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. 2023 Sep 19;34(1):47–57. doi: 10.1038/s41370-023-00600-7

Table 2.

Association of trihalomethanes (THMs) in residential tap water and nitrate waterborne ingestion with chronic lymphocytic leukemia (CLL).

Exposure Controls Cases OR (95% CI) Multivariable adjusteda OR (95% CI) Multivariable adjustedb OR (95% CI) Multivariable adjustedc
Total THMs in residential tap water (μg/L), N = 1374
  Tertile 1 (<52.2) 411 31 Ref. [1] Ref. [1] Ref. [1]
  Tertile 2 (52.2–83.2) 409 23 0.48 (0.20, 1.19) 0.49 (0.19, 1.25) 0.57 (0.22, 1.48)
  Tertile 3 (>83.2) 410 90 2.11 (0.91, 4.89) 2.13 (0.89, 5.14) 2.22 (0.90, 5.48)
  P-trend 1230 144 <0.001 <0.001 <0.001
  Per 10 μg /L 1230 144 1.24 (1.16, 1.32) 1.23 (1.15, 1.32) 1.24 (1.16, 1.34)
Brominated THMs in residential tap water (μg/ L), N = 1374
  Tertile 1 (<30.0) 411 31 Ref. [1] Ref. [1] Ref. [1]
  Tertile 2 (30.0–60.8) 409 23 0.50 (0.21, 1.22) 0.52 (0.21, 1.29) 0.85 (0.31, 2.36)
  Tertile 3 (>60.8) 410 90 2.16 (0.94, 4.94) 2.23 (0.95, 5.26) 2.32 (0.91, 5.91)
  P-trend 1230 144 <0.001 <0.001 <0.001
  Per 10 μg/L 1230 144 1.25 (1.17, 1.33) 1.24 (1.17, 1.3) 1.22 (1.14, 1.31)
Chloroform in residential tap water (μg/L), N = 1374
  Tertile 1 (<17.3) 410 54 Ref. [1] Ref. [1] Ref. [1]
  Tertile 2 (17.3– 22.3) 410 62 0.69 (0.45, 1.06) 0.70 (0.45, 1.08) 0.81 (0.50, 1.31)
  Tertile 3 (>22.3) 410 28 0.23 (0.13, 0.40) 0.23 (0.13, 0.41) 0.42 (0.22, 0.82)
  P-trend 1230 144 <0.001 <0.001 0.02
  Per 10 μg/L 1230 144 0.44 (0.32, 0.61) 0.44 (0.31, 0.61) 0.54 (0.34, 0.87)
Nitrate waterborne ingestion (mg/day), N = 1245
  Tertile 1 (<8.6) 372 34 Ref. [1] Ref. [1] Ref. [1]
  Tertile 2 (8.6–16.8) 371 57 1.54 (0.91, 2.61) 1.57 (0.92, 2.68) 1.52 (0.87, 2.64)
  Tertile 3 (>16.8) 371 40 0.94 (0.53, 1.66) 1.00 (0.56, 1.79) 1.04 (0.57, 1.89)
  P-trend 1114 131 0.36 0.51 0.64
  Per 5 mg/day 1114 131 0.93 (0.83, 1.04) 0.95 (0.84, 1.06) 0.91 (0.80, 1.04)

Odds ratios (OR) and 95% confidence intervals (CI) were calculated using mixed models with residential area (Barcelona, Asturias, Cantabria) as random effect.

Brominated THMs includes bromodichloromethane, dibromochloromethane, and bromoform.

Total THMs includes chloroform, bromodichloromethane, dibromochloromethane, and bromoform.

ORs Odds ratios, 95% CIs 95% confidence intervals.

aModel adjusted for age, sex, and educational level.

bModel further adjusted for family history of hematologic malignancy, body mass index, smoking, physical activity, ever worked in farming or agriculture and alcohol consumption.

cModel further mutually adjusted for the other corresponding components, i.e., total THMs (nitrate model), nitrate (THMs model), chloroform and nitrate (brominated THMs model), brominated THMs and nitrate (chloroform model).