饮用水三卤甲烷暴露与癌症风险：流行病学证据的系统回顾和剂量-反应荟萃分析。

IF 10.1 1区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Environmental Health Perspectives Pub Date : 2025-01-01 Epub Date: 2025-01-21 DOI:10.1289/EHP14505

Emilie Helte, Fredrik Söderlund, Melle Säve-Söderbergh, Susanna C Larsson, Agneta Åkesson

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引用次数: 0

摘要

背景：氯化消毒是一种广泛使用的饮用水消毒方法，其缺点是会向饮用水中引入潜在的致癌化学副产物。目的：系统评价三卤甲烷（THM）消毒副产物暴露与癌症风险的流行病学证据。方法：我们对流行病学研究进行了系统回顾和荟萃分析，以评估暴露于居住浓度的thm与成人癌症风险的关系。在PROSPERO中预注册了一个协议（CRD42023435491）。PubMed、Embase、Web of Science和Cochrane检索了截止到2024年4月的出版物。使用国家毒理学计划健康评估和翻译办公室（NTP OHAT）工具进行研究选择和偏倚风险评估，一式两份。采用随机效应荟萃分析和一期剂量-反应荟萃分析评估总风险估计。结果：文献检索得到2,022条记录，其中29篇出版物评估了14种不同的癌症，符合纳入条件。膀胱癌和结直肠癌的总相对风险（rr）分别基于5860例和9262例，84371例和90272例参与者。四氢呋喃浓度最高与最低暴露者膀胱癌的总危险度（RR）为1.33 (95% CI: 1.04, 1.71)，剂量-反应分析中，四氢呋喃浓度在41μg/L以上的危险度（RR）有统计学意义。对于结直肠癌，总RR为1.15 （95% CI: 1.07, 1.24）。结论：根据世界癌症研究基金会（World Cancer Research Fund）的标准，我们发现了有限的证据，表明饮用水中的THM会增加膀胱癌和结直肠癌的风险，其水平低于美国和欧盟目前的监管限制，表明这些不能保护普通人群免受癌症的侵袭。https://doi.org/10.1289/EHP14505。

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Exposure to Drinking Water Trihalomethanes and Risk of Cancer: A Systematic Review of the Epidemiologic Evidence and Dose-Response Meta-Analysis.

Background: Chlorination is a widespread method for drinking water disinfection that has the drawback of introducing potentially carcinogenic chemical by-products to drinking water.

Objective: We systematically evaluated the epidemiologic evidence of exposure to trihalomethane (THM) disinfection by-products and risk of cancer.

Methods: We conducted a systematic review and meta-analysis of epidemiologic studies that assessed the association of exposure to residential concentrations of THMs with risk of cancer in adults. A protocol was preregistered in PROSPERO (CRD42023435491). PubMed, Embase, Web of Science, and Cochrane were searched for publications up to April 2024. Study selection and risk of bias appraisal using the National Toxicology Program Office of Health Assessment and Translation (NTP OHAT) tool was done in duplicate. Summary risk estimates were assessed using random effects meta-analysis and one-stage dose-response meta-analysis.

Results: The literature search resulted in 2,022 records, of which 29 publications assessing 14 different cancers were eligible for inclusion. Summary relative risks (RRs) were estimated for bladder cancer and colorectal cancer based on 5,860 and 9,262 cases and 84,371 and 90,272 participants, respectively. The summary RR of bladder cancer for the highest exposed compared with the lowest was 1.33 (95% CI: 1.04, 1.71), and in the dose-response analysis, RRs were statistically significant above THM concentrations of $41 μ g / L$ . For colorectal cancer, the summary RR was 1.15 (95% CI: 1.07, 1.24).

Conclusion: According to the World Cancer Research Fund criteria, we found limited-suggestive evidence that THM in drinking water increases the risk of bladder and colorectal cancer at levels below current regulatory limits in the US and EU, indicating that these fail to protect against cancer in the general population. https://doi.org/10.1289/EHP14505.

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来源期刊

Environmental Health Perspectives 环境科学-公共卫生、环境卫生与职业卫生

CiteScore

14.40

自引率

2.90%

发文量

388

审稿时长

6 months

期刊介绍： Environmental Health Perspectives (EHP) is a monthly peer-reviewed journal supported by the National Institute of Environmental Health Sciences, part of the National Institutes of Health under the U.S. Department of Health and Human Services. Its mission is to facilitate discussions on the connections between the environment and human health by publishing top-notch research and news. EHP ranks third in Public, Environmental, and Occupational Health, fourth in Toxicology, and fifth in Environmental Sciences.