title: Long-term health effects of early life exposure to tetrachloroethylene (PCE)-contaminated drinking water: a retrospective cohort study.
abstract: BACKGROUND
  While adult exposure to PCE is known to have toxic effects, there is little information on the long-term impact of prenatal and early childhood exposure. We undertook a retrospective cohort study to examine the effects of their early life exposure to PCE-contaminated drinking water. This retrospective cohort study examined whether prenatal and early childhood exposure to PCE-contaminated drinking water influenced the risk of a variety of chronic conditions among adults who were born between 1969 and 1983 in the Cape Cod area of Massachusetts.
  
  
  METHODS
  Eight hundred and thirty-one participants with prenatal and early childhood PCE exposure and 547 unexposed participants were studied. Individuals completed questionnaires to gather information on demographic characteristics, chronic conditions, and other sources of solvent exposure. The location of residences from birth through 1990 were used to estimate PCE exposure with U.S. EPA's water distribution system modeling software (EPANET) modified to incorporate a leaching and transport model.
  
  
  RESULTS
  No associations were observed between early life PCE exposure and current occurrence of obesity, diabetes, cardiovascular disease, hypertension, color blindness, near- and far sightedness and dry eyes. In contrast, a 1.8-fold increased risk of cancer (95% CI: 0.8, 4.0) was seen among individuals with any early life exposure. These results were based on 31 participants (23 exposed and 8 unexposed) who reported cancers at a variety of anatomical sites, particularly the cervix. A 1.5-fold increase in the risk of epilepsy (95% CI: 0.6, 3.6, based on 16 exposed and 7 unexposed participants) was also observed among individuals with any early life exposure that was further increased to 1.8 (95% CI: 0.7, 4.6) among those with exposure at or above the sample median.
  
  
  CONCLUSIONS
  These results suggest that the risk of epilepsy and certain types of cancer such as cervical cancer may be increased among adults who were exposed to PCE-contaminated drinking water exposure during gestation and early childhood. These findings should be interpreted cautiously because of the study limitations and confirmed in follow-up investigations of similarly exposed populations with medically-confirmed diagnoses. This relatively young study population should also be monitored periodically for subsequent changes in disease risk.
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Talbot 3E, 715 Albany Street, Boston, MA, 02118, USA. aaschen@bu.edu.
authors.forename: Ann
authors.initials: A
authors.lastname: Aschengrau
authors.affiliation: Data Coordinating Center, Boston University School of Public Health, Crosstown, 715 Albany Street, Boston, MA, 02118, USA. mwinter@bu.edu.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Winter
authors.affiliation: University of California, Irvine, Program in Public Health, 653 East Peltason Dr, Irvine, CA, 92697, USA. vmv@bu.edu.
authors.forename: Veronica M
authors.initials: VM
authors.lastname: Vieira
authors.affiliation: Department of Environmental Health, Boston University School of Public Health, Talbot 4 W, 715 Albany Street, Boston, MA, 02118, USA. twebster@bu.edu.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Webster
authors.affiliation: Department of Environmental Health, Boston University School of Public Health, Talbot 4 W, 715 Albany Street, Boston, MA, 02118, USA. paj@bu.edu.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Janulewicz
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Talbot 3E, 715 Albany Street, Boston, MA, 02118, USA. leg@bu.edu.
authors.forename: Lisa G
authors.initials: LG
authors.lastname: Gallagher
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, Crosstown, 715 Albany Street, Boston, MA, 02118, USA. janicew@bu.edu.
authors.forename: Janice
authors.initials: J
authors.lastname: Weinberg
authors.affiliation: Department of Environmental Health, Boston University School of Public Health, Talbot 4 W, 715 Albany Street, Boston, MA, 02118, USA. dozonoff@bu.edu.
authors.forename: David M
authors.initials: DM
authors.lastname: Ozonoff
mesh_terms: D002675:Child, Preschool; D002908:Chronic Disease / Q000453:epidemiology*; D060766:Drinking Water / Q000032:analysis; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D009369:Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D009765:Obesity / Q000139:chemically induced / Q000453:epidemiology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D013750:Tetrachloroethylene / Q000633:toxicity*; D014874:Water Pollutants, Chemical / Q000633:toxicity*
chemical_list: D060766:Drinking Water; D014874:Water Pollutants, Chemical; D013750:Tetrachloroethylene