title: Maternal residential proximity to chlorinated solvent emissions and birth defects in offspring: a case-control study.
abstract: BACKGROUND
  Some studies have noted an association between maternal occupational exposures to chlorinated solvents and birth defects in offspring, but data are lacking on the potential impact of industrial air emissions of these solvents on birth defects.
  
  
  METHODS
  With data from the Texas Birth Defects Registry for births occurring in 1996-2008, we examined the relation between maternal residential proximity to industrial air releases of chlorinated solvents and birth defects in offspring of 60,613 case-mothers and 244,927 control-mothers. Maternal residential exposures to solvent emissions were estimated with metrics that took into account residential distances to industrial sources and annual amounts of chemicals released. Logistic regression was used to generate odds ratios and 95% confidence intervals for the associations between residential proximity to emissions of 14 chlorinated solvents and selected birth defects, including neural tube, oral cleft, limb deficiency, and congenital heart defects. All risk estimates were adjusted for year of delivery and maternal age, education, race/ethnicity, and public health region of residence.
  
  
  RESULTS
  Relative to exposure risk values of 0, neural tube defects were associated with maternal residential exposures (exposure risk values >0) to several types of chlorinated solvents, most notably carbon tetrachloride (adjusted odds ratio [aOR] 1.42, 95% confidence interval [CI] 1.09, 1.86); chloroform (aOR 1.40, 95% CI 1.04, 1.87); ethyl chloride (aOR 1.39, 95% CI 1.08, 1.79); 1,1,2-trichloroethane (aOR 1.56, 95% CI 1.11, 2.18); and 1,2,3-trichloropropane (aOR 1.49, 95% CI 1.08, 2.06). Significant associations were also noted between a few chlorinated solvents and oral cleft, limb deficiency, and congenital heart defects. We observed stronger associations between some emissions and neural tube, oral cleft, and heart defects in offspring of mothers 35 years or older, such as spina bifida with carbon tetrachloride (aOR 2.49, 95% CI 1.09, 5.72), cleft palate with 1,2-dichloroethane (aOR 1.93, 95% 1.05, 3.54), cleft lip with or without cleft palate with ethyl chloride (aOR 1.81, 95% CI 1.06, 3.07), and obstructive heart defects with trichloroethylene (aOR 1.43, 95% CI 1.08, 1.88).
  
  
  CONCLUSIONS
  These findings suggest that maternal residential proximity to industrial emissions of chlorinated solvents might be associated with selected birth defects in offspring, especially among older mothers.
authors.affiliation: Texas A&M Health Science Center School of Public Health, Department of Epidemiology & Biostatistics, College Station, TX 77843-1266, USA. jdbrender@sph.tamhsc.edu.
authors.forename: Jean D
authors.initials: JD
authors.lastname: Brender
authors.forename: Mayura U
authors.initials: MU
authors.lastname: Shinde
authors.forename: F Benjamin
authors.initials: FB
authors.lastname: Zhan
authors.forename: Xi
authors.initials: X
authors.lastname: Gong
authors.forename: Peter H
authors.initials: PH
authors.lastname: Langlois
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000393:Air Pollutants / Q000032:analysis*; D016022:Case-Control Studies; D002648:Child; D000013:Congenital Abnormalities / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000032:analysis*; D018811:Maternal Exposure; D016017:Odds Ratio; D013781:Texas / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000393:Air Pollutants; D006843:Hydrocarbons, Chlorinated