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Nitrate levels in community drinking waters and risk of IDDM. An ecological analysis
J N Kostraba1, E C Gay, M Rewers
1Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver 80262.
Objective:
To investigate whether higher IDDM incidence rates occurred in areas with high nitrate levels in their potable water supplies.
Research Design And Methods:
Incidence rates for the 63 counties in Colorado were calculated using the Colorado IDDM Registry of children diagnosed < 18 yr of age between 1978 and 1988 (n = 1280). A weighted average of the nitrate levels from each water district within each county was calculated using data collected by the Colorado Department of Health between 1984 and 1988.
Results:
The rs between nitrate levels and IDDM incidence was 0.26 (P = 0.03). After controlling for differences in ethnicity, counties with water nitrate levels in the third tertile (0.77-8.2 mg/L) had a significantly increased risk of IDDM compared with those in the first tertile (0.0-0.084 mg/L) (rp = 0.29, P = 0.02).
Conclusions:
This ecological analysis suggests that low-level nitrate exposure through drinking water may play a role in the etiology of IDDM, perhaps as a promoter through the generation of free radicals.