title: Evaluation of exposure to contaminated drinking water and specific birth defects and childhood cancers at Marine Corps Base Camp Lejeune, North Carolina: a case-control study.
abstract: BACKGROUND
  Drinking water supplies at Marine Corps Base Camp Lejeune were contaminated with trichloroethylene, tetrachloroethylene, benzene, vinyl chloride and trans-1,2-dichloroethylene during 1968 through 1985.
  
  
  METHODS
  We conducted a case control study to determine if children born during 1968-1985 to mothers with residential exposure to contaminated drinking water at Camp Lejeune during pregnancy were more likely to have childhood hematopoietic cancers, neural tube defects (NTDs), or oral clefts. For cancers, exposures during the first year of life were also evaluated. Cases and controls were identified through a survey of parents residing on base during pregnancy and confirmed by medical records. Controls were randomly sampled from surveyed participants who had a live birth without a major birth defect or childhood cancer. Groundwater contaminant fate and transport and distribution system models provided estimates of monthly levels of drinking water contaminants at mothers' residences. Magnitude of odds ratios (ORs) was used to assess associations. Confidence intervals (CIs) were used to indicate precision of ORs. We evaluated parental characteristics and pregnancy history to assess potential confounding.
  
  
  RESULTS
  Confounding was negligible so unadjusted results were presented. For NTDs and average 1st trimester exposures, ORs for any benzene exposure and for trichloroethylene above 5 parts per billion were 4.1 (95% CI: 1.4-12.0) and 2.4 (95% CI: 0.6-9.6), respectively. For trichloroethylene, a monotonic exposure response relationship was observed. For childhood cancers and average 1st trimester exposures, ORs for any tetrachloroethylene exposure and any vinyl chloride exposure were 1.6 (95% CI: 0.5-4.8), and 1.6 (95% CI: 0.5-4.7), respectively. The study found no evidence suggesting any other associations between outcomes and exposures.
  
  
  CONCLUSIONS
  Although CIs were wide, ORs suggested associations between drinking water contaminants and NTDs. ORs suggested weaker associations with childhood hematopoietic cancers.
authors.affiliation: Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, 4770 Buford Highway, MS F-58, Atlanta, GA 30341, USA. pruckart@cdc.gov.
authors.forename: Perri Zeitz
authors.initials: PZ
authors.lastname: Ruckart
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Bove
authors.forename: Morris
authors.initials: M
authors.lastname: Maslia
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000139:chemically induced / Q000453:epidemiology; D002972:Cleft Palate / Q000139:chemically induced / Q000453:epidemiology; D000013:Congenital Abnormalities / Q000453:epidemiology / Q000209:etiology; D060766:Drinking Water / Q000032:analysis*; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007938:Leukemia / Q000139:chemically induced / Q000453:epidemiology; D008228:Lymphoma, Non-Hodgkin / Q000139:chemically induced / Q000453:epidemiology; D018811:Maternal Exposure; D009436:Neural Tube Defects / Q000139:chemically induced / Q000453:epidemiology; D009657:North Carolina / Q000453:epidemiology; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology*; D014874:Water Pollutants, Chemical / Q000633:toxicity*; D055815:Young Adult
chemical_list: D060766:Drinking Water; D014874:Water Pollutants, Chemical