Prenatal exposure to tetrachloroethylene-contaminated drinking water and the risk of congenital anomalies: a retrospective cohort study

Abstract

BackgroundPrior animal and human studies of prenatal exposure to solvents including tetrachloroethylene (PCE) have shown increases in the risk of certain congenital anomalies among exposed offspring.ObjectivesThis retrospective cohort study examined whether PCE contamination of public drinking water supplies in Massachusetts influenced the occurrence of congenital anomalies among children whose mothers were exposed around the time of conception.MethodsThe study included 1,658 children whose mothers were exposed to PCE-contaminated drinking water and a comparable group of 2,999 children of unexposed mothers. Mothers completed a self-administered questionnaire to gather information on all of their prior births, including the presence of anomalies, residential histories and confounding variables. PCE exposure was estimated using EPANET water distribution system modeling software that incorporated a fate and transport model.ResultsChildren whose mothers had high exposure levels around the time of conception had an increased risk of congenital anomalies. The adjusted odds ratio of all anomalies combined among children with prenatal exposure in the uppermost quartile was 1.5 (95% CI: 0.9, 2.5). No meaningful increases in the risk were seen for lower exposure levels. Increases were also observed in the risk of neural tube defects (OR: 3.5, 95% CI: 0.8, 14.0) and oral clefts (OR 3.2, 95% CI: 0.7, 15.0) among offspring with any prenatal exposure.ConclusionThe results of this study suggest that the risk of certain congenital anomalies is increased among the offspring of women who were exposed to PCE-contaminated drinking water around the time of conception. Because these results are limited by the small number of children with congenital anomalies that were based on maternal reports, a follow-up investigation should be conducted with a larger number of affected children who are identified by independent records.

Early lifestage exposure and potential developmental susceptibility to tetrachloroethylene

“…Three overlapping studies similarly did not observe any association with birth defects among women who were dry cleaners or laundry workers (Kyyrö nen et al, 1989;Olsen et al, 1990;Taskinen et al, 1989). A recent study in Massachusetts of maternal exposure to drinking water contaminated with perc reported a 20% increased risk (95% CI 5 0.8-1.7) between maternal exposure at the time of conception and congenital anomalies (oral clefts, neural tube defects, and gastrointestinal and genitourinary malformations) in the offspring after adjustment for maternal and paternal ages (Aschengrau et al, 2009). The ability to examine congenital anomalies and perc exposure is quite limited in this study due to lack of validation of exposure assessment assignment and outcome, which was reported by mothers, inability to adjust for other known risk factors, and low statistical power.…”

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

“…For a more detailed explanation see Janulewicz et al, 2008. EPANet software, which was developed by the U.S. Environmental Protection Agency, has been used in multiple epidemiologic studies (Aral, et al 1996,Aschengrau, et al 2009,Maslia, et al 2000,Reif, et al 2003,Rossman 1994). …”

Adult neuropsychological performance following prenatal and early postnatal exposure to tetrachloroethylene (PCE)-contaminated drinking water

“…The pipe's initial stock of PCE was based on the size of the pipe (i.e., diameter and length) and information from the pipe manufacturer on the application of the liner. EPANet software, which was developed by the U.S. Environmental Protection Agency, has been used in multiple epidemiologic studies (Rossman, 1994;Aral et al, 1996;Maslia et al, 2000;Reif et al, 2003;Aschengrau et al, 2009) Study subjects may have been exposed to PCE in drinking water through ingestion, dermal absorption and inhalation, particularly during bathing (Vieira et al, 2005). However, questionnaire data on water consumption and bathing habits occurring decades earlier were not considered to be reliable enough to further refine the exposure measure.…”