Chlorination, chlorination by-products, and cancer: A meta-analysis

R.D. Morris, A.-M. Audet, I.F. Angelillo, T.C. Chalmers and F. Mosteller

American Journal of Public Health, 1992, vol. 82, issue 7, 955-963

Abstract: Objectives. Individual epidemiological investigations into the association between chlorination by-products in drinking water and cancer have been suggestive but inconclusive. Enough studies exist to provide the basis for a meaningful meta-analysis. Methods. An extensive literature search was performed to identify pertinent case-control studies and cohort studies. Consumption of chlorinated water, surface water, or water with high levels of chloroform was used as a surrogate for exposure to chlorination by-products. Relative risk estimates were abstracted from the individual studies and pooled. Results. A simple meta-analysis of all cancer sites yielded a relative risk estimate for exposure to chlorination by-products of 1.15 (95% CI: 1.09, 1.20). Pooled relative risk estimates for organ-specific neoplasms were 1.21 (95% CI: 1.09, 1.34) for bladder cancer and 1.38 (95% CI: 1.01, 1.87) for rectal cancer. When studies that adjusted for potential confounders were pooled separately, estimates of relative risks did not change substantially. Conclusions. The results of this meta-analysis suggest a positive association between consumption of chlorination by-products in drinking water and bladder and rectal cancer in humans.

Date: 1992
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:1992:82:7:955-963_4

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