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Heterogeneity in the Relationship between Disinfection By-Products in Drinking Water and Cancer: A Systematic Review

Author

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  • Tarik Benmarhnia

    (Department of Family Medicine and Public Health & Scripps Institution of Oceanography, University of California, San Diego, CA 92093, USA
    These authors contributed equally to this work.)

  • Ianis Delpla

    (École Supérieure D’aménagement du Territoire et de Développement Régional (ESAD), Université Laval, 1624 Pavillon Savard, Québec, QC G1K-7P4, Canada
    These authors contributed equally to this work.)

  • Lara Schwarz

    (Department of Family Medicine and Public Health & Scripps Institution of Oceanography, University of California, San Diego, CA 92093, USA)

  • Manuel J. Rodriguez

    (École Supérieure D’aménagement du Territoire et de Développement Régional (ESAD), Université Laval, 1624 Pavillon Savard, Québec, QC G1K-7P4, Canada)

  • Patrick Levallois

    (Direction de la Santé Environnementale et de la Toxicologie, Institut National de Santé Publique du Québec, Québec, QC G1V 5B3, Canada
    Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du Centre Hospitalier Universitaire (CHU) de Québec, Québec, QC G1V 2M2, Canada)

Abstract

The epidemiological evidence demonstrating the effect of disinfection by-products (DBPs) from drinking water on colon and rectal cancers is well documented. However, no systematic assessment has been conducted to assess the potential effect measure modification (EMM) in the relationship between DBPs and cancer. The objective of this paper is to conduct a systematic literature review to determine the extent to which EMM has been assessed in the relationship between DBPs in drinking water in past epidemiological studies. Selected articles ( n = 19) were reviewed, and effect estimates and covariates that could have been used in an EMM assessment were gathered. Approximately half of the studies assess EMM ( n = 10), but the majority of studies only estimate it relative to sex subgroups ( n = 6 for bladder cancer and n = 2 both for rectal and colon cancers). Although EMM is rarely assessed, several variables that could have a potential modification effect are routinely collected in these studies, such as socioeconomic status or age. The role of environmental exposures through drinking water can play an important role and contribute to cancer disparities. We encourage a systematic use of subgroup analysis to understand which populations or territories are more vulnerable to the health impacts of DBPs.

Suggested Citation

  • Tarik Benmarhnia & Ianis Delpla & Lara Schwarz & Manuel J. Rodriguez & Patrick Levallois, 2018. "Heterogeneity in the Relationship between Disinfection By-Products in Drinking Water and Cancer: A Systematic Review," IJERPH, MDPI, vol. 15(5), pages 1-13, May.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:5:p:979-:d:146102
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    References listed on IDEAS

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    4. Balazs, C.L. & Ray, I., 2014. "The drinking water disparities framework: On the origins and persistence of inequities in exposure," American Journal of Public Health, American Public Health Association, vol. 104(4), pages 603-611.
    5. Hanna-Attisha, M. & LaChance, J. & Sadler, R.C. & Schnepp, A.C., 2016. "Elevated blood lead levels in children associated with the flint drinking water crisis: A spatial analysis of risk and public health response," American Journal of Public Health, American Public Health Association, vol. 106(2), pages 283-290.
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    Cited by:

    1. Patrick Levallois & Cristina M. Villanueva, 2019. "Drinking Water Quality and Human Health: An Editorial," IJERPH, MDPI, vol. 16(4), pages 1-4, February.
    2. Jessica Stanhope & Gael Davidson & Kimberley McAuley & Angus Cook & Philip Weinstein, 2020. "Spatial and Temporal Variability in Trihalomethane Concentrations in the Bromine-Rich Public Waters of Perth, Australia," IJERPH, MDPI, vol. 17(19), pages 1-11, October.

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