Breast cancer risk and drinking water contaminated by wastewater: a case control study

BACKGROUND: Drinking water contaminated by wastewater is a potential source of exposure to mammary carcinogens and endocrine disrupting compounds from commercial products and excreted natural and pharmaceutical hormones. These contaminants are hypothesized to increase breast cancer risk. Cape Cod, Massachusetts, has a history of wastewater contamination in many, but not all, of its public water supplies; and the region has a history of higher breast cancer incidence that is unexplained by the population's age, in-migration, mammography use, or established breast cancer risk factors. We conducted a case-control study to investigate whether exposure to drinking water contaminated by wastewater increases the risk of breast cancer. METHODS: Participants were 824 Cape Cod women diagnosed with breast cancer in 1988–1995 and 745 controls who lived in homes served by public drinking water supplies and never lived in a home served by a Cape Cod private well. We assessed each woman's exposure yearly since 1972 at each of her Cape Cod addresses, using nitrate nitrogen (nitrate-N) levels measured in public wells and pumping volumes for the wells. Nitrate-N is an established wastewater indicator in the region. As an alternative drinking water quality indicator, we calculated the fraction of recharge zones in residential, commercial, and pesticide land use areas. RESULTS: After controlling for established breast cancer risk factors, mammography, and length of residence on Cape Cod, results showed no consistent association between breast cancer and average annual nitrate-N (OR = 1.8; 95% CI 0.6 – 5.0 for ≥ 1.2 vs. < .3 mg/L), the sum of annual nitrate-N concentrations (OR = 0.9; 95% CI 0.6 – 1.5 for ≥ 10 vs. 1 to < 10 mg/L), or the number of years exposed to nitrate-N over 1 mg/L (OR = 0.9; 95% CI 0.5 – 1.5 for ≥ 8 vs. 0 years). Variation in exposure levels was limited, with 99% of women receiving some of their water from supplies with nitrate-N levels in excess of background. The total fraction of residential, commercial, and pesticide use land in recharge zones of public supply wells was associated with a small statistically unstable higher breast cancer incidence (OR = 1.4; 95% CI 0.8–2.4 for highest compared with lowest land use), but risk did not increase for increasing land use fractions. CONCLUSION: Results did not provide evidence of an association between breast cancer and drinking water contaminated by wastewater. The computer mapping methods used in this study to link routine measurements required by the Safe Drinking Water Act with interview data can enhance individual-level epidemiologic studies of multiple health outcomes, including diseases with substantial latency

Economic Impact of Cape Cod Harbors

The Cape Cod Commission and Urban Harbors Institute at UMass Boston conducted a study to better understand the economic importance of maintaining the functionality of Cape Cod’s harbors. A survey was conducted in the spring of 2020 and leveraged the IMPLAN input-output model to evaluate the economic impacts of employment at harbor-adjacent or -dependent businesses. Although the COVID-19 pandemic impacted the survey response rate, over 100 businesses responded in the four towns that the study focuses on: Chatham, Dennis, Falmouth, and Provincetown. The six harbors within the study areas were Inner Harbor and Great Harbor in Falmouth, Sesuit Harbor in Dennis, Stage Harbor and Aunt Lydia’s Cove in Chatham, and Provincetown Harbor. These survey respondents directly employed 2,328 people across 58 industries, leading to a total employment (direct, indirect, and induced impacts of business and household spending) of 4,446 people. The direct compensation of employees in the top ten industries identified in this study, using survey responses alone, was nearly $150 million. That number would greatly increase should the compensation of employees in every establishment within the study areas be counted. The contributions of businesses that are part of the water-dependent “Blue Economy” on Cape Cod, as well as those that self-identify as harbor-dependent, are highlighted in the Results section. Businesses located along the coast and reliant on access to the harbors are significant economic drivers for Cape Cod. Maintaining and/or enhancing harbor functionality should be a priority for coastal communities in order to secure and improve the economic benefits—including employment—of these industries, and the impacts of climate change must be integrated into capital planning efforts to preserve these facilities into the future

Identification of potential public water-supply areas of the Cape Cod aquifer, Massachusetts, using a geographic information system /

One map on 1 folded leaf in pocket.Shipping list no.: 95-0155-P.Includes bibliographical references (p. 18-19).Mode of access: Internet