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Aggregated cumulative county arsenic in drinking water and associations with bladder, colorectal, and kidney cancers, accounting for population served

Journal of Exposure Science & Environmental Epidemiology volume 31, pages 979–989 (2021)Cite this article

Abstract

Background

Many studies neglect to account for variation in population served by community water systems (CWSs) when aggregating CWS-level contaminant concentrations to county level.

Objective

In an ecological epidemiologic analysis, we explored two methods—unweighted and weighted (proportion of CWS population served by county population)—to account for population served by CWS in association between arsenic and three cancers to determine the impact of population served on aggregated measures of exposure.

Methods

CWS arsenic concentration data for 19 states were obtained from Centers for Disease Control and Prevention (CDC) National Environmental Public Health Tracking Network for 2000–10, aggregated to county level, and linked to county-level cancer data for 2011–5 from National Cancer Institute and CDC State Cancer Profiles. Negative binomial regression models estimated adjusted risk ratios (aRR) and 95% confidence intervals (CI) between county-level bladder, colorectal, and kidney cancers and quartiles of aggregated cumulative county-level arsenic concentration (ppb-years).

Results

We observed positive associations between the highest quartile of exposure, compared to the lowest, of aggregated cumulative county-level arsenic concentration (ppb-year) for bladder [weighted aRR: 1.89(1.53, 2.35)], colorectal [1.64(1.33, 2.01)], and kidney [1.69(1.37, 2.09)] cancers. We observed stronger associations utilizing the weighted exposure assessment method. However, inferences from this study are limited due to the ecologic nature of the analyses and different analytic study designs are needed to assess the utility that the weighted by CWS population served metric has for exposure assessment.

Significance

Weighting by CWS population served accounts for some potential exposure assignment error in epidemiologic analysis.

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Acknowledgements

The authors wish to acknowledge the support and guidance provided by Tim Wade and the Environmental Quality Index team, Stephanie A. Deflorio-Barker, Christine L. Gray, Lynne C. Messer, and Achal P. Patel. We would like to thank Mike Wright, Tom Luben, and Tom Bateson for their thorough review and suggestions to improve this manuscript. The research in this manuscript has been reviewed by the US Environmental Protection Agency and approved for publication. The views expressed in this manuscript are those of the authors and do not necessarily reflect the views or policies of the US Environmental Protection Agency. Mention of trade names or commercial products does not constitute endorsement or recommendation for use.

Funding

This research was supported in part by an appointment to the Research Participation Program for the US Environmental Protection Agency, Office of Research and Development, administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the US Department of Energy and EPA.

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Authors and Affiliations

  1. Oak Ridge Institute for Science and Education (ORISE) Postdoctoral Fellow at United States Environmental Protection Agency (US EPA), Research Triangle Park, NC, USA

    Alison K. Krajewski

  2. US EPA, Office of Research and Development, Center for Public Health & Environmental Assessment, Research Triangle Park, NC, USA

    Alison K. Krajewski, Kristen M. Rappazzo & Danelle T. Lobdell

  3. Oak Ridge Associated Universities (ORAU) Student Services Contractor at US EPA, Research Triangle Park, NC, USA

    Monica P. Jimenez

  4. Division of Environmental and Occupational Health Sciences, University of Illinois at Chicago, School of Public Health, Chicago, IL, USA

    Jyotsna S. Jagai

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  1. Alison K. Krajewski
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Correspondence to Alison K. Krajewski.

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Krajewski, A.K., Jimenez, M.P., Rappazzo, K.M. et al. Aggregated cumulative county arsenic in drinking water and associations with bladder, colorectal, and kidney cancers, accounting for population served. J Expo Sci Environ Epidemiol 31, 979–989 (2021). https://doi.org/10.1038/s41370-021-00314-8

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