Biomedical subjects

J S Reif

Publications and source records attributed to J S Reif.

At least 19 recordsLinked to original sources

PubMed2005

Identifying public water facilities with low spatial variability of disinfection by-products for epidemiological investigations.

BACKGROUND AND AIMS: Epidemiological studies of disinfection by-products (DBPs) and reproductive outcomes have been hampered by misclassification of exposure. In most epidemiological studies conducted to date, all persons living within the boundaries of a water distribution system have been assigned a common exposure value based on facility-wide averages of trihalomethane (THM) concentrations. Since THMs do not develop uniformly throughout a distribution system, assignment of facility-wide averages may be inappropriate. One approach to mitigate this potential for misclassification is to select communities for epidemiological investigations that are served by distribution systems with consistently low spatial variability of THMs. METHODS AND RESULTS: A feasibility study was conducted to develop methods for community selection using the Information Collection Rule (ICR) database, assembled by the US Environmental Protection Agency. The ICR database contains quarterly DBP concentrations collected between 1997 and 1998 from the distribution systems of 198 public water facilities with minimum service populations of 100,000 persons. Facilities with low spatial variation of THMs were identified using two methods; 33 facilities were found with low spatial variability based on one or both methods. Because brominated THMs may be important predictors of risk for adverse reproductive outcomes, sites were categorised into three exposure profiles according to proportion of brominated THM species and average TTHM concentration. The correlation between THMs and haloacetic acids (HAAs) in these facilities was evaluated to see whether selection by total trihalomethanes (TTHMs) corresponds to low spatial variability for HAAs. TTHMs were only moderately correlated with HAAs (r = 0.623). CONCLUSIONS: Results provide a simple method for a priori selection of sites with low spatial variability from state or national public water facility datasets as a means to reduce exposure misclassification in epidemiological studies of DBPs.

Acetic Acid↗

PubMed2002

Melatonin metabolite excretion among cellular telephone users.

PURPOSE: The relationship between cellular telephone use and excretion of the melatonin metabolite 6-hydroxymelatonin sulfate (6-OHMS) was evaluated in two populations of male electric utility workers (Study 1, n=149; Study 2, n=77). MATERIALS AND METHODS: Participants collected urine samples and recorded cellular telephone use over 3 consecutive workdays. Personal 60-Hz magnetic field (MF) and ambient light exposures were characterized on the same days using EMDEX II meters. A repeated measures analysis was used to assess the effects of cellular telephone use, alone and combined with MF exposures, after adjustment for age, participation month and light exposure. RESULTS: No change in 6-OHMS excretion was observed among those with daily cellular telephone use >25 min in Study 1 (5 worker-days). Study 2 workers with >25 min cellular telephone use per day (13 worker-days) had lower creatinine-adjusted mean nocturnal 6-OHMS concentrations (p=0.05) and overnight 6-OHMS excretion (p=0.03) compared with those without cellular telephone use. There was also a linear trend of decreasing mean nocturnal 6-OHMS/creatinine concentrations (p=0.02) and overnight 6-OHMS excretion (p=0.08) across categories of increasing cellular telephone use. A combined effect of cellular telephone use and occupational 60-Hz MF exposure in reducing 6-OHMS excretion was also observed in Study 2. CONCLUSIONS: Exposure-related reductions in 6-OHMS excretion were observed in Study 2, where daily cellular telephone use of >25 min was more prevalent. Prolonged use of cellular telephones may lead to reduced melatonin production, and elevated 60-Hz MF exposures may potentiate the effect.

Adolescent↗

PubMed2001

Opportunities for using Navy marine mammals to explore associations between organochlorine contaminants and unfavorable effects on reproduction.

The Department of Defense (DoD) has a unique marine mammal program maintained by the US Navy that includes the largest force of bottlenose dolphins, Tursiops truncatus, worldwide. In recent years, this population of cetaceans that lives in netted open water enclosures in San Diego Bay has been monitored for levels of organochlorine (OC) contaminants in blubber, blood and milk. Data generated from these studies have afforded insight into the fate and possible effects of OC contaminants in marine mammals. We now report preliminary findings on the effects of maternal OC exposure on pregnancy outcome. Blubber OC levels were compared between females whose calves survived beyond 6 months and females whose calves were stillborn or died within 12 days of birth. The mean concentration of SigmaDDT was more than 3 times as high among dolphins whose calves died as that among dolphins whose calves survived beyond 6 months (P = 0.002). Mean SigmaPCB was more than 2.5 times higher in females whose calves did not survive (P= 0.076). This population is a logical sentinel for the assessment of environmentally mediated disease. Biological tissues and fluids can be sampled on a regular basis from the dolphins for accumulation of tissue residues, facilitated by conditioned husbandry behaviors. These trained behaviors help preclude possible alterations in health measures resulting from capture stress. Animals' diets can be monitored for contaminant levels. With these data, the expertise and facilities available at the Navy laboratory and in collaboration with other experts in the field, controlled studies can be designed to monitor and assess dietary exposure, measurable immune and neurologic responses and assess reproductive and transgenerational effects of contaminants. Biomarkers can be developed to relate the health of individual animals relative to contaminant exposures. Such investigations of natural exposure and response scenarios are a logical adjunct to traditional laboratory toxicity studies.

Adipose Tissue↗

PubMed2000

Prevalence of enteric zoonotic organisms in cats.

OBJECTIVE: To determine prevalence of enteric zoonotic organisms in cats in north-central Colorado. DESIGN: Prospective study. SAMPLE POPULATION: Serum and fecal samples from 87 cats with diarrhea, 106 cats without diarrhea, and 12 cats for which fecal consistency was unknown. PROCEDURES: Samples were obtained from client-owned cats and cats at a humane society shelter. Serum was assayed for feline leukemia virus antigen and antibodies against feline immunodeficiency virus, IgM antibodies against Toxoplasma gondii, and IgG antibodies against T gondii and Cryptosporidium parvum. Microscopic examination of unstained feces was performed after centrifugation in a zinc sulfate solution, thin fecal smears were stained with acid fast stain and examined for C parvum, and bacteriologic culture of feces was used to detect aerobic and anaerobic bacteria. RESULTS: Enteric zoonotic organisms were detected in feces from 27 of 206 (13.1%) cats and included C parvum (5.4%), Giardia spp (2.4%). Toxocara cati (3.9%), Salmonella enterica serotype Typhimurium (1.0%), and Campylobacter jejuni (1.0%); each organism was detected in samples from cats with and without diarrhea. Although differences between groups were not significant, a higher proportion of shelter cats (18.2%) had enteric zoonotic organisms than client-owned cats (10.1%). CONCLUSIONS AND CLINICAL RELEVANCE: Enteric zoonotic organisms were detected in feces of 13.1% of cats, suggesting that cats, particularly those in homes of immunocompromised humans, should be evaluated for enteric zoonotic organisms.

Animals↗

PubMed2000

Melatonin metabolite levels in workers exposed to 60-Hz magnetic fields: work in substations and with 3-phase conductors.

Melatonin suppression by 50/60-Hz magnetic fields represents a plausible biological mechanism for explaining increased health risks in workers. Personal exposure to magnetic fields and ambient light, and excretion of the melatonin metabolite 6-hydroxymelatonin sulfate (6-OHMS), were measured over 3 consecutive workdays in electric utility workers. There was a magnetic field-dependent reduction in adjusted mean nocturnal and post-work 6-OHMS levels among men working more than 2 hours per day in substation and 3-phase environments and no effect among those working 2 hours or less. No changes were observed among men working in 1-phase environments. The results suggest that circular or elliptical magnetic field polarization, or another factor linked to substations and 3-phase electricity, is associated with magnetic field induced melatonin suppression in humans.

Adult↗

PubMed1999

Reduced excretion of a melatonin metabolite in workers exposed to 60 Hz magnetic fields.

The effects of occupational 60 Hz magnetic field and ambient light exposures on the pineal hormone, melatonin, were studied in 142 male electric utility workers in Colorado, 1995-1996. Melatonin was assessed by radioimmunoassay of its metabolite, 6-hydroxymelatonin sulfate (6-OHMS), in post-work shift urine samples. Personal magnetic field and light exposures were measured over 3 consecutive days using EMDEX C meters adapted with light sensors. Two independent components of magnetic field exposure, intensity (geometric time weighted average) and temporal stability (standardized rate of change metric or RCMS), were analyzed for their effects on creatinine-adjusted 6-OHMS concentrations (6-OHMS/cr) after adjustment for age, month, and light exposure. Geometric mean magnetic field exposures were not associated with 6-OHMS/cr excretion. Men in the highest quartile of temporally stable magnetic field exposure had lower 6-OHMS/cr concentrations on the second and third days compared with those in the lowest quartile. Light exposure modified the magnetic field effect. A progressive decrease in mean 6-OHMS/cr concentrations in response to temporally stable magnetic fields was observed in subjects with low workplace light exposures (predominantly office workers), whereas those with high ambient light exposure showed negligible magnetic field effects. Melatonin suppression may be useful for understanding human biologic responses to magnetic field exposures.

Adult↗

PubMed1999

Geomagnetic disturbances are associated with reduced nocturnal excretion of a melatonin metabolite in humans.

The effects of geomagnetic disturbances on urinary excretion of the melatonin metabolite, 6-hydroxymelatonin sulfate (6-OHMS), were studied in conjunction with 60 Hz magnetic field (MF) and ambient light exposure in 132 electric utility workers. Geomagnetic activity was assessed using a local (equivalent amplitude or A(K), Boulder, CO) and global (average antipodal or aa) index. Personal exposures to 60 Hz MFs and light were obtained using data-logging meters. The relationship between geomagnetic activity and 6-OHMS was assessed with adjustment for age, light exposure, and month of participation. Mean overnight 6-OHMS excretion was lower on days when the 36-h A(K) or aa values exceeded 30 nT. A greater reduction in 6-OHMS excretion was observed when increased geomagnetic activity was combined with elevated 60 Hz MF or reduced ambient light exposures.

Circadian Rhythm↗

PubMed1999

Evaluation of serologic and viral detection methods for diagnosing feline herpesvirus-1 infection in cats with acute respiratory tract or chronic ocular disease.

OBJECTIVE: To determine the value of virus isolation (VI), immunofluorescent antibody (IFA) assay, serum neutralization (SN), and ELISA for the diagnosis of clinical feline herpesvirus-1 (FHV-1) infection in cats. ANIMALS: 46 clinically normal cats, 17 cats with signs of acute respiratory tract disease, and 38 cats with signs of chronic ocular disease. PROCEDURE: Conjunctival swabs for VI, conjunctival scrapings for IFA testing, and venous blood samples for SN or ELISA testing were obtained from all cats. RESULTS: FHV-1 was detected in 10.9 and 28.3% of clinically normal cats and in 18.2 and 33.3% of cats with FHV-1-associated disease by VI and the IFA assay, respectively. There were no significant differences in the viral detection rate between cats with acute respiratory tract disease and cats with chronic ocular disease or between diseased cats and clinically normal cats; however, FHV-1 was never detected by both methods in clinically normal cats. Overall FHV-1 seroprevalence was 97% when tested by ELISA and 66% when tested by SN. Seroprevalence did not vary significantly among the 3 groups for either serologic test. Magnitude of SN and ELISA titers varied greatly but independently of presence or absence of clinical signs of FHV-1-associated disease. Sensitivity, specificity, and positive and negative predictive values were assessed for VI and the IFA assay--jointly and individually--and for each SN and ELISA titer magnitude. Values never all exceeded 50%. CLINICAL IMPLICATIONS: Because FHV-1 can be detected commonly in clinically normal cats by the IFA assay or VI, neither test appears to aid in the clinical diagnosis of FHV-1 infection. Seroprevalence does not appear to vary between affected and clinically normal cats. SN, ELISA, VI, and the IFA assay appear to be of limited value in the diagnosis of FHV-1-associated disease in cats. Concurrent assessment of the IFA assay and VI results may permit exclusion of FHV-1 as an etiologic agent if results of both tests are negative.

Acute Disease↗

PubMed1999

Regional seroprevalence of Cryptosporidium parvum-specific IgG of cats in the United States.

The objective of this study was to determine the regional prevalence of Cryptosporidium parvum-specific IgG in the sera of cats in the United States. The continental United States was partitioned into eight regional areas. Serum samples from 75 cats from each region were assayed for C. parvum-specific IgG using an indirect enzyme-linked immunosorbent assay (ELISA). Age, sex, breed, and indoor/outdoor status were examined as possible risk factors for developing a positive C. parvum-specific IgG antibody titer. The presence of gastro-intestinal signs and Toxoplasma gondii-specific IgG in the serum were also evaluated for association with C. parvum seropositivity. Of the 600 samples assayed, 50 (8.3%) were positive for C. parvum-specific IgG. Regional seroprevalence ranged from 1.3% in the mid-Atlantic states to 14.7% in the south-eastern states. The oldest group of cats (>10 years) had the highest seroprevalence (15.3%). The prevalence of C. parvum-specific IgG was higher among male (10.1%) than among female cats (6.9%), although, the difference was not statistically significant (p = 0.17). Seropositivity was not associated with pure-bred status. C. parvum-specific IgG antibodies was detected most frequently in T. gondii-specific IgG seropositive cats, outdoor cats, and cats with gastro-intestinal signs. These results suggest that cats in the United States are commonly exposed to C. parvum.

Age Factors↗

PubMed1999

Animals as sentinels of human health hazards of environmental chemicals.

A workshop titled "Using Sentinel Species Data to Address the Potential Human Health Effects of Chemicals in the Environment," sponsored by the U.S. Army Center for Environmental Health Research, the National Center for Environmental Assessment of the EPA, and the Agency for Toxic Substances and Disease Registry, was held to consider the use of sentinel and surrogate animal species data for evaluating the potential human health effects of chemicals in the environment. The workshop took a broad view of the sentinel species concept, and included mammalian and nonmammalian species, companion animals, food animals, fish, amphibians, and other wildlife. Sentinel species data included observations of wild animals in field situations as well as experimental animal data. Workshop participants identified potential applications for sentinel species data derived from monitoring programs or serendipitous observations and explored the potential use of such information in human health hazard and risk assessments and for evaluating causes or mechanisms of effect. Although it is unlikely that sentinel species data will be used as the sole determinative factor in evaluating human health concerns, such data can be useful as for additional weight of evidence in a risk assessment, for providing early warning of situations requiring further study, or for monitoring the course of remedial activities. Attention was given to the factors impeding the application of sentinel species approaches and their acceptance in the scientific and regulatory communities. Workshop participants identified a number of critical research needs and opportunities for interagency collaboration that could help advance the use of sentinel species approaches.

Animals↗

PubMed1998

Cancer of the nasal cavity and paranasal sinuses and exposure to environmental tobacco smoke in pet dogs.

A case-control study of nasal cancer in pet dogs was conducted to test the hypothesis that exposure to environmental tobacco smoke increases risk. Cases (n = 103) were selected from a teaching hospital during 1986-1990. Controls (n = 378) with other forms of cancer were selected from the same study base. Exposure to environmental tobacco smoke was evaluated by determining the number of smokers in the household, the packs of cigarettes smoked per day at home by each smoker, the number of years that each person smoked during the dog's lifetime, and the proportion of time spent indoors by the dog. The crude odds ratio for exposure to environmental tobacco smoke was 1.1 (95% confidence interval (CI) 0.7-1.8) and was unchanged after adjustment for confounders. Skull shape was found to exert a pronounced modifying effect; among dolichocephalic (long-nosed) dogs, the odds ratio for a smoker in the house was 2.0 (95% CI 1.0-4.1). A monotonic increase in the odds ratios across strata of total packs smoked and total indoor exposure to environmental tobacco smoke was found in this group of dogs, with risks of approximately 2.5 for the highest stratum. Conversely, all odds ratios for exposure to environmental tobacco smoke among short- and medium-length-nosed dogs were approximately 0.5. The data support an association between environmental tobacco smoke and canine nasal cancer.

Air Pollution, Indoor↗

PubMed1998

Nocturnal excretion of a urinary melatonin metabolite among electric utility workers.

OBJECTIVES: The effects of 60-Hz magnetic field and ambient light exposures on the pineal hormone melatonin were studied among electric utility workers. METHODS: Personal exposure was measured at 15-second intervals over 3 consecutive 24-hour periods. Exposure metrics based on magnetic field intensity, intermittence, or temporal stability were calculated for periods of work, home, and sleep. A rate-of-change metric (RCM) was used to estimate intermittence, and the standardized RCM (RCMS = RCM/standard deviation) was used to evaluate temporal stability. The effects of magnetic field exposure on total overnight 6-hydroxymelatonin sulfate (6-OHMS) excretion and creatinine-adjusted nocturnal 6-OHMS (6-OHMS/cr) concentration were analyzed with adjustment for age, month, and light exposure. RESULTS: Magnetic field intensity, intermittence, or cumulative exposure had little influence on nocturnal 6-OHMS excretion. Residential RCMS magnetic field exposures were associated with lower nocturnal 6-OHMS/cr concentrations. In multivariate statistical analyses, the interaction term for geometric mean and RCMS magnetic field exposures at home was associated with lower nocturnal 6-OHMS/cr and overnight 6-OHMS levels. Modest reductions in the mean 6-OHMS levels occurred after RCMS exposures during work. The greatest reductions occurred when RCMS exposures both at work and at home were combined; therefore the effects of temporally stable magnetic fields may be integrated over a large portion of the day. CONCLUSIONS: Results from this study provide evidence that temporally stable magnetic field exposures are associated with reduced nocturnal 6-OHMS excretion in humans.

Adult↗

PubMed1997

Elevated interleukin 6 activity in aqueous humor of cats with uveitis.

The purpose of this study was to assess the role of interleukin 6 (IL-6) in feline uveitis by measuring IL-6 activity in the serum and aqueous humor of cats. Serum and aqueous humor was collected from clinically normal, random source cats (n = 10); clinically normal, specific-pathogen free cats experimentally inoculated with Toxoplasma gondii strain ME49 and sampled sequentially for 20 months (n = 4); and client-owned cats with uveitis (n = 27). Interleukin 6 activity was measured in each sample. Client-owned cats with uveitis were also evaluated for evidence of present or prior exposure to T. gondii, feline leukemia virus, feline immunodeficiency virus, and feline coronaviruses. Interleukin 6 activity was non-detectable or low in serum from cats of each group. Interleukin 6 activity was not detected in aqueous humor of clinically normal cats. Interleukin 6 activity was detected in 22/27 (81.5%) aqueous humor samples from cats with uveitis, with a range of 28.9 U ml(-1)-15702.9 U ml(-1) (mean = 1911.9 U ml[-1], SD = 3946.7 U ml[-1]). Serologic evidence of exposure to T gondii, feline immunodeficiency virus, feline leukemia virus, or a coronavirus was present in 21/27 (77.8%) cats with uveitis. Interleukin 6 was detected in the aqueous humor of 18/21 (85.7%) and 3/6 (50%) of the cats with and without serologic evidence of exposure to one to the infectious diseases, respectively. Statistically significant increases in mean IL-6 activity in aqueous humor were found for cats with any evidence of infection with T. gondii, for cats with T. gondii antigen in aqueous humor and for cats with coronavirus antibody titers > or = 1:100. Aqueous humor IL-6 activity was greater than corresponding serum IL-6 activity in 21/27 cats. These results show that IL-6 is produced intraocularly in some cats with uveitis and that IL-6 may be a mediator of uveitis in cats.

Animals↗

PubMed1996

Reproductive and developmental effects of disinfection by-products in drinking water.

Recent epidemiologic studies have reported associations between the consumption of chlorinated drinking water and reproductive and developmental effects. Here we review the available epidemiologic data, assess the hazard potential posed by exposure to disinfection by-products, identify critical data gaps, and offer recommendations for further research. The epidemiologic evidence supporting associations between exposure to water disinfection by-products (DBPs) and adverse pregnancy outcomes is sparse, and positive findings should be interpreted cautiously. The methods used during the early stages of research in this area have been diverse. Variability in exposure assessment and endpoints makes it difficult to synthesize or combine the available data. Exposure misclassification and unmeasured confounding may have lead to bias in risk estimation. Future studies of reproductive outcome and exposure to chlorinated water should use improved methods for exposure assessment to 1) assure selection of appropriate exposure markers, 2) assess seasonal and annual fluctuations in DBPs, 3) assess variability within the distribution system, and 4) assess exposure through multiple routes such as bathing and showering, as well as consumption. Population-based studies should be conducted to evaluate male and female fertility, conception delay, growth retardation, and specific birth defects. The reproductive and developmental effects of exposure to DBPs could be efficiently explored in ongoing investigations by incorporating valid exposure markers and relevant questionnaire information. Future studies should make use of naturally occurring variability in the concentrations of DBPs and may incorporate biomarkers of exposure and effect in their design. Epidemiologic investigations should be conducted in parallel with laboratory-based and animal studies in a coordinated, multidisciplinary approach.

Abnormalities, Drug-Induced↗

PubMed1995

Residential exposure to magnetic fields and risk of canine lymphoma.

A hospital-based case-control study was conducted to determine whether residential exposure to magnetic fields increased risk for canine lymphoma in pet dogs. Cases were patients at a veterinary teaching hospital with histologically confirmed lymphoma diagnosed between 1987 and 1990. Hospital controls with other forms of cancer were obtained by frequency matching on zip code and year of diagnosis. Information regarding the dog's activity patterns, residence history, and exposure to potential confounders was obtained by telephone interview. Wire codes and magnetic fields were measured at the homes at diagnosis of 93 cases and 137 controls. When exposure was categorized into two levels (high or very high wire codes compared with low, very low, or buried lines), the risk was elevated (odds ratio (OR) = 1.6, 95% confidence interval (CI) 0.9-2.9) and increased (OR = 1.8, 95% CI 0.9-3.4) after adjustment for potential confounders. Dogs that lived in homes with very high current codes had the highest risk (OR = 6.8, 95% CI 1.6-28.5). Moderate, imprecise increases in risk (odds ratios of 1.5-1.9) were found for residence in a home with a sidewalk (plumbing), backyard, or front yard magnetic field of 2.0 mG or greater, but not for indoor measurements at this level. Risk increased among dogs that spent more than 25% of the day outdoors. Laboratory and observational studies of dogs as an animal model for the effects of magnetic fields are recommended.

Animals↗

PubMed1995

Parental occupations as risk factors for craniosynostosis in offspring.

In a population-based case-control study, we examined relations between maternal and paternal occupations and the risk of infant craniosynostosis. Cases were 212 children born to Colorado residents and diagnosed during 1986-1989 with radiographically confirmed synostosis of unknown etiology. Controls were 291 children randomly selected from state birth records and frequency matched to cases on month and year of birth. Trained staff conducted telephone interviews of mothers of case and control children. Information was obtained about each job held by either parent during the pregnancy, and any job that the father held during the 3 months before the last menstrual period before conception. Jobs were coded using 1980 Census occupation and industry codes. We found no strong associations for maternal occupations. Of paternal occupations, two groups were associated with moderately increased odds ratios after adjustment for maternal smoking and altitude: agriculture and forestry (odds ratio = 2.3; 95% confidence interval = 1.0-5.2), and mechanics and repairmen (odds ratio = 2.7; 95% confidence interval = 1.2-6.1). For both, the odds ratios were higher for males.

Adolescent↗

PubMed1995

Comparison of methods for estimation of Toxoplasma gondii-specific antibody production in the aqueous humor of cats.

Intraocular production of Toxoplasma gondii-specific antibody in cats has been estimated by comparing the ratio of T gondii-specific antibody in aqueous humor and serum with the ratio of total immunoglobulins in serum and aqueous humor (Goldmann-Witmer coefficient; aqueous antibody coefficient; C value). It has been proposed that in human beings, comparison of the ratio of T gondii-specific antibody in aqueous humor and serum with the ratio of antibodies against a nonocular pathogen in serum and aqueous humor is more accurate than methods using total immunoglobulin quantification. We developed an ELISA for detection of calicivirus-specific antibodies in the serum and aqueous humor of cats. By evaluating calicivirus-specific antibody concentrations in the aqueous humor of healthy and diseased cats, calicivirus was assessed as a nonintraocular pathogen. The ratio of T gondii-specific antibodies in the aqueous humor and serum and the ratio of calicivirus-specific antibodies in serum and aqueous humor were evaluated as a means of estimating intraocular T gondii-specific antibody production. A field strain of feline calicivirus was isolated, cultured, and purified. A calicivirus-specific IgG ELISA was developed for detection of feline calicivirus-specific IgG in serum and aqueous humor. Calicivirus-specific IgG was measured in the serum and aqueous humor from 3 groups of control cats. Results suggested that calicivirus is a nonintraocular pathogen in cats and that calicivirus IgG detected in aqueous humor is attributable to leakage across a damaged blood-ocular barrier.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1993

Case-control study of bladder cancer and water disinfection methods in Colorado.

A population-based case-control study of bladder cancer and drinking water disinfection methods was conducted during 1990-1991 in Colorado. Surface water in Colorado has historically been disinfected with chlorine (chlorination) or with a combination of chlorine and ammonia (chloramination). A total of 327 histologically verified bladder cancer cases were frequency matched by age and sex to 261 other-cancer controls. Subjects were interviewed by telephone about residential and water source histories. This information was linked to data from water utility and Colorado Department of Health records to create a drinking water exposure profile. After adjustment for cigarette smoking, tap water and coffee consumption, and medical history factors by logistic regression, years of exposure to chlorinated surface water were significantly associated with risk for bladder cancer (p = 0.0007). The odds ratio for bladder cancer increased for longer durations of exposure to a level of 1.8 (95% confidence interval 1.1-2.9) for more than 30 years of exposure to chlorinated surface water compared with no exposure. The increased bladder cancer risk was similar for males and females and for nonsmokers and smokers. Levels of total trihalomethanes, nitrates, and residual chlorine were not associated with bladder cancer risk after controlling for years of exposure to chlorinated water.

Adult↗