Biological and Statistical Approaches for Modeling Exposure to Specific Trihalomethanes and Bladder Cancer Risk | Zendy

Lucas A. Salas | Zendy; Kenneth P. Cantor | Zendy; Adonina Tardón | Zendy; Consol Serra | Zendy; Alfredo Carrato | Zendy; Reina García-Closas | Zendy; Nathaniel Rothman | Zendy; Núria Malats | Zendy; Debra T. Silverman | Zendy; Manolis Kogevinas | Zendy; Cristina M. Villanueva | Zendy

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Biological and Statistical Approaches for Modeling Exposure to Specific Trihalomethanes and Bladder Cancer Risk

Author(s) -

Lucas A. Salas,

Kenneth P. Cantor,

Adonina Tardón,

Consol Serra,

Alfredo Carrato,

Reina García-Closas,

Nathaniel Rothman,

Núria Malats,

Debra T. Silverman,

Manolis Kogevinas,

Cristina M. Villanueva

Publication year - 2013

Publication title -

american journal of epidemiology

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 2.33

H-Index - 256

eISSN - 1476-6256

pISSN - 0002-9262

DOI - 10.1093/aje/kwt009

Subject(s) - bromoform , conditional logistic regression , trihalomethane , logistic regression , risk assessment , bladder cancer , chloroform , environmental science , toxicology , statistics , cancer , mathematics , chemistry , medicine , odds ratio , environmental engineering , chromatography , water treatment , biology , computer science , computer security

Lifetime exposure to trihalomethanes (THM) has been associated with increased risk of bladder cancer. We explored methods of analyzing bladder cancer risk associated with 4 THM (chloroform, bromodichloromethane, dibromochloromethane, and bromoform) as surrogates for disinfection by-product (DBP) mixtures in a case-control study in Spain (1998-2001). Lifetime average concentrations of THM in the households of 686 incident bladder cancer cases and 750 matched hospital-based controls were calculated. Several exposure metrics were modeled through conditional logistic regression, including the following analyses: total THM (μg/L), cytotoxicity-weighted sum of total THM (pmol/L), 4 THM in separate models, 4 THM in 1 model, chloroform and the sum of brominated THM in 1 model, and a principal-components analysis. THM composition, concentrations, and correlations varied between areas. The model for total THM was stable and showed increasing dose-response trends. Models for separate THM provided unstable estimates and inconsistent dose-response relationships. Risk estimation for specific THM is hampered by the varying composition of the mixture, correlation between species, and imprecision of historical estimates. Total THM (μg/L) provided a proxy measure of DBPs that yielded the strongest dose-response relationship with bladder cancer risk. A variety of metrics and statistical approaches should be used to evaluate this association in other settings.

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