{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T22:38:08Z","timestamp":1789771088461,"version":"4.0.1"},"reference-count":43,"publisher":"American Chemical Society (ACS)","issue":"1","license":[{"start":{"date-parts":[[2017,12,29]],"date-time":"2017-12-29T00:00:00Z","timestamp":1514505600000},"content-version":"vor","delay-in-days":541,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Evidence on the association between colorectal cancer and exposure to disinfection by-products in drinking water is inconsistent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We assessed long-term exposure to trihalomethanes (THMs), the most prevalent group of chlorination by-products, to evaluate the association with colorectal cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A multicenter case\u2013control study was conducted in Spain and Italy in 2008\u20132013. Hospital-based incident cases and population-based (Spain) and hospital-based (Italy) controls were interviewed to ascertain residential histories, type of water consumed in each residence, frequency and duration of showering\/bathing, and major recognized risk factors for colorectal cancer. We estimated adjusted odds ratios (OR) for colorectal cancer in association with quartiles of estimated average lifetime THM concentrations in each participant\u2019s residential tap water (micrograms\/liter; from age 18 to 2 years before the interview) and estimated average lifetime THM ingestion from drinking residential tap water (micrograms\/day).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We analyzed 2,047 cases and 3,718 controls. Median values (ranges) for average lifetime residential tap water concentrations of total THMs, chloroform, and brominated THMs were 30 (0\u2013174), 17 (0\u201363), and 9 (0\u2013145) \u03bcg\/L, respectively. Total THM concentration in residential tap water was not associated with colorectal cancer (OR = 0.92, 95% CI: 0.66, 1.28 for highest vs. lowest quartile), but chloroform concentrations were inversely associated (OR = 0.31, 95% CI: 0.24, 0.41 for highest vs. lowest quartile). Brominated THM concentrations showed a positive association among men in the highest versus the lowest quartile (OR = 1.43, 95% CI: 0.83, 2.46). Patterns of association were similar for estimated average THM ingestion through residential water consumption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We did not find clear evidence of an association between detailed estimates of lifetime total THM exposure and colorectal cancer in our large case\u2013control study population. Negative associations with chloroform concentrations and ingestion suggest differences among specific THMs, but these findings should be confirmed in other study populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Citation:<\/jats:title>\n                    <jats:p>Villanueva CM, Gracia-Lavedan E, Bosetti C, Righi E, Molina AJ, Mart\u00edn V, Boldo E, Aragon\u00e9s N, Perez-Gomez B, Pollan M, Gomez Acebo I, Altzibar JM, Jim\u00e9nez Zabala A, Ardanaz E, Peir\u00f3 R, Tard\u00f3n A, Chirlaque MD, Tavani A, Polesel J, Serraino D, Pisa F, Casta\u00f1o-Vinyals G, Espinosa A, Espejo-Herrera N, Palau M, Moreno V, La Vecchia C, Aggazzotti G, Nieuwenhuijsen MJ, Kogevinas M. 2017. Colorectal cancer and long-term exposure to trihalomethanes in drinking water: a multicenter case\u2013\u2013\u2013control study in Spain and Italy. Environ Health Perspect 125:56\u201365;\u2002http:\/\/dx.doi.org\/10.1289\/EHP155<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1289\/ehp155","type":"journal-article","created":{"date-parts":[[2016,7,6]],"date-time":"2016-07-06T08:46:50Z","timestamp":1467794810000},"page":"56-65","source":"Crossref","is-referenced-by-count":56,"title":["Colorectal Cancer and Long-Term Exposure to Trihalomethanes in Drinking Water: A Multicenter Case\u2013Control Study in Spain and Italy"],"prefix":"10.1021","volume":"125","author":[{"given":"Cristina M.","family":"Villanueva","sequence":"first","affiliation":[{"name":"ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain"},{"name":"IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain"},{"name":"Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain"},{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Gracia-Lavedan","sequence":"additional","affiliation":[{"name":"ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain"},{"name":"Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain"},{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Bosetti","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, IRCCS (Istituto di Ricerche Farmacologiche Mario Negri), Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Righi","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio Jos\u00e9","family":"Molina","sequence":"additional","affiliation":[{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Madrid, Spain"},{"name":"Department of Preventive Medicine and Public Health, University of Le\u00f3n, Le\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente","family":"Mart\u00edn","sequence":"additional","affiliation":[{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Madrid, Spain"},{"name":"Department of Preventive Medicine and Public Health, University of Le\u00f3n, Le\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Boldo","sequence":"additional","affiliation":[{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Madrid, Spain"},{"name":"Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain"},{"name":"Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS (Instituto de Investigaci\u00f3n Sanitaria) Puerta De Hierro, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Aragon\u00e9s","sequence":"additional","affiliation":[{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Madrid, Spain"},{"name":"Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain"},{"name":"Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS (Instituto de Investigaci\u00f3n Sanitaria) Puerta De Hierro, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Perez-Gomez","sequence":"additional","affiliation":[{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Madrid, Spain"},{"name":"Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain"},{"name":"Cancer Epidemiology Research Group, Oncology and 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Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jone M.","family":"Altzibar","sequence":"additional","affiliation":[{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Madrid, Spain"},{"name":"Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Jim\u00e9nez","family":"Zabala","sequence":"additional","affiliation":[{"name":"Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Ardanaz","sequence":"additional","affiliation":[{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Madrid, Spain"},{"name":"Instituto de Salud P\u00fablica y Laboral de Navarra, Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosana","family":"Peir\u00f3","sequence":"additional","affiliation":[{"name":"CIBER 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Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Tavani","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, IRCCS (Istituto di Ricerche Farmacologiche Mario Negri), Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry","family":"Polesel","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology and Biostatistics, CRO (Centro di Riferimento Oncologico) Aviano National Cancer Institute, IRCCS, Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Serraino","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology and Biostatistics, CRO (Centro di Riferimento Oncologico) Aviano National Cancer Institute, IRCCS, Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Pisa","sequence":"additional","affiliation":[{"name":"Institute of Hygiene and Clinical Epidemiology, University Hospital 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