Long-Term Exposure to Nitrate and Trihalomethanes in Drinking Water and Gastric Cancer: A Multicase-Control Study in Spain (MCC-Spain)

BACKGROUND: Disinfection byproducts and N-nitroso compounds (NOC) formed endogenously after nitrate ingestion have been shown to be carcinogenic in animal studies, but epidemiological evidence is limited, especially in relation to gastric cancer. OBJECTIVE: We evaluated the association between drink...

ver descrição completa

Detalhes bibliográficos
Autores: Donat-Vargas, C, Kogevinas, M, Castaño-Vinyals, G, Pérez-Gómez, B, Aragonés, N, Guevara, M, Gómez-Acebo, I, Molina, A, Fernandez-Tardon, G, Vanaclocha-Espí, M, Molina-Barceló, A, Moreno, V, Pollan, M, Villanueva, CM
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Recursos:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p20086
Acesso em linha:https://fisabio.portalinvestigacion.com/publicaciones/20086
https://www.scopus.com/inward/record.uri?eid=2-s2.0-105006687865&doi=10.1289%2fEHP15039&partnerID=40&md5=d721f905d3aa9909aedd9361630a9f7c
Access Level:acceso abierto
Palavra-chave:Adult
Aged
Case-Control Studies
Drinking Water
Environmental Exposure
Female
Humans
Male
Middle Aged
Nitrates
Spain
Stomach Neoplasms
Trihalomethanes
Water Pollutants, Chemical
alpha tocopherol
ascorbic acid
bromodichloromethane
bromoform
chloroform
dibromochloromethane
drinking water
nitrate
nitroso derivative
trihalomethane
water
nitric acid derivative
adult
aged
alcohol consumption
Article
body mass
cancer risk
case control study
cohort analysis
controlled study
dietary pattern
female
human
interview
logistic regression analysis
long term exposure
major clinical study
male
metabolic equivalent
physical activity
primary health care
risk factor
smoking
sociodemographics
stomach cancer
structured questionnaire
water borne disease
chemistry
environmental exposure
epidemiology
middle aged
stomach tumor
toxicity
water pollutant
id ES_f5bb7b004adf20ab4d1966c5ea8a46a5
oai_identifier_str oai:fisabio.fundanetsuite.com:p20086
network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv Long-Term Exposure to Nitrate and Trihalomethanes in Drinking Water and Gastric Cancer: A Multicase-Control Study in Spain (MCC-Spain)
title Long-Term Exposure to Nitrate and Trihalomethanes in Drinking Water and Gastric Cancer: A Multicase-Control Study in Spain (MCC-Spain)
spellingShingle Long-Term Exposure to Nitrate and Trihalomethanes in Drinking Water and Gastric Cancer: A Multicase-Control Study in Spain (MCC-Spain)
Donat-Vargas, C
Adult
Aged
Case-Control Studies
Drinking Water
Environmental Exposure
Female
Humans
Male
Middle Aged
Nitrates
Spain
Stomach Neoplasms
Trihalomethanes
Water Pollutants, Chemical
alpha tocopherol
ascorbic acid
bromodichloromethane
bromoform
chloroform
dibromochloromethane
drinking water
nitrate
nitroso derivative
trihalomethane
water
nitric acid derivative
trihalomethane
adult
aged
alcohol consumption
Article
body mass
cancer risk
case control study
cohort analysis
controlled study
dietary pattern
female
human
interview
logistic regression analysis
long term exposure
major clinical study
male
metabolic equivalent
physical activity
primary health care
risk factor
smoking
sociodemographics
Spain
stomach cancer
structured questionnaire
water borne disease
chemistry
environmental exposure
epidemiology
middle aged
stomach tumor
toxicity
water pollutant
title_short Long-Term Exposure to Nitrate and Trihalomethanes in Drinking Water and Gastric Cancer: A Multicase-Control Study in Spain (MCC-Spain)
title_full Long-Term Exposure to Nitrate and Trihalomethanes in Drinking Water and Gastric Cancer: A Multicase-Control Study in Spain (MCC-Spain)
title_fullStr Long-Term Exposure to Nitrate and Trihalomethanes in Drinking Water and Gastric Cancer: A Multicase-Control Study in Spain (MCC-Spain)
title_full_unstemmed Long-Term Exposure to Nitrate and Trihalomethanes in Drinking Water and Gastric Cancer: A Multicase-Control Study in Spain (MCC-Spain)
title_sort Long-Term Exposure to Nitrate and Trihalomethanes in Drinking Water and Gastric Cancer: A Multicase-Control Study in Spain (MCC-Spain)
dc.creator.none.fl_str_mv Donat-Vargas, C
Kogevinas, M
Castaño-Vinyals, G
Pérez-Gómez, B
Aragonés, N
Guevara, M
Gómez-Acebo, I
Molina, A
Fernandez-Tardon, G
Vanaclocha-Espí, M
Molina-Barceló, A
Moreno, V
Pollan, M
Villanueva, CM
author Donat-Vargas, C
author_facet Donat-Vargas, C
Kogevinas, M
Castaño-Vinyals, G
Pérez-Gómez, B
Aragonés, N
Guevara, M
Gómez-Acebo, I
Molina, A
Fernandez-Tardon, G
Vanaclocha-Espí, M
Molina-Barceló, A
Moreno, V
Pollan, M
Villanueva, CM
author_role author
author2 Kogevinas, M
Castaño-Vinyals, G
Pérez-Gómez, B
Aragonés, N
Guevara, M
Gómez-Acebo, I
Molina, A
Fernandez-Tardon, G
Vanaclocha-Espí, M
Molina-Barceló, A
Moreno, V
Pollan, M
Villanueva, CM
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Adult
Aged
Case-Control Studies
Drinking Water
Environmental Exposure
Female
Humans
Male
Middle Aged
Nitrates
Spain
Stomach Neoplasms
Trihalomethanes
Water Pollutants, Chemical
alpha tocopherol
ascorbic acid
bromodichloromethane
bromoform
chloroform
dibromochloromethane
drinking water
nitrate
nitroso derivative
trihalomethane
water
nitric acid derivative
trihalomethane
adult
aged
alcohol consumption
Article
body mass
cancer risk
case control study
cohort analysis
controlled study
dietary pattern
female
human
interview
logistic regression analysis
long term exposure
major clinical study
male
metabolic equivalent
physical activity
primary health care
risk factor
smoking
sociodemographics
Spain
stomach cancer
structured questionnaire
water borne disease
chemistry
environmental exposure
epidemiology
middle aged
stomach tumor
toxicity
water pollutant
topic Adult
Aged
Case-Control Studies
Drinking Water
Environmental Exposure
Female
Humans
Male
Middle Aged
Nitrates
Spain
Stomach Neoplasms
Trihalomethanes
Water Pollutants, Chemical
alpha tocopherol
ascorbic acid
bromodichloromethane
bromoform
chloroform
dibromochloromethane
drinking water
nitrate
nitroso derivative
trihalomethane
water
nitric acid derivative
trihalomethane
adult
aged
alcohol consumption
Article
body mass
cancer risk
case control study
cohort analysis
controlled study
dietary pattern
female
human
interview
logistic regression analysis
long term exposure
major clinical study
male
metabolic equivalent
physical activity
primary health care
risk factor
smoking
sociodemographics
Spain
stomach cancer
structured questionnaire
water borne disease
chemistry
environmental exposure
epidemiology
middle aged
stomach tumor
toxicity
water pollutant
description BACKGROUND: Disinfection byproducts and N-nitroso compounds (NOC) formed endogenously after nitrate ingestion have been shown to be carcinogenic in animal studies, but epidemiological evidence is limited, especially in relation to gastric cancer. OBJECTIVE: We evaluated the association between drinking water exposure to nitrate and trihalomethanes (THMs) and gastric cancer in a multicasecontrol study conducted in Spain (MCC-Spain). METHODS: In 20082013, 254 hospital-based incident gastric cancer cases and 2,365 population-based controls were recruited, providing information on residential histories and type of water consumed. Adult lifetime average nitrate and THM levels in residences from age 18 until 2 years before the interview were estimated and linked with water consumption information to calculate waterborne ingested nitrate, brominated (Br)-THMs, and chloroform. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression, with adjustment for potential confounders. We assessed the effect modification by factors influencing endogenous NOC formation. RESULTS: Median [percentile 25th (P-25)percentile 75 (P-75)] (P25-P75) lifetime waterborne ingested nitrate (mg/day), Br-THMs (mu g/day), and chloroform (mu g/day) were 2.7 (1.45.6), 3.8 (1.58.1), and 12.2 (4.023.7), respectively, in cases and 3.8 (1.88.5), 5.7 (2.619.2), and 12.9 (4.624.5) in controls, respectively. Adjusted OR (95% CI) for gastric cancer comparing nitrate intake >9.7 vs. <= 9.7mg/day (percentile 80th, P-80) was 1.42 (0.88, 2.29). This association was more pronounced among participants with low consumption of vegetables [2.24 (1.02, 4.91)], vitamin C [2.10 (0.94, 4.71)], and vitamin E [2.81 (1.16, 6.78)] and among those with high consumption of alcohol [2.78 (0.98, 7.93)] or processed meat [1.91 (0.97, 3.75)]. When stratified by age, the association only remained in the >65 years of age group (median 73 years of age). OR for gastric cancer comparing Br-THM ingestion = vs. 80th <80th percentile was 0.65 (0.33, 1.28) and for chloroform was 1.36 (0.87, 2.14). Comparable ORs were found for residential concentrations. CONCLUSIONS: Long-term waterborne nitrate exposure below regulatory limits may increase gastric cancer risk among older adults and in those with poor dietary patterns. These findings need to be confirmed by cohort studies with larger sample sizes. https://doi.org/10.1289/EHP15039
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/20086
https://www.scopus.com/inward/record.uri?eid=2-s2.0-105006687865&doi=10.1289%2fEHP15039&partnerID=40&md5=d721f905d3aa9909aedd9361630a9f7c
url https://fisabio.portalinvestigacion.com/publicaciones/20086
https://www.scopus.com/inward/record.uri?eid=2-s2.0-105006687865&doi=10.1289%2fEHP15039&partnerID=40&md5=d721f905d3aa9909aedd9361630a9f7c
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE
publisher.none.fl_str_mv US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE
dc.source.none.fl_str_mv ENVIRONMENTAL HEALTH PERSPECTIVES
ISSN: 00916765
ISSNe: 15529924
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869424643500146688
spelling Long-Term Exposure to Nitrate and Trihalomethanes in Drinking Water and Gastric Cancer: A Multicase-Control Study in Spain (MCC-Spain)Donat-Vargas, CKogevinas, MCastaño-Vinyals, GPérez-Gómez, BAragonés, NGuevara, MGómez-Acebo, IMolina, AFernandez-Tardon, GVanaclocha-Espí, MMolina-Barceló, AMoreno, VPollan, MVillanueva, CMAdultAgedCase-Control StudiesDrinking WaterEnvironmental ExposureFemaleHumansMaleMiddle AgedNitratesSpainStomach NeoplasmsTrihalomethanesWater Pollutants, Chemicalalpha tocopherolascorbic acidbromodichloromethanebromoformchloroformdibromochloromethanedrinking waternitratenitroso derivativetrihalomethanewaternitric acid derivativetrihalomethaneadultagedalcohol consumptionArticlebody masscancer riskcase control studycohort analysiscontrolled studydietary patternfemalehumaninterviewlogistic regression analysislong term exposuremajor clinical studymalemetabolic equivalentphysical activityprimary health carerisk factorsmokingsociodemographicsSpainstomach cancerstructured questionnairewater borne diseasechemistryenvironmental exposureepidemiologymiddle agedstomach tumortoxicitywater pollutantBACKGROUND: Disinfection byproducts and N-nitroso compounds (NOC) formed endogenously after nitrate ingestion have been shown to be carcinogenic in animal studies, but epidemiological evidence is limited, especially in relation to gastric cancer. OBJECTIVE: We evaluated the association between drinking water exposure to nitrate and trihalomethanes (THMs) and gastric cancer in a multicasecontrol study conducted in Spain (MCC-Spain). METHODS: In 20082013, 254 hospital-based incident gastric cancer cases and 2,365 population-based controls were recruited, providing information on residential histories and type of water consumed. Adult lifetime average nitrate and THM levels in residences from age 18 until 2 years before the interview were estimated and linked with water consumption information to calculate waterborne ingested nitrate, brominated (Br)-THMs, and chloroform. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression, with adjustment for potential confounders. We assessed the effect modification by factors influencing endogenous NOC formation. RESULTS: Median [percentile 25th (P-25)percentile 75 (P-75)] (P25-P75) lifetime waterborne ingested nitrate (mg/day), Br-THMs (mu g/day), and chloroform (mu g/day) were 2.7 (1.45.6), 3.8 (1.58.1), and 12.2 (4.023.7), respectively, in cases and 3.8 (1.88.5), 5.7 (2.619.2), and 12.9 (4.624.5) in controls, respectively. Adjusted OR (95% CI) for gastric cancer comparing nitrate intake >9.7 vs. <= 9.7mg/day (percentile 80th, P-80) was 1.42 (0.88, 2.29). This association was more pronounced among participants with low consumption of vegetables [2.24 (1.02, 4.91)], vitamin C [2.10 (0.94, 4.71)], and vitamin E [2.81 (1.16, 6.78)] and among those with high consumption of alcohol [2.78 (0.98, 7.93)] or processed meat [1.91 (0.97, 3.75)]. When stratified by age, the association only remained in the >65 years of age group (median 73 years of age). OR for gastric cancer comparing Br-THM ingestion = vs. 80th <80th percentile was 0.65 (0.33, 1.28) and for chloroform was 1.36 (0.87, 2.14). Comparable ORs were found for residential concentrations. CONCLUSIONS: Long-term waterborne nitrate exposure below regulatory limits may increase gastric cancer risk among older adults and in those with poor dietary patterns. These findings need to be confirmed by cohort studies with larger sample sizes. https://doi.org/10.1289/EHP15039US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/20086https://www.scopus.com/inward/record.uri?eid=2-s2.0-105006687865&doi=10.1289%2fEHP15039&partnerID=40&md5=d721f905d3aa9909aedd9361630a9f7cENVIRONMENTAL HEALTH PERSPECTIVESISSN: 00916765ISSNe: 15529924reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p200862026-06-11T12:45:17Z
score 15.811543