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

International Journal of Environmental Research and Public Health
Tarik BenmarhniaPatrick Levallois

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...Continue Reading

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Citations

Feb 24, 2019·International Journal of Environmental Research and Public Health·Patrick Levallois, Cristina M Villanueva
Oct 9, 2020·International Journal of Environmental Research and Public Health·Jessica StanhopePhilip Weinstein
Jul 10, 2021·Food Chemistry·Jacqueline Peixoto Miranda BadaróCamila Lima Santos

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