Breast Cancer Risk and Drinking Water Contaminated by Wastewater: A Case Control Study


Show simple item record Brody, Julia Green en_US Aschengrau, Ann en_US McKelvey, Wendy en_US Swartz, Christopher H en_US Kennedy, Theresa en_US Rudel, Ruthann A en_US 2011-12-29T22:41:33Z 2011-12-29T22:41:33Z 2006 en_US 2006-10-6 en_US
dc.identifier.citation Brody, Julia Green, Ann Aschengrau, Wendy McKelvey, Christopher H Swartz, Theresa Kennedy, Ruthann A Rudel. "Breast cancer risk and drinking water contaminated by wastewater: a case control study" Environmental Health 5:28. (2006) en_US
dc.identifier.issn 1476-069X en_US
dc.description.abstract BACKGROUND: Drinking water contaminated by wastewater is a potential source of exposure to mammary carcinogens and endocrine disrupting compounds from commercial products and excreted natural and pharmaceutical hormones. These contaminants are hypothesized to increase breast cancer risk. Cape Cod, Massachusetts, has a history of wastewater contamination in many, but not all, of its public water supplies; and the region has a history of higher breast cancer incidence that is unexplained by the population's age, in-migration, mammography use, or established breast cancer risk factors. We conducted a case-control study to investigate whether exposure to drinking water contaminated by wastewater increases the risk of breast cancer. METHODS: Participants were 824 Cape Cod women diagnosed with breast cancer in 1988–1995 and 745 controls who lived in homes served by public drinking water supplies and never lived in a home served by a Cape Cod private well. We assessed each woman's exposure yearly since 1972 at each of her Cape Cod addresses, using nitrate nitrogen (nitrate-N) levels measured in public wells and pumping volumes for the wells. Nitrate-N is an established wastewater indicator in the region. As an alternative drinking water quality indicator, we calculated the fraction of recharge zones in residential, commercial, and pesticide land use areas. RESULTS: After controlling for established breast cancer risk factors, mammography, and length of residence on Cape Cod, results showed no consistent association between breast cancer and average annual nitrate-N (OR = 1.8; 95% CI 0.6 – 5.0 for ≥ 1.2 vs. < .3 mg/L), the sum of annual nitrate-N concentrations (OR = 0.9; 95% CI 0.6 – 1.5 for ≥ 10 vs. 1 to < 10 mg/L), or the number of years exposed to nitrate-N over 1 mg/L (OR = 0.9; 95% CI 0.5 – 1.5 for ≥ 8 vs. 0 years). Variation in exposure levels was limited, with 99% of women receiving some of their water from supplies with nitrate-N levels in excess of background. The total fraction of residential, commercial, and pesticide use land in recharge zones of public supply wells was associated with a small statistically unstable higher breast cancer incidence (OR = 1.4; 95% CI 0.8–2.4 for highest compared with lowest land use), but risk did not increase for increasing land use fractions. CONCLUSION: Results did not provide evidence of an association between breast cancer and drinking water contaminated by wastewater. The computer mapping methods used in this study to link routine measurements required by the Safe Drinking Water Act with interview data can enhance individual-level epidemiologic studies of multiple health outcomes, including diseases with substantial latency. en_US
dc.description.sponsorship Commonwealth of Massachusetts; Susan G. Komen Breast Cancer Foundation; National Institute of Environmental Health Sciences (2P42 ES07381); United States Environmental Protection Agency; National Cancer Institute (5 R03 CA103478-02) en_US
dc.language.iso en en_US
dc.publisher BioMed Central en_US
dc.rights Copyright 2006 Brody et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution 2.0 License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. en_US
dc.rights.uri en_US
dc.title Breast Cancer Risk and Drinking Water Contaminated by Wastewater: A Case Control Study en_US
dc.type article en_US
dc.identifier.doi 10.1186/1476-069X-5-28 en_US
dc.identifier.pubmedid 17026759 en_US
dc.identifier.pmcid 1622744 en_US

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