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Beth A. Mueller,^1,2 Katherine Newton,^1,3 Elizabeth A. Holly,⁴ and Susan Preston-Martin⁵

¹Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington USA; ²Epidemiology Department, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA; ³Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington, USA; ⁴Department of Epidemiology and Biostatistics, University of California San Francisco, California, USA; ⁵Department of Preventive Medicine, University of Southern California Los Angeles, California, USA

Abstract

Gestation may represent a window of susceptibility to transplacental effects of environmental exposures, including chemicals in water. The N-nitroso compounds (NNC) , a class of chemicals with demonstrated neurocarcinogenic potential, include substances detected in drinking water. We used data from a study of possible risk factors for childhood brain tumors (CBT) to investigate the association of source of residential drinking water during pregnancy and CBT occurrence among offspring. In addition, dipstick measurements were made of nitrates and nitrites in tap water for the subset of women living in the same home they had lived in during their pregnancies. Population-based CBT cases (n = 540) and controls (n = 801) were identified in three regions including Los Angeles County, and the San Francisco Bay Area of California, and the Seattle-Puget Sound area of western Washington state. Overall, we observed no increased risk of CBT in offspring associated with wells as the source of residential water. However, an increased risk of CBT [odds ratio (OR) = 2.6 ; 95% confidence interval (CI) , = 1.3-5.2] was observed in western Washington among offspring of women who relied exclusively on well water, and a decreased risk of CBT (OR = 0.2 ; 95% CI, 0.1-0.8) was observed in Los Angeles County. Among the small subset of subjects for whom dipstick measurements of tap water were available, the risk of CBT associated with the presence of either measurable nitrite and/or nitrate was 1.1 (95% CI, 0.7-2.0) . Given the crude measurement method employed and because measurements often were obtained years after these pregnancies occurred, the relevance of the dipstick findings is unclear. The lack of consistency in our findings related to residential water source does not support the hypothesis of increased risk related to consumption of well water ; however, regional differences in well water content may exist, and the increased risk observed in western Washington deserves further evaluation. Key words: childhood brain tumors, drinking water, environmental exposures, nitrates, nitrites. Environ Health Perspect 109:551-556 (2001) . [Online 18 May 2001]

http://ehpnet1.niehs.nih.gov/docs/2001/109p551-556mueller/ abstract.html

Address correspondence to B.A. Mueller, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, (MP-381) , PO Box 19024, Seattle, WA 98109-1024 USA. Telephone: (206) 667-4630. Fax: (206) 667-5948. E-mail: bmueller@fhcrc.org

We thank the other collaborators who gave valuable input, particularly during the design of the study and the development of the study questions. We also thank A. Hadley, T. Paoff, M. Paul, I. Gaeta, B. Nist, J. Kristiansen, and S. Parrisher for their contributions to this work.

This work was supported by NIH grant CA 47082. In Seattle, this work was also supported by the Cancer Surveillance System of the Fred Hutchinson Cancer Research Center, funded by contract NO1-CN-05230 from the Surveillance, Epidemiology and End Results Program of the National Cancer Institute with additional support from the Fred Hutchinson Cancer Research Center. In Los Angeles, cancer incidence data were collected under contracts CA17054 from NIH and 050 (C-G) -8709 from the State of California Department of Health Services.

This work was part of an international collaborative study of childhood brain tumors coordinated by the SEARCH Program of the International Agency for Research on Cancer.

Received 21 June 2000 ; accepted 7 December 2000.