MSGID: 1:317/3 64096105   
   PID: hpt/lnx 1.9.0-cur 2019-01-08   
   TID: hpt/lnx 1.9.0-cur 2019-01-08   
    Long-term exposure to nitrate in drinking water may be a risk factor for   
   prostate cancer    
      
     Date:   
         March 8, 2023   
     Source:   
         Barcelona Institute for Global Health (ISGlobal)   
     Summary:   
         The nitrate ingested over the course of a person's adult lifetime   
         through the consumption of tap water and bottled water could be   
         a risk factor for prostate cancer, particularly in the case of   
         aggressive tumors and in younger men.   
      
      
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   FULL STORY   
   ==========================================================================   
   The nitrate ingested over the course of a person's adult lifetime through   
   the consumption of tap water and bottled water could be a risk factor   
   for prostate cancer, particularly in the case of aggressive tumours   
   and in younger men. This is the conclusion of a study conducted in   
   Spain and led by the Barcelona Institute for Global Health (ISGlobal),   
   a centre supported by the "la Caixa" Foundation. The findings have been   
   published in Environmental Health Perspectives.   
      
      
   ==========================================================================   
   The study also suggests that diet plays an important role. The researchers   
   found that eating plenty of fibre, fruit/vegetables and vitamin C could   
   reduce the negative effect of nitrate in drinking water.   
      
   Ingestion of Waterborne Nitrate and Trihalomethanes The aim of the study   
   was to assess whether there was an association between the ingestion of   
   waterborne nitrate and trihalomethanes (THMs) and the risk of prostate   
   cancer. Nitrate and THMs are two of the most common contaminants in   
   drinking water. The nitrate present in the water comes from agricultural   
   fertilisers and manure from intensive livestock farming; it is washed into   
   aquifers and rivers by rainfall. "Nitrate is a compound that is a part   
   of nature, but we have altered its natural cycle," explained Cristina   
   Villanueva, an ISGlobal researcher specialised in water pollution. The   
   new study looked at whether long-term exposure to nitrite throughout   
   adulthood could lead to cancer.   
      
   THMs are by-products of water disinfection -- i.e. chemical compounds   
   formed after drinking water is disinfected, usually with chlorine. Unlike   
   nitrate, for which the only route of entry is ingestion, THMs can also   
   be inhaled and absorbed through the skin while showering, swimming in   
   pools or washing dishes.   
      
   Long-term exposure to THMs has been associated with an increased risk   
   of bladder cancer, but evidence of the relationship between THMs and   
   other types of cancer is, to date, very limited.   
      
   Prostate Cancer and Long-Term Exposure to Nitrate and THMs in Drinking   
   Water To evaluate the possible association between prostate cancer and   
   long-term exposure to nitrate and THMs in drinking water, a research   
   team led by ISGlobal studied 697 cases of prostate cancer in Spanish   
   hospitals between 2008 and 2013 (including 97 aggressive tumours), as   
   well as a control group made up of 927 men aged 38-85 years who had not   
   been diagnosed with cancer at the time of the study. The average nitrate   
   and trihalomethanes to which each participant had been exposed since   
   the age of 18 was estimated based on where they had lived and the type   
   (tap water, bottled water or, in some cases, well water) and amount of   
   water they had drunk throughout their lives. Estimates were made on   
   the basis of available data from drinking water controls carried out   
   by municipalities or concessionary companies, from analyses of bottled   
   water of the most widely distributed brands, and from measurements taken   
   in different Spanish locations supplied by groundwater.   
      
   The findings showed that the higher the nitrate intake, the greater the   
   association with prostate cancer. Participants with higher waterborne   
   nitrate ingestion (lifetime average of more than 14 mg per day) were 1.6   
   times more likely to develop low-grade or medium-grade prostate cancer   
   and nearly 3 times more likely to develop an aggressive prostate tumour   
   than participants with lower nitrate intakes (lifetime average of less   
   than 6 mg per day).   
      
   "It has been suggested that aggressive prostate cancers, which   
   are associated with a worse prognosis, have different underlying   
   aetiological causes than slow-growing tumours with an indolent course,   
   and our findings confirm this possibility," explained ISGlobal researcher   
   Carolina Donat-Vargas, lead author of the study. "The risks associated   
   with waterborne nitrate ingestion are already observed in people who   
   consume water with nitrate levels below the maximum level allowed by   
   European directives, which is 50 mg of nitrate per litre of water."   
   Drinking Water Does Not Imply Getting Cancer The authors noted that this   
   study simply provides the first evidence of the association, which will   
   need to be confirmed through further research.   
      
   Therefore, there is still a long way to go before we can assert a   
   causal relationship. "Being exposed to nitrates through drinking   
   water does not mean that you are going to develop prostate cancer,"   
   commented Donat-Vargas. "Our hope is that this study, and others, will   
   encourage a review of the levels of nitrate that are allowed in water,   
   in order to ensure that there is no risk to human health."  While the   
   ingestion of waterborne THMs was not associated with prostate cancer,   
   THM concentrations in residential tap water were associated with the   
   development of these tumours, suggesting that inhalation and dermal   
   exposure may play a significant role in total exposure. Further studies   
   properly quantifying exposure to THMs via multiple routes are needed to   
   draw firm conclusions.   
      
   Fibre, Fruit, Vegetables and Vitamin C to Prevent Prostate Cancer   
   Participants also completed a food frequency questionnaire, which provided   
   individual dietary information. A striking finding of the study was that   
   the association between ingested nitrate and prostate cancer were only   
   observed in men with lower intakes of fibre, fruit/vegetables and vitamin   
   C. "Antioxidants, vitamins and polyphenols in fruits and vegetables may   
   inhibit the formation of nitrosamines -- compounds with carcinogenic   
   potential -- in the stomach," explained Donat-Vargas. "Moreover, vitamin   
   C has shown significant anti-tumour activity. And fibre, for its part,   
   benefits the intestinal bacteria, which protect against food-derived   
   toxicants, including nitrosamines." In participants with lower intakes   
   of fibre (<=11 g/day), higher nitrate intake increased the likelihood   
   of prostate cancer by a factor of 2.3. However, in those with higher   
   intakes of fibre (>11 g/day), higher nitrate intake was not associated   
   with an increased likelihood of prostate cancer.   
      
   The research team hopes that this study will help to raise awareness of   
   the potential environmental and human health impacts of pollutants in   
   water, and to persuade authorities to ensure more rigorous control of   
   this natural resource.   
      
   Among the measures proposed by the authors of the study to reduce nitrate   
   levels are "putting an end to the indiscriminate use of fertilisers and   
   pesticides," and encouraging the adoption of diets that prioritise the   
   health of the planet by reducing the consumption of animal-based foods,   
   especially meat.   
      
   Prostate Cancer: The Most Common Cancer in Spanish Men Prostate cancer   
   appears to be on the rise worldwide. It is currently the most common   
   cancer in Spanish men, among whom it accounts for 22% of all tumours   
   diagnosed. However, its causes remain largely unknown, and it is one of   
   the few cancers for which the International Agency for Research on Cancer   
   (IARC) has not identified a clear carcinogenic agent. The currently   
   recognised risk factors -- age, ethnicity and family history -- are   
   non-modifiable. However, it is suspected that certain environmental   
   exposures may contribute to the development of prostate cancer,   
   especially in its advanced-stage and more aggressive forms. Therefore,   
   it is vitally important to continue exploring the environmental factors   
   that may contribute to the development of this cancer, so that action   
   can be taken to prevent it.   
      
       * RELATED_TOPICS   
             o Health_&_Medicine   
                   # Men's_Health # Prostate_Cancer # Urology #   
                   Prostate_Health   
             o Earth_&_Climate   
                   # Water # Drought_Research # Environmental_Issues #   
                   Pollution   
       * RELATED_TERMS   
             o Prostate_cancer o Stomach_cancer o Cholera o   
             Water_purification o Desalination o Hair o Esophageal_cancer   
             o Cancer   
      
   ==========================================================================   
   Story Source: Materials provided by   
   Barcelona_Institute_for_Global_Health_(ISGlobal). Note: Content may be   
   edited for style and length.   
      
      
   ==========================================================================   
   Journal Reference:   
      1. Carolina Donat-Vargas, Manolis Kogevinas, Gemma Castan~o-Vinyals,   
      Beatriz   
         Pe'rez-Go'mez, Javier Llorca, Mercedes Vanaclocha-Espi',   
         Guillermo Fernandez-Tardon, Laura Costas, Nuria Aragone's,   
         Ine's Go'mez-Acebo, Victor Moreno, Marina Pollan, Cristina   
         M. Villanueva. Long-Term Exposure to Nitrate and Trihalomethanes   
         in Drinking Water and Prostate Cancer: A Multicase-Control Study   
         in Spain (MCC-Spain). Environmental Health Perspectives, 2023;   
         131 (3) DOI: 10.1289/EHP11391   
   ==========================================================================   
      
   Link to news story:   
   https://www.sciencedaily.com/releases/2023/03/230308112202.htm   
      
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