title: Evaluation of contaminated drinking water and male breast cancer at Marine Corps Base Camp Lejeune, North Carolina: a case control study.
abstract: BACKGROUND
  Solvents contaminated drinking water supplies at Marine Corps Base Camp Lejeune during 1950s-1985.
  
  
  METHODS
  We conducted a case-control study among Marines to evaluate associations between residential exposure to contaminated drinking water at Camp Lejeune and male breast cancer risk. The study included 71 male breast cancer cases and 373 controls identified from the Department of Veteran's Affairs (VA) cancer registry whose military personnel records were available. Controls were selected from cancers not known to be associated with solvent exposure and included 270 skin cancers, 71 mesotheliomas, and 32 bone cancers. Base assignment and risk factor information came from military personnel and VA records. Groundwater contaminant fate/transport and distribution system models provided monthly estimated residential contaminant levels. We conducted exact logistic regression using the 50th percentile level among exposed controls to create low and high exposure categories. We calculated 95% confidence intervals (CIs) to indicate precision of effect estimates. Exploratory analyses used proportional hazards methods to evaluate associations between exposures and age at diagnosis.
  
  
  RESULTS
  After adjusting for age at diagnosis, race, and service in Vietnam, the odds ratio (OR) for ever stationed at Camp Lejeune was 1.14 (95% CI: 0.65, 1.97). Adjusted ORs for high residential cumulative exposures to tetrachloroethylene (PCE), t-1,2 dichloroethylene (DCE), and vinyl chloride were 1.20 [95% CI: 0.16-5.89], 1.50 [95% CI: 0.30-6.11], 1.19 [95% CI: 0.16-5.89], respectively, with a monotonic exposure response relationship for PCE only. However these results were based on two or three cases in the high cumulative exposure categories. Ever stationed at Camp Lejeune and high cumulative exposures to trichloroethylene (TCE), PCE, DCE and vinyl chloride were associated with earlier age at onset for male breast cancer; hazard ratios ranged from 1.4-2.7 with wide confidence intervals for cumulative exposure variables.
  
  
  CONCLUSIONS
  Findings suggested possible associations between male breast cancer and being stationed at Camp Lejeune and cumulative exposure to PCE, DCE, and vinyl chloride. TCE, PCE, DCE and vinyl chloride cumulative exposures showed possible associations with earlier age at onset of male breast cancer. However, this study was limited by small numbers of cases in high exposure categories.
authors.affiliation: Agency for Toxic Substances and Disease Registry, Division of Toxicology and Human Health Sciences, Atlanta, USA. pruckart@cdc.gov.
authors.forename: Perri Zeitz
authors.initials: PZ
authors.lastname: Ruckart
authors.affiliation: Agency for Toxic Substances and Disease Registry, Division of Toxicology and Human Health Sciences, Atlanta, USA. fbove@cdc.gov.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Bove
authors.affiliation: National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, Office of the Director, Atlanta, USA. eshanley@cdc.gov.
authors.forename: Edwin
authors.initials: E
authors.lastname: Shanley
authors.affiliation: Agency for Toxic Substances and Disease Registry, Division of Community Health Investigations, 4770 Buford Highway, MS F-58, Atlanta, GA, 30341, USA. mmaslia@cdc.gov.
authors.forename: Morris
authors.initials: M
authors.lastname: Maslia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018567:Breast Neoplasms, Male / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D016022:Case-Control Studies; D060766:Drinking Water / Q000032:analysis*; D004781:Environmental Exposure; D060587:Groundwater / Q000032:analysis; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D018570:Risk Assessment; D012997:Solvents / Q000633:toxicity*; D014874:Water Pollutants, Chemical / Q000633:toxicity*; D055815:Young Adult
chemical_list: D060766:Drinking Water; D012997:Solvents; D014874:Water Pollutants, Chemical