Abstract
Background
Many studies neglect to account for variation in population served by community water systems (CWSs) when aggregating CWS-level contaminant concentrations to county level.
Objective
In an ecological epidemiologic analysis, we explored two methods—unweighted and weighted (proportion of CWS population served by county population)—to account for population served by CWS in association between arsenic and three cancers to determine the impact of population served on aggregated measures of exposure.
Methods
CWS arsenic concentration data for 19 states were obtained from Centers for Disease Control and Prevention (CDC) National Environmental Public Health Tracking Network for 2000–10, aggregated to county level, and linked to county-level cancer data for 2011–5 from National Cancer Institute and CDC State Cancer Profiles. Negative binomial regression models estimated adjusted risk ratios (aRR) and 95% confidence intervals (CI) between county-level bladder, colorectal, and kidney cancers and quartiles of aggregated cumulative county-level arsenic concentration (ppb-years).
Results
We observed positive associations between the highest quartile of exposure, compared to the lowest, of aggregated cumulative county-level arsenic concentration (ppb-year) for bladder [weighted aRR: 1.89(1.53, 2.35)], colorectal [1.64(1.33, 2.01)], and kidney [1.69(1.37, 2.09)] cancers. We observed stronger associations utilizing the weighted exposure assessment method. However, inferences from this study are limited due to the ecologic nature of the analyses and different analytic study designs are needed to assess the utility that the weighted by CWS population served metric has for exposure assessment.
Significance
Weighting by CWS population served accounts for some potential exposure assignment error in epidemiologic analysis.
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References
Agency for Toxic Substances and Disease Registry (ASTDR). Toxicological PRofile For Arsenic. 2007. https://www.atsdr.cdc.gov/toxprofiles/tp.asp?id=22&tid=3. Last accessed 31 Aug 2020.
United States Environmental Protection Agency (US EPA). National Primary Drinking Water Regulations. 2018. https://www.epa.gov/ground-water-and-drinking-water/national-primary-drinking-water-regulations. Last accessed 31 Aug 2020.
International Agency for Research on Cancer (IARC). IARC monographs on the evaluation of carcinogenic risks to humans: arsenic, metals, fibres, and dusts. Vol. 100C. Lyon: World Health Organization (WHO); 2012. https://monographs.iarc.fr/iarc-monographs-on-the-evaluation-of-carcinogenic-risks-to-humans-19/. Last accessed 31 Aug 2020.
United States Environmental Protection Agency (US EPA). IRIS Arsenic, Inorganic. 2017. https://cfpub.epa.gov/ncea/iris2/chemicalLanding.cfm?substance_nmbr=0278. Last accessed 31 Aug 2020.
Federal Register. National primary drinking water regulations; arsenic and clarifications to compliance and new source contaminants monitoring. 2001. https://www.federalregister.gov/documents/2001/01/22/01-1668/national-primary-drinking-water-regulations-arsenic-and-clarifications-to-compliance-and-new-source. Last accessed 31 Aug 2020.
United States Environmental Protection Agency (US EPA). SDWIS federal reports advanced search. 2017. https://ofmpub.epa.gov/apex/sfdw/f?p=108:1:::NO:1. Last accessed 31 Aug 2020.
Bulka CM, Jones RM, Turyk ME, Stayner LT, Argos M. Arsenic in drinking water and prostate cancer in Illinois counties: an ecological study. Environ Res. 2016;148:450–6. https://doi.org/10.1016/j.envres.2016.04.030
Mendez WM Jr, Eftim S, Cohen J, Warren I, Cowden J, Lee JS, et al. Relationship between arsenic concentrations in drinking water and lung and bladder cancer incidence in US counties. J Expo Sci Environ Epidemiol. 2017;27:235–43. https://doi.org/10.1038/jes.2016.58
Roh T, Lynch CF, Weyer P, Wang K, Kelly KM, Ludewig G. Low-level arsenic exposure from drinking water is associated with prostate cancer in Iowa. Envrion Res. 2017;159:338–43. https://doi.org/10.1016/j.envres.2017.08.026
Baris D, Waddell R, Beane-Freeman LE, Schwenn M, Colt JS, Ayotte JD, et al. Elevated bladder cancer in northern New England: the role of drinking water and arsenic. J Natl Cancer Inst. 2016;108:djw099 https://doi.org/10.1093/jnci/djw09.
Bates MN, Smith AH, Canter KP. Case-control study of bladder cancer and arsenic in drinking water. Am J Epidemiol. 1995;141:523–30.
Bates MN, Rey OA, Biggs ML, Hopenhayn C, Moore LE, Kalman D, et al. Case-control study of bladder cancer and exposure to arsenic in Argentina. Am J Epidemiol 2004;159:381–9. https://doi.org/10.1093/aje/kwh054
Kurttio P, Pukkala E, Kahelin H, Auvinen A, Pekkanen J. Arsenic concentrations in well water and risk of bladder and kidney cancer in Finland. Environ Health Perspect. 1999;107:705–10.
Meliker JR, Slotnick MJ, AvRuskin GA, Schottenfeld D, Jacquex GM, Wilson ML, et al. Lifetime exposure to arsenic in drinking water and bladder cancer: a population-based case-control study in Michigan, USA. Cancer Causes Control. 2010;21:745–57. https://doi.org/10.1007/s10552-010-9503-z
Saint-Jacques N, Parker L, Brown P, Dummer TJ. Arsenic in drinking water and urinary tract cancers: a systematic review of 30 years of epidemiological evidence. Environ Health. 2014;13:44 https://doi.org/10.1186/1476-069X-13-44
Saint-Jacques N, Brown P, Nauta L, Boxall J, Parker L, Dummer TJB. Estimating the risk of bladder and kidney cancer from exposure to low-levels of arsenic in drinking water, Nova Scotia, Canada. Environ Int. 2018;110:95–104. https://doi.org/10.1016/j.envint.2017.10.014
Smith AH, Marshall G, Roh T, Ferreccio C, Liaw J, Steinmaus C. Lung, bladder, and kidney cancer mortality 40 years after arsenic exposure reduction. J Natl Cancer Inst. 2018;110:241–9. https://doi.org/10.1093/jnci/djx201
Bardach AE, Ciapponi A, Soto N, Chaparro MR, Calderon M, Briatore A, et al. Epidemiology of chronic disease related to arsenic in Argentina: a systematic review. Sci Total Environ. 2015;538:802–16. https://doi.org/10.1016/j.scitotenv.2015.08.070
Han YY, Weissfeld JL, Davis DL, Talbott EO. Arsenic levels in ground water and cancer incidence in Idaho: an ecologic study. Int Acrh Occup Environ Health. 2009;82:84.849 https://doi.org/10.1007/s00420-008-0362-9
Mostafa MG, Cherry N. Arsenic in drinking water and renal cancers in rural Bangladesh. Occup Environ Med. 2013;70:768–73. https://doi.org/10.1136/oemed-2013-101443
Yuan Y, Mashall G, Ferreccio C, Steinmaus C, Liaw J, Bates M, et al. Kidney cancer mortality: fifty-year latency patterns related to arsenic exposure. Epidemiology. 2010;21:103–8. https://doi.org/10.1097/EDE.0b013e3181c21e46
Almberg KS, Turyk ME, Jones RM, Rankin K, Freels S, Graber JM, et al. Arsenic in drinking water and adverse birth outcomes in Ohio. Environ Res. 2017;157:52–59. https://doi.org/10.1016/j.envres.2017.05.010
Engel RR, Smith AH. Arsenic in drinking water and mortality from vascular disease: an ecologic analysis in 30 counties in the United States. Arch Environ Health. 1994;49:418–27.
Jones RM, Graber JM, Anderson R, Rockne K, Turyk M, Stayner LT. Community drinking water quality monitoring data: utility for public health research and practice. J Public Health Manag Pract. 2014;20:210–19. https://doi.org/10.1097/PHH.0b013e3182980ca2
Centers for Disease Control and Prevention (CDC). National environmental public health tracking. 2018. https://www.cdc.gov/nceh/tracking/. Last accessed 31 Aug 2020.
Monti MM, David F, Shin M, Vaidyanathan A. Community drinking water data on the National Environmental Public Health Tracking Network: a surveillance summary of data from 2000 to 2010. Environ Monit Assess 2019;191:557 https://doi.org/10.1007/s10661-019-7710-y
National Cancer Institute (NCI) and Centers for Disease Control and Prevention (CDC). State cancer profiles, incidence rate tables. 2018. https://statecancerprofiles.cancer.gov/incidencerates/index.php. Last accessed 31 Aug 2020.
National Cancer Institute (NCI) and Centers for Disease Control and Prevention (CDC). About state cancer profiles. 2018. https://statecancerprofiles.cancer.gov/about/. Last accessed 31 Aug 2020.
Koutros S, Barius D, Waddell R, Beane Freeman LE, Colt JS, Schwenn M, et al. Potential effect modifiers of the arsenic-bladder cancer risk relationship. Int J Cancer. 2018;143:2640–6. https://doi.org/10.1002/ijc.3172
United States Cancer Statistics Working Group. US cancer statistics data visualizations tool, based on November 2018 submission data (1999–2016). 2019 June. https://gis.cdc.gov/Cancer/USCS/DataViz.html. Last accessed 31 August 2020.
Lobdell DT, Jagai JS, Rappazzo K, Messer LC. Data sources for an environmental quality index: availability, quality, and utility. Am J Public Health. 2011;101 Suppl 1:S277–85. https://doi.org/10.2105/AJPH.2011.300184
Messer LC, Jagai JS, Rappazzo KM, Lobdell DT. Construction of an environmental quality index for public health research. Environ Health. 2014;13:39 https://doi.org/10.1186/1476-069X-13-39
United States Environmental Protection Agency (US EPA). Environmental dataset gateway download locations: EQI. 2018. https://edg.epa.gov/data/Public/ORD/NHEERL/EQI. Last accessed 31 August 2020.
Centers for Disease Control and Prevention (CDC). National environmental public health tracking: indicators and data. 2018. https://ephtracking.cdc.gov/showIndicatorPages. Last accessed 31 August 2020.
United States Environmental Protection Agency (US EPA). Providing safe drinking water in America: 2013 National Public Water Systems Compliance Report. 2015. https://www.epa.gov/sites/production/files/2015-06/documents/sdwacom2013.pdf.
Tsuji JS, Alexander DD, Perez V, Mink PJ. Arsenic exposure and bladder cancer: quantitative assessment of studies in human populations to detect risks at low-doses. Toxicology. 2014;317:17–30. https://doi.org/10.1016/j.tox.2014.01.004
United States Environmental Protection Agency (US EPA). About private water wells. 2016. https://19january2017snapshot.epa.gov/privatewells/about-private-water-wells_.html. Last accessed 31 August 2020.
United States Environmental Protection Agency (US EPA). Potential well water contaminants and their impacts. 2019. https://www.epa.gov/privatewells/potential-well-water-contaminants-and-their-impacts. Last accessed 31 August 2020.
United States Geological Survey (USGS). Estimated use of water in the United States county-level data for 2010. 2016. https://water.usgs.gov/watuse/data/2010/index.html. Last accessed 31 August 2020.
Acknowledgements
The authors wish to acknowledge the support and guidance provided by Tim Wade and the Environmental Quality Index team, Stephanie A. Deflorio-Barker, Christine L. Gray, Lynne C. Messer, and Achal P. Patel. We would like to thank Mike Wright, Tom Luben, and Tom Bateson for their thorough review and suggestions to improve this manuscript. The research in this manuscript has been reviewed by the US Environmental Protection Agency and approved for publication. The views expressed in this manuscript are those of the authors and do not necessarily reflect the views or policies of the US Environmental Protection Agency. Mention of trade names or commercial products does not constitute endorsement or recommendation for use.
Funding
This research was supported in part by an appointment to the Research Participation Program for the US Environmental Protection Agency, Office of Research and Development, administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the US Department of Energy and EPA.
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Krajewski, A.K., Jimenez, M.P., Rappazzo, K.M. et al. Aggregated cumulative county arsenic in drinking water and associations with bladder, colorectal, and kidney cancers, accounting for population served. J Expo Sci Environ Epidemiol 31, 979–989 (2021). https://doi.org/10.1038/s41370-021-00314-8
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DOI: https://doi.org/10.1038/s41370-021-00314-8
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