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Title: Socioeconomic status and exposure to disinfection by-products in drinking water in Spain.
Authors: Castaņo-Vinyals G,  Cantor KP,  Villanueva CM,  Tardon A,  Garcia-Closas R,  Serra C,  Carrato A,  Malats N,  Rothman N,  Silverman D,  Kogevinas M
Journal: Environ Health
Date: 2011
Branches: MEB, OEEB
PubMed ID: 21410938
PMC ID: PMC3068078
Abstract: BACKGROUND: Disinfection by-products in drinking water are chemical contaminants that have been associated with cancer and other adverse effects. Exposure occurs from consumption of tap water, inhalation and dermal absorption. METHODS: We determined the relationship between socioeconomic status and exposure to disinfection by-products in 1271 controls from a multicentric bladder cancer case-control study in Spain. Information on lifetime drinking water sources, swimming pool attendance, showering-bathing practices, and socioeconomic status (education, income) was collected through personal interviews. RESULTS: The most highly educated subjects consumed less tap water (57%) and more bottled water (33%) than illiterate subjects (69% and 17% respectively, p-value = 0.003). These differences became wider in recent time periods. The time spent bathing or showering was positively correlated with attained educational level (p < 0.001). Swimming pool attendance was more frequent among highly educated subjects compared to the illiterate (odds ratio = 3.4; 95% confidence interval 1.6-7.3). CONCLUSIONS: The most highly educated subjects were less exposed to chlorination by-products through ingestion but more exposed through dermal contact and inhalation in pools and showers/baths. Health risk perceptions and economic capacity may affect patterns of water consumption that can result in differences in exposure to water contaminants.