title: Impact of tetrachloroethylene-contaminated drinking water on the risk of breast cancer: using a dose model to assess exposure in a case-control study.
abstract: BACKGROUND
  A population-based case-control study was undertaken in 1997 to investigate the association between tetrachloroethylene (PCE) exposure from public drinking water and breast cancer among permanent residents of the Cape Cod region of Massachusetts. PCE, a volatile organic chemical, leached from the vinyl lining of certain water distribution pipes into drinking water from the late 1960s through the early 1980s. The measure of exposure in the original study, referred to as the relative delivered dose (RDD), was based on an amount of PCE in the tap water entering the home and estimated with a mathematical model that involved only characteristics of the distribution system.
  
  
  METHODS
  In the current analysis, we constructed a personal delivered dose (PDD) model that included personal information on tap water consumption and bathing habits so that inhalation, ingestion, and dermal absorption were also considered. We reanalyzed the association between PCE and breast cancer and compared the results to the original RDD analysis of subjects with complete data.
  
  
  RESULTS
  The PDD model produced higher adjusted odds ratios than the RDD model for exposures > 50th and >75th percentile when shorter latency periods were considered, and for exposures < 50th and >90th percentile when longer latency periods were considered. Overall, however, the results from the PDD analysis did not differ greatly from the RDD analysis.
  
  
  CONCLUSIONS
  The inputs that most heavily influenced the PDD model were initial water concentration and duration of exposure. These variables were also included in the RDD model. In this study population, personal factors like bath and shower temperature, bathing frequencies and durations, and water consumption did not differ greatly among subjects, so including this information in the model did not significantly change subjects' exposure classification.
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA. vmv@bu.edu <vmv@bu.edu>
authors.forename: Verónica
authors.initials: V
authors.lastname: Vieira
authors.forename: Ann
authors.initials: A
authors.lastname: Aschengrau
authors.forename: David
authors.initials: D
authors.lastname: Ozonoff
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000139:chemically induced* / Q000453:epidemiology; D016022:Case-Control Studies; D004784:Environmental Monitoring / Q000379:methods*; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013750:Tetrachloroethylene / Q000633:toxicity*; D013997:Time Factors; D014874:Water Pollutants, Chemical / Q000633:toxicity*; D014881:Water Supply / Q000032:analysis*
chemical_list: D014874:Water Pollutants, Chemical; D013750:Tetrachloroethylene
references.citation: Pharm Res. 1992 May;9(5):663-9
references.pmid: 1608900
references.citation: Pharm Res. 1993 Apr;10(4):497-506
references.pmid: 8483831
references.citation: Arch Environ Health. 1993 Sep-Oct;48(5):284-92
references.pmid: 8215591
references.citation: Environ Health Perspect. 1999 Apr;107(4):265-71
references.pmid: 10090704
references.citation: Arch Environ Health. 1993 Sep-Oct;48(5):293-7
references.pmid: 8215592
references.citation: Epidemiology. 1995 Jul;6(4):387-90
references.pmid: 7548346
references.citation: Am J Public Health. 1996 Sep;86(9):1289-96
references.pmid: 8806382
references.citation: J Expo Anal Environ Epidemiol. 1996 Oct-Dec;6(4):413-23
references.pmid: 9087862
references.citation: Am J Ind Med. 1997 Jul;32(1):1-14
references.pmid: 9131206
references.citation: Environ Health Perspect. 1998 Aug;106 Suppl 4:947-53
references.pmid: 9703477
references.citation: Environ Health Perspect. 2003 Feb;111(2):167-73
references.pmid: 12573900
references.citation: Environ Health Perspect. 2004 Jun;112(8):889-97
references.pmid: 15175178
references.citation: Toxicol Ind Health. 1994 May-Jun;10(3):119-41
references.pmid: 7855862