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American Journal of Epidemiology Vol. 136, No. 7: 836-842
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health


ORIGINAL CONTRIBUTIONS

Cancer of the Pancreas and Drinking Water: A Population-based Case-Control Study in Washington County, Maryland

Carel B. IJsselmuiden1, Charlotte Gaydos2, Brian Feighner3, William L. Novakoski4, David Serwadda5, Luis H. Caris6, David Vlahov7 and George W. Comstock7

1 Department of Community Health, Medical University of Southern Africa, MEDUNSA South Africa
2 Infectious Disease Division, Department of Medicine, The Johns Hopkins University Baltimore, MD
3 Walter Reed Army Institute of Research Washington, DC
4 Division of Preventive Medicine, Walter Reed Army Institute of Research Washington, DC
5 Makerere Medical School, Department of Medicine, Mulago Hospital Kampala, Uganda
6 School of Hygiene, University of Chile Independencia 929, Santiago, Chile
7 Department of Epidemiology, The Johns Hopkins University School of Hygiene and Public Health Baltimore, MD

Reprint requests to Dr. George W. Comstock, Training Center for Public Health Research, Box 2067, Hagerstown, MD 21742-2067

Received for publication August 12, 1991. Revision received July 7, 1992. A case-control study was done to assess a potential association between drinking water and pancreatic cancer in Washington County, Maryland. Cases of pancreatic cancer occurring from 1975 through 1989 were identified from the cancer registry. Controls were selected from the private 1975 census of Washington County. There were 101 cases and 206 controls. Chlorinated municipal water was used as a source of drinking water by 79% of cases and 63% of controls, yielding a significant odds ratio of 2.2. Adjustment for age and smoking had almost no effect on the risk, although both age and smoking were independently associated with an increased risk of pancreatic cancer. Although these findings must be interpreted with caution because of limitations in exposure assessment, these results have implications for the prevention of pancreatic cancer because chlorination of water is so widely practiced.

case-control studies; chlorine; pancreatic neoplasms; water supply


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