Nitrate contamination of drinking water may increase cancer risk, because nitrate is endogenously reduced to nitrite and subsequent nitrosation reactions give rise to N-nitroso compounds; these compounds are highly carcinogenic and can act systemically. We analyzed cancer incidence in a cohort of 21,977 Iowa women who were 55-69 years of age at baseline in 1986 and had used the same water supply more than 10 years (87% > 20 years); 16,541 of these women were on a municipal supply, and the remainder used a private well. We assessed nitrate exposure from 1955 through 1988 using public databases for municipal water supplies in Iowa (quartile cutpoints: 0.36, 1.01, and 2.46 mg per liter nitrate-nitrogen). As no individual water consumption data were available, we assigned each woman an average level of exposure calculated on a community basis; no nitrate data were available for women using private wells. Cancer incidence (N = 3,150 cases) from 1986 through 1998 was determined by linkage to the Iowa Cancer Registry. For all cancers, there was no association with increasing nitrate in drinking water, nor were there clear and consistent associations for non-Hodgkin lymphoma; leukemia; melanoma; or cancers of the colon, breast, lung, pancreas, or kidney. There were positive associations for bladder cancer [relative risks (RRs) across nitrate quartiles = 1, 1.69, 1.10, and 2.83] and ovarian cancer (RR = 1, 1.52, 1.81, and 1.84), and inverse associations for uterine cancer (RR = 1, 0.86, 0.86, and 0.55) and rectal cancer (RR = 1, 0.72, 0.95, and 0.47) after adjustment for a variety of cancer risk/protective factors, agents that affect nitrosation (smoking, vitamin C, and vitamin E intake), dietary nitrate, and water source. Similar results were obtained when analyses were restricted to nitrate level in drinking water from 1955 through 1964. The positive association for bladder cancer is consistent with some previous data; the associations for ovarian, uterine, and rectal cancer were unexpected.

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The State-Wide Rural Well-Water Survey was conducted between April 1988 and June 1989. About 18% of Iowa's private, rural drinking-water wells contain nitrate above the recommended health advisory level (levels of NO3-N greater than 10 mg/L); 37% of the wells have levels greater than 3 mg/L, typically considered indicative of anthropogenic pollution. Thirty-five percent of wells less than 15 m deep exceed the health advisory level, and the mean concentration of nitrate-nitrogen for these wells exceeds 10 mg/L. Depth of well is the best predictor of well-water contamination. Individually, NO3-N levels of more than 10 mg/L occurred alone in about 4% of the private wells statewide; pesticides were present alone in about 5%. Total coliform positives occurred alone at 27% of the sites. In a cumulative sense, these three contaminants were detected in nearly 55% of rural private water supplies.

Rainfall was sampled for pesticides to assess their occurrence in precipitation and potential impacts on water resources. Three areas in Iowa were sampled; two localities were in rural settings, and a third in an urban area. Fourteen pesticides, including ten herbicides and four insecticides, were detected from October 1987 through September 1990. Atrazine, alachlor, cyanazine, and metolachlor were the most commonly detected, with one or more of these four herbicides found in almost every rainfall sample during the growing season. Concentrations of individual pesticides ranged from 0.1 µg L−1 to 40.0 µg L−1, with most detections under 1.0 µg L−1. Pesticide detections in rainfall began in April and ended in July or August, probably related to the timing of chemical application and greater volatilization rates during warmer weather. Samples from the urban site had detections of the same agricultural chemicals found at the rural sites, but in lesser quantities. In addition to the commonly detected herbicides, three of the four insecticides detected in rainfall were only found in urban samples. Two of these have urban as well as agricultural uses. Some variation of pesticide detections were seen at the three sampling localities, related to regional and local use patterns. Concentrations were greater at sampling sites near fields where pesticides are applied, suggesting that local volatilization and distance of transport affect the concentrations in rainfall. Pesticide concentrations were highest at the beginning of a rainfall event with concentrations becoming lower in samples taken later in the event.