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dc.contributor.authorPicetti, Roberto
dc.contributor.authorDeeney, Megan
dc.contributor.authorPastorino, Silvia
dc.contributor.authorMiller, Mark R.
dc.contributor.authorShah, Anoop
dc.contributor.authorLeon, David A.
dc.contributor.authorDangour, Alan D.
dc.contributor.authorGreen, Rosemary
dc.date.accessioned2022-08-16T11:51:39Z
dc.date.available2022-08-16T11:51:39Z
dc.date.issued2022-02-22
dc.description.abstractBackground: Pollution of water sources, largely from wide-scale agricultural fertilizer use has resulted in nitrate and nitrite contamination of drinking water. The effects on human health of raised nitrate and nitrite levels in drinking water are currently unclear.<p> <p>Objectives: We conducted a systematic review of peer-reviewed literature on the association of nitrate and nitrite in drinking water with human health with a specific focus on cancer. <p>Methods: We searched eight databases from 1 January 1990 until 28 February 2021. Meta-analyses were conducted when studies had the same exposure metric and outcome. <p>Results: Of 9835 studies identified in the literature search, we found 111 studies reporting health outcomes, 60 of which reported cancer outcomes (38 case-control studies; 12 cohort studies; 10 other study designs). Most studies were set in the USA (24), Europe (20) and Taiwan (14), with only 3 studies from low and middle-income countries. Nitrate exposure in water (59 studies) was more commonly investigated than nitrite exposure (4 studies). Colorectal (15 studies) and gastric (13 studies) cancers were the most reported. In meta-analyses (4 studies) we identified a positive association of nitrate exposure with gastric cancer, OR = 1.91 (95%CI = 1.09–3.33) per 10 mg/L increment in nitrate ion. We found no association of nitrate exposure with colorectal cancer (10 studies; OR = 1.02 [95%CI = 0.96–1.08]) or cancers at any other site. <p>Conclusions: We identified an association of nitrate in drinking water with gastric cancer but with no other cancer site. There is currently a paucity of robust studies from settings with high levels nitrate pollution in drinking water. Research into this area will be valuable to ascertain the true health burden of nitrate contamination of water and the need for public policies to protect human health.en_US
dc.identifier.citationPicetti, Deeney, Pastorino, Miller, Shah, Leon, Dangour, Green. Nitrate and nitrite contamination in drinking water and cancer risk: A systematic review with meta-analysis. Environmental Research. 2022;210en_US
dc.identifier.cristinIDFRIDAID 2026536
dc.identifier.doi10.1016/j.envres.2022.112988
dc.identifier.issn0013-9351
dc.identifier.issn1096-0953
dc.identifier.urihttps://hdl.handle.net/10037/26217
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.relation.journalEnvironmental Research
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2022 The Author(s)en_US
dc.titleNitrate and nitrite contamination in drinking water and cancer risk: A systematic review with meta-analysisen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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