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dc.contributor.authorDonat-Vargas, Carolina
dc.contributor.authorKogevinas, Manolis
dc.contributor.authorCastaño-Vinyals, Gemma
dc.contributor.authorPerez-Gomez, Beatriz 
dc.contributor.authorLlorca, Javier
dc.contributor.authorVanaclocha-Espí, Mercedes
dc.contributor.authorFernandez-Tardon, Guillermo
dc.contributor.authorCostas, Laura
dc.contributor.authorAragonés, Nuria
dc.contributor.authorGómez-Acebo, Inés
dc.contributor.authorMoreno, Victor
dc.contributor.authorPollan-Santamaria, Marina 
dc.contributor.authorVillanueva, Cristina M
dc.identifier.citationEnviron Health Perspect. 2023 Mar;131(3):37004.es_ES
dc.description.abstractBackground: Nitrate and trihalomethanes (THMs) in drinking water are widespread and are potential human carcinogens. Objective: We evaluated the association between drinking-water exposure to nitrate and THMs and prostate cancer. Methods: During the period 2008-2013, 697 hospital-based incident prostate cancer cases (97 aggressive tumors) and 927 population-based controls were recruited in Spain, providing information on residential histories and type of water consumed. Average nitrate and THMs levels in drinking water were linked with lifetime water consumption to calculate waterborne ingestion. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using mixed models with recruitment area as random effect. Effect modification by tumor grade (Gleason score), age, education, lifestyle, and dietary factors was explored. Results: Mean (±standard deviation) adult lifetime waterborne ingested nitrate (milligrams per day), brominated (Br)-THMs (micrograms per day), and chloroform (micrograms per day) were 11.5 (±9.0), 20.7 (±32.4), and 15.1 (±14.7) in controls. Waterborne ingested nitrate >13.8 vs. <5.5mg/d was associated with an OR of 1.74 (95% CI: 1.19, 2.54) overall, and 2.78 (95% CI: 1.23, 6.27) for tumors with Gleason scores ≥8. Associations were higher in the youngest and those with lower intakes of fiber, fruit/vegetables, and vitamin C. Waterborne ingested THMs were not associated with prostate cancer. Residential tap water levels of Br-THMs and chloroform showed, respectively, inverse and positive associations with prostate cancer. Conclusions: Findings suggest long-term waterborne ingested nitrate could be a risk factor of prostate cancer, particularly for aggressive tumors. High intakes of fiber, fruit/vegetables and vitamin C may lower this risk. Association with residential levels but not ingested chloroform/Br-THM may suggest inhalation and dermal routes could be relevant for prostate cancer.es_ES
dc.description.sponsorshipThe study was partially funded by the “Accion Transversal del Cancer,” approved on the Spanish Ministry Council on 11 October 2007, by the Instituto de Salud Carlos III-FEDER (PI08/1770, PI08/0533, PI08/1359, PS09/00773, PS09/01286, PS09/01903, PS09/02078, PS09/01662, PI11/01889, PI11/00226, PI12/01270, PI12/00715, PI14/0613, PI15/00914, PI17CIII/00034), by the Fundación Marqués de Valdecilla (API 10/09), by the Conselleria de Sanitat of the Generalitat Valenciana (AP_061/10), by the European Commission grants FOOD-CT-2006-036224-HIWATE, by the Spanish Association Against Cancer (AECC) Scientific Foundation, by the Catalan Government-Agency for Management of University and Research Grants (AGAUR) grants 2017SGR723 and 2014SGR850, by the Fundación Caja de Ahorros de Asturias, and by the University of Oviedo. ISGlobal acknowledges support from the Spanish Ministry of Science and Innovation through the “Centro de Excelencia Severo Ochoa 2019–2023” Program (CEX2018-000806-S) and support from the Generalitat de Catalunya through the CERCA Program.es_ES
dc.publisherNational Institute of Environmental Health Sciences (NIEHS) es_ES
dc.subject.meshDrinking Water es_ES
dc.subject.meshProstatic Neoplasms es_ES
dc.subject.meshWater Pollutants, Chemical es_ES
dc.subject.meshAdult es_ES
dc.subject.meshMale es_ES
dc.subject.meshHumans es_ES
dc.subject.meshNitrates es_ES
dc.subject.meshEnvironmental Exposure es_ES
dc.subject.meshTrihalomethanes es_ES
dc.subject.meshChloroform es_ES
dc.subject.meshSpain es_ES
dc.subject.meshAscorbic Acid es_ES
dc.titleLong-Term Exposure to Nitrate and Trihalomethanes in Drinking Water and Prostate Cancer: A Multicase-Control Study in Spain (MCC-Spain)es_ES
dc.typeresearch articlees_ES
dc.rights.licenseAtribución 4.0 Internacional*
dc.contributor.funderInstituto de Salud Carlos III es_ES
dc.contributor.funderUnión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF) es_ES
dc.contributor.funderFundación Marqués de Valdecilla es_ES
dc.contributor.funderGeneralitat Valenciana (España) es_ES
dc.contributor.funderUnión Europea. Comisión Europea es_ES
dc.contributor.funderAsociación Española Contra el Cáncer es_ES
dc.contributor.funderGovernment of Catalonia (España) es_ES
dc.contributor.funderAgència de Gestió d'Ajuts Universitaris i de Recerca (AGAUR) es_ES
dc.contributor.funderFundación Caja de Ahorros de Asturias es_ES
dc.contributor.funderUniversity of Oviedo (España) es_ES
dc.contributor.funderMinisterio de Ciencia e Innovación. Centro de Excelencia Severo Ochoa (España) es_ES
dc.identifier.journalEnvironmental health perspectiveses_ES
dc.repisalud.centroISCIII::Centro Nacional de Epidemiologíaes_ES
dc.rights.accessRightsopen accesses_ES
dc.relation.projectFISinfo:fis/Instituto de Salud Carlos III/null/null/Subprograma de proyectos de investigacion en salud (AES 2011) (2011)/PI11/01889es_ES
dc.relation.projectFISinfo:fis/Instituto de Salud Carlos III/null/null/Subprograma de proyectos de investigacion en salud (AES 2011) (2011)/PI11/00226es_ES
dc.relation.projectFISinfo:fis/Instituto de Salud Carlos III/null/null/Subprograma de proyectos de investigacion en salud (AES 2012) (2012)/PI12/01270es_ES
dc.relation.projectFISinfo:fis/Instituto de Salud Carlos III/null/null/Subprograma de proyectos de investigacion en salud (AES 2012) (2012)/PI12/00715es_ES
dc.relation.projectFISinfo:fis/Instituto de Salud Carlos III/null/null/Subprograma de proyectos de investigacion en salud (AES 2015). Modalidad proyectos en salud. (2015)/PI15/00914es_ES
dc.relation.projectFISinfo:fis/Instituto de Salud Carlos III/Programa Estatal de Fomento de la Investigación Científica y Técnica de Excelencia/Subprograma Estatal de Generación de Conocimiento/PI17-ISCIII Modalidad Proyectos de Investigacion en Salud Intramurales. (2017)/PI17CIII/00034es_ES

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