Chlorination disinfection by-products in drinking water and risk of pancreatic cancer.

This thesis studied the effect of chlorination disinfection by-products (CDBPs) in drinking water on the risk of developing pancreatic cancer. The study was based on the case-control component of the National Enhanced Cancer Surveillance System. Incident cases and frequency-matched population controls recruited between 1994 and 1997 from six Canadian provinces were used to estimate pancreatic cancer risks associated with exposure to CDBPs. Residence history collected from subjects was linked to two sources of water quality data to estimate historical exposure. The first source provided a lifetime average estimate of known exposure to trihalomethane (THM), bromodichloromethane (BDCM), and chloroform (TCM), while the second provided residence-specific estimates of THM exposure. Adjusted risk estimates were based on the most recent 30 years of exposure with missing data imputed using Observed Control Mean Imputation. Overall, no consistent significant increase (or decrease) in pancreatic cancer risks was observed with 30-year exposure to THM, BDCM, and TCM after adjusting for potential confounders