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Int. J. Environ. Res. Public Health 2016, 13(6), 523; doi:10.3390/ijerph13060523

Urolithiasis, Urinary Cancer, and Home Drinking Water Source in the United States Territory of Guam, 2006–2010

1
Guam Department of Public Health and Social Services, 123 Chalan Kareta, Mangilao, GU 96913, USA
2
Centers for Disease Control and Prevention, National Center for Environmental Health, 4770 Buford Hwy., NE (Mail Stop F-60), Atlanta, GA 30341, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 13 April 2016 / Revised: 9 May 2016 / Accepted: 19 May 2016 / Published: 24 May 2016
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Abstract

We reviewed patient records with a first-listed diagnosis of urolithiasis—also known as urinary tract or kidney stone disease, nephrolithiasis—upon discharge from Guam’s sole civilian hospital during 2006 to 2010 and urinary cancer mortality records from the Guam Cancer Registry for 1970 to 2009 to determine the source of municipal water supplied to the patients’ residence. The objective was to investigate a possible relationship between the sources of municipal water supplied to Guam villages and the incidence of urolithiasis and urinary cancer. We analyzed hospital discharge diagnoses of urolithiasis or renal calculi by calculating the incidence of first-mentioned discharge for urolithiasis or renal calculi and comparing rates across demographic or geographic categories while adjusting by age, sex, and ethnicity/race. We reviewed cancer registry records of urinary cancer deaths by patient residence. The annual incidence of hospitalization for urolithiasis was 5.22 per 10,000. Rates adjusted for sex or age exhibited almost no change. The rate of 9.83 per 10,000 among Chamorros was significantly higher (p < 0.05) than the rates among any other ethnic group or race. When villages were grouped by water source, rates of patients discharged with a first-listed diagnosis of urolithiasis, adjusted for ethnicity/race, were similar for villages using either well water (5.44 per 10,000) or mixed source water (5.39 per 10,000), and significantly greater than the rate for villages using exclusively reservoir water (1.35 per 10,000). No statistically significant differences were found between the water source or village of residence and urinary cancer mortality. Some Guam residents living in villages served completely or partly by deep well water high in calcium carbonate may be at increased risk for urolithiasis compared with residents living in villages served by surface waters. Although the risk appears to be highest in villagers of Chamorro ethnicity, residents should be aware of other contributing risk factors and steps to take to avoid developing this health problem. View Full-Text
Keywords: urolithiasis; urinary cancer; municipal water; hard water; well water; calcium carbonate urolithiasis; urinary cancer; municipal water; hard water; well water; calcium carbonate
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MDPI and ACS Style

Haddock, R.L.; Olson, D.R.; Backer, L.; Malilay, J. Urolithiasis, Urinary Cancer, and Home Drinking Water Source in the United States Territory of Guam, 2006–2010. Int. J. Environ. Res. Public Health 2016, 13, 523.

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