 1988–1995 and 745 controls who lived in homes served by public drinking water supplies and never lived in a home served by a Cape Cod private well. We assessed each woman's exposure yearly since 1972 at each of her Cape Cod addresses, using nitrate nitrogen (nitrate-N) levels measured in public wells and pumping volumes for the wells. Nitrate-N is an established wastewater indicator in the region. As an alternative drinking water quality indicator, we calculated the fraction of recharge zones in residential, commercial, and pesticide land use areas. RESULTS: After controlling for established breast cancer risk factors, mammography, and length of residence on Cape Cod, results showed no consistent association between breast cancer and average annual nitrate-N (OR = 1.8; 95% CI 0.6 – 5.0 for ≥ 1.2 vs. < .3 mg/L), the sum of annual nitrate-N concentrations (OR = 0.9; 95% CI 0.6 – 1.5 for ≥ 10 vs. 1 to < 10 mg/L), or the number of years exposed to nitrate-N over 1 mg/L (OR = 0.9; 95% CI 0.5 – 1.5 for ≥ 8 vs. 0 years). Variation in exposure levels was limited, with 99% of women receiving some of their water from supplies with nitrate-N levels in excess of background. The total fraction of residential, commercial, and pesticide use land in recharge zones of public supply wells was associated with a small statistically unstable higher breast cancer incidence (OR = 1.4; 95% CI 0.8–2.4 for highest compared with lowest land use), but risk did not increase for increasing land use fractions. CONCLUSION: Results did not provide evidence of an association between breast cancer and drinking water contaminated by wastewater. The computer mapping methods used in this study to link routine measurements required by the Safe Drinking Water Act with interview data can enhance individual-level epidemiologic studies of multiple health outcomes, including diseases with substantial latency.en_US
dc.description.sponsorshipCommonwealth of Massachusetts; Susan G. Komen Breast Cancer Foundation; National Institute of Environmental Health Sciences (2P42 ES07381); United States Environmental Protection Agency; National Cancer Institute (5 R03 CA103478-02)en_US
dc.language.isoenen_US
dc.publisherBioMed Centralen_US
dc.rightsCopyright 2006 Brody et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution 2.0 License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en_US
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_US
dc.titleBreast Cancer Risk and Drinking Water Contaminated by Wastewater: A Case Control Studyen_US
dc.typearticleen_US
dc.identifier.doi10.1186/1476-069X-5-28en_US
dc.identifier.pubmedid17026759en_US
dc.identifier.pmcid1622744en_US


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Copyright 2006 Brody et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution 2.0 License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Except where otherwise noted, this item's license is described as Copyright 2006 Brody et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution 2.0 License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.