Aim: To assess the potential impact of mine water contamination on the increased risk of malignant neoplasms among the population of an industrially affected region of Ukraine (Kryvyi Rih Iron Ore Basin). Materials and Methods: Hygienic, epidemiological and statistical methods of research were used in the study. The study of mine water was conducted using samples obtained from 63 points representing the main mining horizons of the Kryvyi Rih Iron Ore Basin (Ukraine), using the following indicators: dissolved oxygen, biochemical oxygen demand over 5 days (BOD5), hydrogen index (pH), suspended solids, chemical oxygen demand (COD), dry residue, chlorides, sulfates, ammonium nitrogen, nitrites, nitrates, phosphates, oil products, total iron, and phenols. Results: Laboratory analysis of mine water revealed that the concentrations of several substances exceeded permissible levels. The integral pollution coef ficients suggested the water to be extremely polluted, and the ecological state of the environment as critical. The risk of malignant neoplasms in the Kryvyi Rih industrial region was 25,054 (95% CI 25,010-25,098). Teenagers aged 15–17 had the highest risk of developing malignant neoplasms (OR 16,310 [95% CI 5,927-44,888]). Children under the age of 14 ranked second (OR 5,528 [95% CI 3,423-8,925]). Adults (.18 years old) had a lower risk of malignant neo plasms (OR 2,461 [95% CI 2,309-2,622]). Children and adolescents were more affected than adults, i.e. the etiologic fraction of mine water pollution in the development of malignant neoplasms was 81,9% and 94,3%, respectively (vs. 59,6% in adults). Conclusions: Considering the extremely polluted state of mine waters in the industrially affected region of Ukraine, and assessing the related malignant neoplasm risks in the context of public health, the development of innovative preventive strategies and methodologies is required, taking into account all relevant determinants, including environmental factors.