Nitrate in public water supplies and the risk of renal cell carcinoma

Cancer Causes Control. 2007 Dec;18(10):1141-51. doi: 10.1007/s10552-007-9053-1. Epub 2007 Aug 24.


Drinking water and dietary sources of nitrate and nitrite can react in vivo with amines and amides to form N-nitroso compounds (NOC), potent animal carcinogens. Nitrate is a widespread contaminant of drinking water supplies especially in agricultural areas. We conducted a population-based case-control study of renal cell carcinoma in 1986-1989 in Iowa, a state with elevated levels in many public water supplies. We collected a lifetime water source history, but due to limited monitoring data, most analyses focused on the subpopulation, who used Iowa public supplies with nitrate measurements (actual or imputed data) for > or = 70% of their person-years since 1960 (201 cases, 1,244 controls). We computed the average nitrate level and years using a public supply with nitrate levels >5 and >10 mg/l. Dietary nitrate and nitrite were estimated from a 55-item food frequency questionnaire. There was no association of renal cell carcinoma with the average nitrate level and years using public supplies >5 and >10 mg/l nitrate-nitrogen (10+ years >5 mg/l odds ratio (OR) = 1.03, 95% confidence interval (CI) 0.66, 1.60). However, higher nitrate exposure was associated with an increased risk among subgroups with above the median red meat intake (10+ years >5 mg/l OR = 1.91, 95% CI 1.04-3.51) or below the median vitamin C intake (10+ years >5 mg/l OR = 1.90, 95% CI 1.01, 3.56), dietary factors that increase the endogenous formation of NOC. Exclusion of long-term Des Moines residents, a large proportion of the high exposure categories, attenuated the association. These findings deserve additional study in populations with high water nitrate intake and information on dietary intakes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amines / metabolism
  • Carcinoma, Renal Cell / chemically induced*
  • Carcinoma, Renal Cell / epidemiology
  • Female
  • Food Contamination
  • Humans
  • Iowa
  • Kidney Neoplasms / chemically induced*
  • Kidney Neoplasms / epidemiology
  • Male
  • Middle Aged
  • Nitrates / adverse effects*
  • Nitrates / metabolism
  • Nitroso Compounds / metabolism
  • Retrospective Studies
  • Risk Factors
  • SEER Program*
  • Water
  • Water Pollutants, Chemical / adverse effects*
  • Water Supply*


  • Amines
  • Nitrates
  • Nitroso Compounds
  • Water Pollutants, Chemical
  • Water