American scientists analyzed data concerning over 53,000 women in California and established a link between elevated levels of trihalomethanes in tap water and a high risk of developing uterine cancer, including endometrioid tumors.
Impact of Various Chemicals
In addition to trihalomethanes, it was found that halogenated acetic acid also influences this correlation, being associated with an increased risk of non-endometrioid tumor development. These trihalomethanes are formed as a result of centralized water disinfection.
Context of the Problem and Risk Factors
According to the scientists, there has been a continuous increase in the incidence of uterine cancer worldwide since the 1990s, with endometrial malignant growths accounting for over 95% of all cases. The researchers emphasize significant regional differences in the prevalence of this disease, suggesting a possible influence of environmental factors.
Tap water is considered a potential source of carcinogenic substances. Among the most common regulated compounds in water supply systems capable of negatively affecting health are nitrates, arsenic, uranium, and disinfection byproducts—trihalomethanes and halogenated acetic acid. The International Agency for Research on Cancer previously classified some of these substances as 'possibly carcinogenic to humans.'
Study Methodology
A group of scientists led by Rena Jones from the US National Cancer Institute assessed the relationship between uterine cancer incidence and exposure levels to water disinfection byproducts—trihalomethanes and halogenated acetic acid, as well as nitrates, uranium, and arsenic. Average concentrations of these substances were calculated over a 15-year period, from 1990 to 2005. The study included 53,100 female teachers from California, whose average age was 50 years.
Multifactorial Analysis Results
Multifactorial analysis showed that doubling the concentration of trihalomethanes did not reveal a direct link with exposure levels of arsenic, nitrates, or uranium. Furthermore, additional adjustment for baseline reproductive factors, such as pregnancies, menopause, and oral contraceptive use, did not significantly alter the estimated risks.
The analysis of overall associations demonstrated that the combination of trihalomethanes, arsenic, uranium, and nitrates increased the probability of developing uterine cancer by 21 percent, and endometrioid tumors by 34 percent. Specifically, chloroform and dibromochloromethane contributed to a positive association of the mixture with uterine cancer and endometrioid tumors, while bromoform and bromodichloromethane were linked to non-endometrioid tumors.
Conclusions and Recommendations
Despite the limited sample size, the study results indicate a negative impact of high concentrations of water disinfection byproducts on the female reproductive system. Therefore, changing water disinfection technologies and standards may help reduce oncological risks.



