A retrospective epidemiological study investigated the cancer incidence in water supply areas with different source water qualities. The conceptual background was the serious contamination of the river Elbe with various industrial wastewaters upstream of most of the potable water abstraction sites for the cities and towns of the Elbe valley. Using the National Cancer Register (started in 1952) the incidence of different types of cancer suspected to be at least partially caused by polluted water was checked. About 10 000 cases of cancer from a 17-year period (1968 - 1984) were checked in 3 communities. The results show that Pirna (lying upstream of the main wastewater receiving points in the GDR) has a significantly higher relative risk for 3, Dresden (approximately 30 km downstream) for 4, and Riesa (about 7 0 km downstream) for 5 cancer sites. The cancer risk related to the risk in the country was as high as 145% in Pirna and 160% in Riesa for liver cancer and 170 % in Riesa for kidney cancer. Measures to improve the drinking water quality in the Upper Elbe Valley are urgently needed.

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