Prenatal and Early Childhood Exposure to Tetrachloroethylene and Adult Vision

et al. 2016

IJERPH

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Fish is a major source of nutrients critical for brain development during early life. The importance of childhood fish consumption is supported by several studies reporting associations of n-3 polyunsaturated fatty acid (n-3 PUFA) supplementation with better behavior and school performance. However, fish may have a different effect than n-3 PUFA alone due to the neurotoxic effects of methylmercury, a frequent contaminant. We investigated associations of childhood fish consumption with learning and behavioral disorders in birth cohort study of the neurotoxic effects of early life exposure to solvent-contaminated drinking water. Childhood (age 7–12 years) fish consumption and learning and behavioral problems were reported in self-administered questionnaires (age 23–41 at questionnaire completion). Fish consumption was not meaningfully associated with repeating a grade, tutoring, attending summer school, special class placement, or low educational attainment. However, participants who ate fish several times a week had an elevated odds of Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (odds ratio: 5.2; 95% confidence interval: 1.5–18) compared to participants who did not eat fish. While these findings generally support the safety of the observed level of fish consumption, the absence of a beneficial effect may be attributed to insufficient fish intake or the choice of relatively low n-3 PUFA fish.

Section: Methodsmentioning

confidence: 99%

Childhood Fish Consumption and Learning and Behavioral Disorders

Carwile

Butler

et al. 2016

IJERPH

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“…The 63 participants with early life exposure whose vision was examined also had evidence of long-term subclinical visual dysfunction 16 . Participants exposed to high PCE levels exhibited lower contrast sensitivity at intermediate and high spatial frequencies compared to unexposed participants.…”

Section: Resultsmentioning

confidence: 99%

“…Eligible subjects who completed the survey were also invited to participate in a clinical study comprised of neuropsychological tests to evaluate visuospatial abilities, attention and executive function, short-term memory, motor skills, academic achievement, omnibus intelligence and mood; vision exams to assess color discrimination and contrast sensitivity; and magnetic resonance imaging (MRI) to measure white and gray matter volumes and white matter hypointensities 16–18 . Prior studies among adults suggested that these outcomes might be affected by early life exposure to solvents 21–25 .…”

Section: Summary Of Methods Used In the Cape Cod Health Studymentioning

confidence: 99%

“…The Cape Cod Health Study initially assessed the short-term impact of prenatal exposure to PCE-contaminated drinking water on reproductive outcomes, including low birth weight 12 , prematurity 12 , miscarriage 13 , stillbirth 14 , and congenital anomalies 15 . More recently, we extended the study to examine the long-term impact of both prenatal and childhood exposure on neurological outcomes, including vision 16 , neuropsychological functioning 17 , brain structure 18 , risky behaviors 19 , and mental illness 20 . There is a dearth of information on long-term neurotoxic effects of early life exposure despite well-established short-term effects among adults 1 .…”

Section: Introductionmentioning

confidence: 99%

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Long-term Neurotoxic Effects of Early-life Exposure to Tetrachloroethylene-contaminated Drinking Water

Aschengrau

Annals of Global Health

White

et al. 2016

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Background Tetrachloroethene (PCE) is a common environmental and occupational contaminant and an acknowledged neurotoxicant. From 1968 through 1983 widespread contamination of public drinking water supplies with PCE occurred in the Cape Cod region of Massachusetts. The source of the contamination was a vinyl liner applied to the inner surface of water distribution pipes. Objectives A retrospective cohort study (“the Cape Cod Health Study”) was undertaken to examine possible health consequences of early life exposure to PCE-contaminated drinking water. This review describes the study methods and findings regarding the impact of prenatal and childhood exposure on neurological outcomes during early adulthood, including vision, neuropsychological functioning, brain structure, risky behaviors, and mental illness. The review also describes the strengths and challenges of conducting population-based epidemiological research in this unique setting. Methods Subjects were identified by cross-matching birth certificate and water system data. Information on health outcomes and confounding variables was collected from self-administered surveys (N= 1,689), neuropsychological tests (N=63), vision exam (N=63), and magnetic resonance imaging (N=42). Early life exposure to PCE was estimated using a leaching and transport model. The data analysis compared the occurrence of each health outcome among subjects with prenatal and early childhood PCE exposure to unexposed subjects while considering the impact of confounding variables. Results The study found evidence that early life exposure to PCE-contaminated drinking water has long-term neurotoxic effects. The strongest associations were seen with illicit drug use, bipolar disorder, and post-traumatic stress disorder. Key strengths of the study were availability of historical data on affected water systems, a relatively high exposure prevalence and wide range of exposure levels, and little confounding. Challenges arose mainly from the historical nature of the exposure assessments. Conclusions The Cape Cod Health Study demonstrates how scientists can take advantage of unique “natural experiments” to learn about the health effects of environmental pollution. This body of work has improved our understanding of the long-term health effects of early life exposure to this common environmental contaminant and will help risk assessors and policy makers ensure that U.S. drinking water supplies are safe for vulnerable populations.

“…The parent study that generated these data was undertaken to examine a wide range of neurotoxic effects following prenatal and early postnatal exposure to PCE contaminated drinking water. Outcomes that were examined included risky behaviors (Aschengrau, et al 2011); mental illness (Aschengrau, et al 2012); clinical and behavioral problems and learning disabilities based on questionnaire data (Janulewicz, et al 2008); and subtle functional changes assessed with neuropsychological (Janulewicz, et al 2012) and vision tests (Getz, et al 2012); overt structural brain changes using MRIs. The current paper focuses only on the structural MRI results.…”

Section: Introductionmentioning

confidence: 99%

Structural Magnetic Resonance Imaging in an adult cohort following prenatal and early postnatal exposure to tetrachloroethylene (PCE)-contaminated drinking water

Neurotoxicology and Teratology

Killiany

White

et al. 2013

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This population-based retrospective cohort study examined Structural Magnetic Resonance Imaging (MRI) of the brain in relation to prenatal and early postnatal exposure to tetrachloroethylene (PCE)-contaminated drinking water on Cape Cod, Massachusetts. Subjects were identified through birth records from 1969 through 1983. Exposure was modeled using pipe network information from town water departments, a PCE leaching and transport algorithm, EPANet water flow modeling software, and Geographic Information System (GIS) methodology. Brain imaging was performed on 26 exposed and 16 unexposed subjects. Scans were acquired on a Philips 3T whole body scanner using the ADNI T1-weighted MP-RAGE scan. The scans were processed by FreeSurfer version 4.3.1 software to obtain measurements of specific brain regions. There were no statistically significant differences between exposed and unexposed subjects on measures of white matter hypointensities (β: 127.5 mm3, 95% CI: −259.1, 1514.0), white matter volumes (e.g. total cerebral white matter: β: 21230.0 mm3, 95% CI: −4512.6, 46971.7) or gray matter volumes (e.g. total cerebral gray matter: β: 11976.0 mm3, 95% CI: −13657.2, 37609.3). The results of this study suggest that exposure to PCE during gestation and early childhood, at the levels observed in this population, is not associated with alterations in the brain structures studied.