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Chlorination, chlorination by-products, and cancer: A meta-analysis

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  • Morris, R.D.
  • Audet, A.-M.
  • Angelillo, I.F.
  • Chalmers, T.C.
  • Mosteller, F.

Abstract

Objectives. Individual epidemiological investigations into the association between chlorination by-products in drinking water and cancer have been suggestive but inconclusive. Enough studies exist to provide the basis for a meaningful meta-analysis. Methods. An extensive literature search was performed to identify pertinent case-control studies and cohort studies. Consumption of chlorinated water, surface water, or water with high levels of chloroform was used as a surrogate for exposure to chlorination by-products. Relative risk estimates were abstracted from the individual studies and pooled. Results. A simple meta-analysis of all cancer sites yielded a relative risk estimate for exposure to chlorination by-products of 1.15 (95% CI: 1.09, 1.20). Pooled relative risk estimates for organ-specific neoplasms were 1.21 (95% CI: 1.09, 1.34) for bladder cancer and 1.38 (95% CI: 1.01, 1.87) for rectal cancer. When studies that adjusted for potential confounders were pooled separately, estimates of relative risks did not change substantially. Conclusions. The results of this meta-analysis suggest a positive association between consumption of chlorination by-products in drinking water and bladder and rectal cancer in humans.

Suggested Citation

  • Morris, R.D. & Audet, A.-M. & Angelillo, I.F. & Chalmers, T.C. & Mosteller, F., 1992. "Chlorination, chlorination by-products, and cancer: A meta-analysis," American Journal of Public Health, American Public Health Association, vol. 82(7), pages 955-963.
    • Handle: RePEc:aph:ajpbhl:1992:82:7:955-963_4
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    Cited by:

    1. S. Michelle Driedger & John Eyles & Susan D. Elliott & Donald C. Cole, 2002. "Constructing Scientific Authorities: Issue Framing of Chlorinated Disinfection Byproducts in Public Health," Risk Analysis, John Wiley & Sons, vol. 22(4), pages 789-802, August.
    2. Prakash Poudel & Saurav Sharma & Mohamed Nainar Mohamed Ansari & Pushpendra Kumar & Sobhy M. Ibrahim & Rahul Vaish & Rajeev Kumar & Paramanandam Thomas, 2022. "The Bacterial Disinfection of Water Using a Galloping Piezoelectric Wind Energy Harvester," Energies, MDPI, vol. 15(17), pages 1-16, August.
    3. Baaijens, Sef & Nijkamp, Peter, 2000. "Meta-Analytic Methods for Comparative and Exploratory Policy Research: An Application to the Assessment of Regional Tourist Multipliers," Journal of Policy Modeling, Elsevier, vol. 22(7), pages 821-858, December.

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