Evidence map›Paper›PMID 41558286›Full record

ArticleEcotoxicology and environmental safety2026

Ingested nitrate and nitrite, drinking water disinfection by-products, and incidence of thyroid cancer among licensed pesticide applicators and spouses in the Agricultural Health Study.

Dazhe Chen, Christine G Parks, Laura E Beane Freeman, Jonathan N Hofmann, Maya Spaur, Jessica M Madrigal, Rashmi Sinha, Rena R Jones, Mary H Ward, Dale P Sandler

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Ecotoxicology and environmental safety, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Dazhe ChenEpidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
Christine G ParksEpidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
Laura E Beane FreemanOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA.
Jonathan N HofmannOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA.
Maya SpaurOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA.
Jessica M MadrigalOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA.
Rashmi SinhaMetabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA.
Rena R JonesOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA.
Mary H WardOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA.
Dale P SandlerEpidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA. Electronic address: sandler@niehs.nih.gov.

Funding

HEALTH EFFECTS OF EXPOSURES IN AGRICULTUREZ01ES049030 · NIEHS · NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES · PI SANDLER, DALE P · 1997 to 2008
$889k
Intramural NIH HHS Z01 ES049030
6 · The paper itself

Abstract

backgroundIngested nitrate and nitrite and some disinfection by-products (DBPs) are suspected carcinogens. However, epidemiologic evidence linking these exposures to thyroid cancer (TC) is limited.

objectivesWe examined water nitrate and dietary nitrate and nitrite exposures in relation to incident TC in the Agricultural Health Study. We stratified analyses by sex and smoking status. We also explored associations with two drinking water DBPs, total trihalomethanes (TTHM) and five haloacetic acids (HAA5).

methodsWe determined the primary drinking water source for participants at enrollment (1993-1997). We computed nitrate and DBP exposures for public water supply users (N = 14,779) from historical measurement data. For private well users (N = 44,896), we estimated nitrate exposure using random forest models and assumed they had negligible DBP exposures. Dietary nitrate and nitrite exposures were assessed among 29,371 participants who completed a diet history questionnaire at the first follow-up (1999-2003). We calculated adjusted hazard ratios (HRs) and 95 %CI for associations of tertiles (T) of exposure with incident TCs between study enrollment or first follow-up and 2021.

resultsWe found modest but statistically non-significant associations between water nitrate exposure and TC in women (T2 vs. T1 HR: 1.37, 95 %CI: 0.86, 2.21; T3 vs. T1 HR: 1.44, 95 %CI: 0.91, 2.26) and ever smokers (T3 vs. T1 HR: 1.72, 95 %CI: 0.91, 3.27) without evidence of a trend (p-trend>0.05). No association was found for dietary nitrate, dietary nitrite, or drinking water DBPs.

conclusionWe did not find clear evidence associating drinking water nitrate, drinking water DBPs, or dietary nitrate and nitrite with TC.

Indexed as

DisinfectantsDrinking WaterNitratesNitritesPesticidesThyroid NeoplasmsWater Pollutants, ChemicalAdultAgricultureFemaleHumansIncidenceMaleMiddle AgedDisinfectantsDrinking WaterNitratesNitritesPesticidesWater Pollutants, Chemicaldietdisinfection by-productsnitratenitritethyroid cancerwater pollution

Identifiers

PMID41558286
PMCPMC12947278

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.