Nitrate in Drinking Water and Risk of Childhood Diabetes Mellitus in The Netherlands. J.M.S. van Maanen, H.J. Albering, S.G.J. van Breda, and D.M.J. Curfs, Maastricht University, Department of Health Risk Analysis and Toxicology, P.O. Box 616, 6200 MD, Maastricht, The Netherlands, telephone 31 43 3881094/3881097, fax 31 43 3670924, (e-mail H.Albering@grat.unimaas.nl; A.W. Ambergen, Department of Methodology and Statistics, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands; B.H.R. Wolffenbuttel, Department of Internal Medicine, University Hospital Maastricht, The Netherlands; J.C.S. Kleinjan, Maastricht University, Department of Health Risk Analysis and Toxicology, P.O. Box 616, 6200 MD, Maastricht, The Netherlands; and H.M. Reeser, Juliana Children’s Hospital, The Hague and TNO Prevention and Health, Leiden, The Netherlands
In recent years, several studies - e.g. from Yorkshire, Colorado U.S.A. and Sweden - have been published which describe a relationship between nitrate exposure and childhood type 1 insulin-dependent diabetes mellitus (IDDM). The present ecological study sets out to describe a relation between incidence of IDDM and nitrate levels in drinking water in The Netherlands. 1081 cases of IDDM were diagnosed in the period 1993-1995 among the age group of 0-14 year old children. The postal code areas of the places of residence of these cases were known. Data on mean nitrate levels in drinking water in the period 1991-1995 were obtained from the Dutch National Institute of Public Health and Environmental Protection and 25 Dutch drinking water supply companies. In this way, mean nitrate levels in drinking water in 3932 postal code areas in the whole country of The Netherlands could be obtained. Two different exposure categories with different nitrate concentration ranges were used. One category was based on equal number of children exposed to different nitrate levels (three nitrate concentration ranges of 0.25-2.08 mg/l, 2.10-6.42 mg/l and 6.44-41.19 mg/l); the other was based on cut-off values of 10 and 25 mg/l (three nitrate concentration ranges of <10 mg/l, 10-25 mg/l and >25 mg/l). With regard to both exposure categories, standardized incidence ratios were determined for IDDM with respect to nitrate exposure levels, gender and age (using groups of 0-4, 5-9 and 10-14 year old children) and compared in univariate analysis using the chi-squared test for trend; a comparison of incidence rate ratios was performed by multivariate analysis in a Poisson regression model. An effect of increasing age of the children on incidence of IDDM was found, but no effect of gender and no effect of nitrate concentration in drinking water on incidence of IDDM was observed. It is concluded that nitrate in drinking water at current exposure levels is probably not a risk factor for childhood type 1 diabetes mellitus in The Netherlands.
Go to . . .
1999 SRA-Europe Table of Contents
1999 SRA-Europe Author Index
Main Abstracts Menu Page
RiskWorld Home Page