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dc.contributor.authorKogevinas, Manolis
dc.contributor.authorNieuwenhuijsen, Mark J
dc.contributor.authorAggazzotti, Gabriella
dc.contributor.authorLa Vecchia, Carlo
dc.contributor.authorMoreno, Victor
dc.contributor.authorPalau, Margarita
dc.contributor.authorEspejo-Herrera, Nadia
dc.contributor.authorEspinosa, Ana
dc.contributor.authorCastaño-Vinyals, Gemma
dc.contributor.authorPisa, Federica
dc.contributor.authorSerraino, Diego
dc.contributor.authorPolesel, Jerry
dc.contributor.authorTavani, Alessandra
dc.contributor.authorChirlaque, Maria Dolores
dc.contributor.authorTardón, Adonina
dc.contributor.authorPeiró, Rosana
dc.contributor.authorArdanaz, Eva
dc.contributor.authorZabala, Ana Jiménez
dc.contributor.authorAltzibar, Jone M
dc.contributor.authorAcebo, Ines Gomez
dc.contributor.authorPollan-Santamaria, Marina 
dc.contributor.authorPerez-Gomez, Beatriz 
dc.contributor.authorAragones, Nuria 
dc.contributor.authorBoldo, Elena 
dc.contributor.authorMartín, Vicente
dc.contributor.authorMolina, Antonio José
dc.contributor.authorRighi, Elena
dc.contributor.authorBosetti, Cristina
dc.contributor.authorGracia-Lavedan, Esther
dc.contributor.authorVillanueva, Cristina M.
dc.identifier.citationEnviron Health Perspect. 2017;125(1):56-65es_ES
dc.description.abstractBACKGROUND: Evidence on the association between colorectal cancer and exposure to disinfection by-products in drinking water is inconsistent. OBJECTIVES: We assessed long-term exposure to trihalomethanes (THMs), the most prevalent group of chlorination by-products, to evaluate the association with colorectal cancer. METHODS: A multicenter case-control study was conducted in Spain and Italy in 2008-2013. Hospital-based incident cases and population-based (Spain) and hospital-based (Italy) controls were interviewed to ascertain residential histories, type of water consumed in each residence, frequency and duration of showering/bathing, and major recognized risk factors for colorectal cancer. We estimated adjusted odds ratios (OR) for colorectal cancer in association with quartiles of estimated average lifetime THM concentrations in each participant's residential tap water (micrograms/liter; from age 18 to 2 years before the interview) and estimated average lifetime THM ingestion from drinking residential tap water (micrograms/day). RESULTS: We analyzed 2,047 cases and 3,718 controls. Median values (ranges) for average lifetime residential tap water concentrations of total THMs, chloroform, and brominated THMs were 30 (0-174), 17 (0-63), and 9 (0-145) μg/L, respectively. Total THM concentration in residential tap water was not associated with colorectal cancer (OR = 0.92, 95% CI: 0.66, 1.28 for highest vs. lowest quartile), but chloroform concentrations were inversely associated (OR = 0.31, 95% CI: 0.24, 0.41 for highest vs. lowest quartile). Brominated THM concentrations showed a positive association among men in the highest versus the lowest quartile (OR = 1.43, 95% CI: 0.83, 2.46). Patterns of association were similar for estimated average THM ingestion through residential water consumption. CONCLUSIONS: We did not find clear evidence of an association between detailed estimates of lifetime total THM exposure and colorectal cancer in our large case-control study population. Negative associations with chloroform concentrations and ingestion suggest differences among specific THMs, but these findings should be confirmed in other study populations. Citation: Villanueva CM, Gracia-Lavedan E, Bosetti C, Righi E, Molina AJ, Martín V, Boldo E, Aragonés N, Perez-Gomez B, Pollan M, Gomez Acebo I, Altzibar JM, Jiménez Zabala A, Ardanaz E, Peiró R, Tardón A, Chirlaque MD, Tavani A, Polesel J, Serraino D, Pisa F, Castaño-Vinyals G, Espinosa A, Espejo-Herrera N, Palau M, Moreno V, La Vecchia C, Aggazzotti G, Nieuwenhuijsen MJ, Kogevinas M. 2017. Colorectal cancer and long-term exposure to trihalomethanes in drinking water: a multicenter case---control study in Spain and Italy. Environ Health Perspect 125:56-65;
dc.description.sponsorshipWe appreciate the contribution of the institutions and local governments that provided data on municipal water in Spain, particularly to J. Lázaro Arias Paredes (Mancomunidad de Canales del Taibilla, Murcia, Spain). We also thank F. Gallino (IRCCS, Istituto Nazionale dei Tumori, Milan, Italy), A. Tonini and C. Dellanoce (Ospedale Niguarda Cà Granda, Milan, Italy) for their collaboration in conducting the study. We appreciate the contribution of G. Sesana and D. Ravetta of the regional Environmental Health Agency “Arpa Lombardia” and the contribution of E. Zamparo and F. del Bianco of the Health Authority n.5 “Friuli Occidentale” for providing data on DBPs (disinfection by-products) in Italian drinking water. We thank L. Font-Ribera and L.A. Salas for comments on the draft manuscript and X. Basagaña for the contribution to the statistical approach.es_ES
dc.publisherBioMed Centrales_ES
dc.relation.isversionofPublisher's versiones_ES
dc.subjectColorectal Canceres_ES
dc.titleColorectal Cancer and Long-Term Exposure to Trihalomethanes in Drinking Water: A Multicenter Case–Control Study in Spain and Italyes_ES
dc.rights.licenseAtribución-NoComercial-CompartirIgual 4.0 Internacional*
dc.identifier.journalEnvironmental Health Perspectiveses_ES
dc.repisalud.centroISCIII::Centro Nacional de Epidemologíaes_ES

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Atribución-NoComercial-CompartirIgual 4.0 Internacional
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