title: Adverse birth outcomes and maternal exposure to trichloroethylene and tetrachloroethylene through soil vapor intrusion in New York State.
abstract: BACKGROUND
  Industrial spills of volatile organic compounds (VOCs) in Endicott, New York (USA), have led to contamination of groundwater, soil, and soil gas. Previous studies have reported an increase in adverse birth outcomes among women exposed to VOCs in drinking water.
  
  
  OBJECTIVE
  We investigated the prevalence of adverse birth outcomes among mothers exposed to trichloroethylene (TCE) and tetrachloroethylene [or perchloroethylene (PCE)] in indoor air contaminated through soil vapor intrusion.
  
  
  METHODS
  We examined low birth weight (LBW), preterm birth, fetal growth restriction, and birth defects among births to women in Endicott who were exposed to VOCs, compared with births statewide. We used Poisson regression to analyze births and malformations to estimate the association between maternal exposure to VOCs adjusting for sex, mother's age, race, education, parity, and prenatal care. Two exposure areas were identified based on environmental sampling data: one area was primarily contaminated with TCE, and the other with PCE.
  
  
  RESULTS
  In the TCE-contaminated area, adjusted rate ratios (RRs) were significantly elevated for LBW [RR = 1.36; 95% confidence interval (CI): 1.07, 1.73; n = 76], small for gestational age (RR = 1.23; 95% CI: 1.03, 1.48; n = 117), term LBW (RR = 1.68; 95% CI: 1.20, 2.34; n = 37), cardiac defects (RR = 2.15; 95% CI: 1.27, 3.62; n = 15), and conotruncal defects (RR = 4.91; 95% CI: 1.58, 15.24; n = 3). In the PCE-contaminated area, RRs for cardiac defects (five births) were elevated but not significantly. Residual socioeconomic confounding may have contributed to elevations of LBW outcomes.
  
  
  CONCLUSIONS
  Maternal residence in both areas was associated with cardiac defects. Residence in the TCE area, but not the PCE area, was associated with LBW and fetal growth restriction.
authors.affiliation: Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, Troy, New York 12180 , USA. spf02@health.state.ny.us
authors.forename: Steven P
authors.initials: SP
authors.lastname: Forand
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Lewis-Michl
authors.forename: Marta I
authors.initials: MI
authors.lastname: Gomez
mesh_terms: D000293:Adolescent; D000328:Adult; D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D016902:Air Pollution, Indoor / Q000009:adverse effects* / Q000032:analysis; D000013:Congenital Abnormalities / Q000453:epidemiology; D005260:Female; D005317:Fetal Growth Retardation / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure; D009518:New York / Q000453:epidemiology; D016012:Poisson Distribution; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000139:chemically induced / Q000453:epidemiology; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D012989:Soil Pollutants / Q000032:analysis / Q000633:toxicity; D011795:Surveys and Questionnaires; D013750:Tetrachloroethylene / Q000032:analysis / Q000633:toxicity*; D014241:Trichloroethylene / Q000032:analysis / Q000633:toxicity*; D014835:Volatilization; D055815:Young Adult
chemical_list: D000393:Air Pollutants; D012989:Soil Pollutants; D014241:Trichloroethylene; D013750:Tetrachloroethylene