Exposure to disinfection by-products and risk of cancer: A systematic review and dose-response meta-analysis
Disinfection by-products (DBPs), including trihalomethanes (THMs) and haloacetic acids (HAAs), have attracted attention due to their carcinogenic properties, leading to varying conclusions. This meta-analysis aimed to evaluate the dose-response relationship and the dose-dependent effect of DBPs on c...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Ecotoxicology and Environmental Safety |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S014765132301429X |
| _version_ | 1797350625162297344 |
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| author | Jingyi Shi Kui Zhang Tianshu Xiao Jingxuan Yang Yanan Sun Chan Yang Hao Dai Wenxing Yang |
| author_facet | Jingyi Shi Kui Zhang Tianshu Xiao Jingxuan Yang Yanan Sun Chan Yang Hao Dai Wenxing Yang |
| author_sort | Jingyi Shi |
| collection | DOAJ |
| description | Disinfection by-products (DBPs), including trihalomethanes (THMs) and haloacetic acids (HAAs), have attracted attention due to their carcinogenic properties, leading to varying conclusions. This meta-analysis aimed to evaluate the dose-response relationship and the dose-dependent effect of DBPs on cancer risk. We performed a selective search in PubMed, Web of Science, and Embase databases for articles published up to September 15th, 2023. Our meta-analysis eventually included 25 articles, encompassing 8 cohort studies with 6038,525 participants and 10,668 cases, and 17 case-control studies with 10,847 cases and 20,702 controls. We observed a positive correlation between increased cancer risk and higher concentrations of total trihalomethanes (TTHM) in water, longer exposure durations, and higher cumulative TTHM intake. These associations showed a linear trend, with relative risks (RRs) and 95 % confidence intervals (CIs) being 1.02 (1.01–1.03), 1.04 (1.02–1.06), and 1.02 (1.00–1.03), respectively. Gender-specific analyses revealed slightly U-shaped relationships in both males and females, with males exhibiting higher risks. The threshold dose for TTHM in relation to cancer risk was determined to be 55 µg/L for females and 40 µg/L for males. A linear association was also identified between bladder cancer risk and TTHM exposure, with an RR and 95 % CI of 1.08 (1.05–1.11). Positive linear associations were observed between cancer risk and exposure to chloroform, bromodichloromethane (BDCM), and HAA5, with RRs and 95 % CIs of 1.02 (1.01–1.03), 1.33 (1.18–1.50), and 1.07 (1.03–1.12), respectively. Positive dose-dependent effects were noted for brominated THMs above 35 µg/L and chloroform above 75 µg/L. While heterogeneity was observed in the studies for quantitative synthesis, no publication bias was detected. Exposure to TTHM, chloroform, BDCM, or HAA5 may contribute to carcinogenesis, and the risk of cancer appears to be dose-dependent on DBP exposure levels. A cumulative effect is suggested by the positive correlation between TTHM exposure and cancer risk. Bladder cancer and endocrine-related cancers show dose-dependent and positive associations with TTHM exposure. Males may be more susceptible to TTHM compared to females. |
| first_indexed | 2024-03-08T12:47:35Z |
| format | Article |
| id | doaj.art-a86c871a9f0146a8a0f0221a13edf408 |
| institution | Directory Open Access Journal |
| issn | 0147-6513 |
| language | English |
| last_indexed | 2024-03-08T12:47:35Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Ecotoxicology and Environmental Safety |
| spelling | doaj.art-a86c871a9f0146a8a0f0221a13edf4082024-01-21T05:05:32ZengElsevierEcotoxicology and Environmental Safety0147-65132024-01-01270115925Exposure to disinfection by-products and risk of cancer: A systematic review and dose-response meta-analysisJingyi Shi0Kui Zhang1Tianshu Xiao2Jingxuan Yang3Yanan Sun4Chan Yang5Hao Dai6Wenxing Yang7Department of Physiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of ChinaDepartment of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of ChinaDepartment of Physiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of ChinaDepartment of Physiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of ChinaDepartment of Physiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of ChinaDepartment of Physiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of ChinaDepartment of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of ChinaDepartment of Physiology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China; Corresponding author.Disinfection by-products (DBPs), including trihalomethanes (THMs) and haloacetic acids (HAAs), have attracted attention due to their carcinogenic properties, leading to varying conclusions. This meta-analysis aimed to evaluate the dose-response relationship and the dose-dependent effect of DBPs on cancer risk. We performed a selective search in PubMed, Web of Science, and Embase databases for articles published up to September 15th, 2023. Our meta-analysis eventually included 25 articles, encompassing 8 cohort studies with 6038,525 participants and 10,668 cases, and 17 case-control studies with 10,847 cases and 20,702 controls. We observed a positive correlation between increased cancer risk and higher concentrations of total trihalomethanes (TTHM) in water, longer exposure durations, and higher cumulative TTHM intake. These associations showed a linear trend, with relative risks (RRs) and 95 % confidence intervals (CIs) being 1.02 (1.01–1.03), 1.04 (1.02–1.06), and 1.02 (1.00–1.03), respectively. Gender-specific analyses revealed slightly U-shaped relationships in both males and females, with males exhibiting higher risks. The threshold dose for TTHM in relation to cancer risk was determined to be 55 µg/L for females and 40 µg/L for males. A linear association was also identified between bladder cancer risk and TTHM exposure, with an RR and 95 % CI of 1.08 (1.05–1.11). Positive linear associations were observed between cancer risk and exposure to chloroform, bromodichloromethane (BDCM), and HAA5, with RRs and 95 % CIs of 1.02 (1.01–1.03), 1.33 (1.18–1.50), and 1.07 (1.03–1.12), respectively. Positive dose-dependent effects were noted for brominated THMs above 35 µg/L and chloroform above 75 µg/L. While heterogeneity was observed in the studies for quantitative synthesis, no publication bias was detected. Exposure to TTHM, chloroform, BDCM, or HAA5 may contribute to carcinogenesis, and the risk of cancer appears to be dose-dependent on DBP exposure levels. A cumulative effect is suggested by the positive correlation between TTHM exposure and cancer risk. Bladder cancer and endocrine-related cancers show dose-dependent and positive associations with TTHM exposure. Males may be more susceptible to TTHM compared to females.http://www.sciencedirect.com/science/article/pii/S014765132301429XDisinfection by-productsTrihalomethanesHaloacetic acidsCancerMeta-analysisDose-response meta-analysis |
| spellingShingle | Jingyi Shi Kui Zhang Tianshu Xiao Jingxuan Yang Yanan Sun Chan Yang Hao Dai Wenxing Yang Exposure to disinfection by-products and risk of cancer: A systematic review and dose-response meta-analysis Ecotoxicology and Environmental Safety Disinfection by-products Trihalomethanes Haloacetic acids Cancer Meta-analysis Dose-response meta-analysis |
| title | Exposure to disinfection by-products and risk of cancer: A systematic review and dose-response meta-analysis |
| title_full | Exposure to disinfection by-products and risk of cancer: A systematic review and dose-response meta-analysis |
| title_fullStr | Exposure to disinfection by-products and risk of cancer: A systematic review and dose-response meta-analysis |
| title_full_unstemmed | Exposure to disinfection by-products and risk of cancer: A systematic review and dose-response meta-analysis |
| title_short | Exposure to disinfection by-products and risk of cancer: A systematic review and dose-response meta-analysis |
| title_sort | exposure to disinfection by products and risk of cancer a systematic review and dose response meta analysis |
| topic | Disinfection by-products Trihalomethanes Haloacetic acids Cancer Meta-analysis Dose-response meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S014765132301429X |
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