Occurrence of mental illness following prenatal and early childhood exposure to tetrachloroethylene (PCE)-contaminated drinking water: A retrospective cohort study

Department of Epidemiology, Boston University School of Public Health, Talbot 3E, 715 Albany Street, Boston, MA 02118, USA.
Environmental Health (Impact Factor: 3.37). 01/2012; 11(1):2. DOI: 10.1186/1476-069X-11-2
Source: PubMed


While many studies of adults with solvent exposure have shown increased risks of anxiety and depressive disorders, there is little information on the impact of prenatal and early childhood exposure on the subsequent risk of mental illness. This retrospective cohort study examined whether early life exposure to tetrachloroethylene (PCE)-contaminated drinking water influenced the occurrence of depression, bipolar disorder, post-traumatic stress disorder, and schizophrenia among adults from Cape Cod, Massachusetts.
A total of 1,512 subjects born between 1969 and 1983 were studied, including 831 subjects with both prenatal and early childhood PCE exposure and 547 unexposed subjects. Participants completed questionnaires to gather information on mental illnesses, demographic and medical characteristics, other sources of solvent exposure, and residences from birth through 1990. PCE exposure originating from the vinyl-liner of water distribution pipes was assessed using water distribution system modeling software that incorporated a leaching and transport algorithm.
No meaningful increases in risk ratios (RR) for depression were observed among subjects with prenatal and early childhood exposure (RR: 1.1, 95% CI: 0.9-1.4). However, subjects with prenatal and early childhood exposure had a 1.8-fold increased risk of bipolar disorder (N = 36 exposed cases, 95% CI: 0.9-1.4), a 1.5-fold increased risk post-traumatic stress disorder (N = 47 exposed cases, 95% CI: 0.9-2.5), and a 2.1-fold increased risk of schizophrenia (N = 3 exposed cases, 95% CI: 0.2-20.0). Further increases in the risk ratio were observed for bipolar disorder (N = 18 exposed cases, RR; 2.7, 95% CI: 1.3-5.6) and post-traumatic stress disorder (N = 18 exposed cases, RR: 1.7, 95% CI: 0.9-3.2) among subjects with the highest exposure levels.
The results of this study provide evidence against an impact of early life exposure to PCE on the risk of depression. In contrast, the results provide support for an impact of early life exposure on the risk of bipolar disorder and post-traumatic stress disorder. The number of schizophrenia cases was too small to draw reliable conclusions. These findings should be confirmed in investigations of other similarly exposed populations.

Download full-text


Available from: Lisa G Gallagher,
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: In support of the Integrated Risk Information System (IRIS), the U.S. Environmental Protection Agency (EPA) completed a toxicological review of trichloroethylene (TCE) in September 2011, which was the result of an effort spanning > 20 years. Objectives: We summarized the key findings and scientific issues regarding the human health effects of TCE in the U.S. EPA’s toxicological review. Methods: In this assessment we synthesized and characterized thousands of epidemiologic, experimental animal, and mechanistic studies, and addressed several key scientific issues through modeling of TCE toxicokinetics, meta-analyses of epidemiologic studies, and analyses of mechanistic data. Discussion: Toxicokinetic modeling aided in characterizing the toxicological role of the complex metabolism and multiple metabolites of TCE. Meta-analyses of the epidemiologic data strongly supported the conclusions that TCE causes kidney cancer in humans and that TCE may also cause liver cancer and non-Hodgkin lymphoma. Mechanistic analyses support a key role for mutagenicity in TCE-induced kidney carcinogenicity. Recent evidence from studies in both humans and experimental animals point to the involvement of TCE exposure in autoimmune disease and hypersensitivity. Recent avian and in vitro mechanistic studies provided biological plausibility that TCE plays a role in developmental cardiac toxicity, the subject of substantial debate due to mixed results from epidemiologic and rodent studies. Conclusions: TCE is carcinogenic to humans by all routes of exposure and poses a potential human health hazard for noncancer toxicity to the central nervous system, kidney, liver, immune system, male reproductive system, and the developing embryo/fetus.
    Environmental Health Perspectives 12/2012; 122(4). DOI:10.1289/ehp.1205879 · 7.98 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: 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: 127.5mm(3), 95% CI: -259.1, 1514.0), white matter volumes (e.g. total cerebral white matter: β: 21230.0mm(3), 95% CI: -4512.6, 46971.7) or gray matter volumes (e.g. total cerebral gray matter: β: 11976.0mm(3), 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.
    Neurotoxicology and Teratology 04/2013; 38. DOI:10.1016/j.ntt.2013.03.060 · 2.76 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background The biomass burning that occurs in the Amazon region has an adverse effect on environmental and human health. However, in this region, there are limited studies linking atmospheric pollution and genetic damage. Objective We conducted a comparative study during intense and moderate biomass burning periods focusing on the genetic damage and physicochemical analyses of the particulate matter (PM). Method PM and black carbon (BC) were determined; organic compounds were identified and quantified using gas chromatography with flame ionization detection, the cyto-genotoxicity test was performed using two bioassays: cytokinesis-block micronucleus (CBMN) in A549 cells and Tradescantia pallida micronucleus (Trad-MCN) assay. Results The PM10 concentrations were lower than the World Health Organization air quality standard for 24 h. The n-alkanes analyses indicate anthropogenic and biogenic influences during intense and moderate biomass burning periods, respectively. Retene was identified as the most abundant polycyclic aromatic hydrocarbon during both sampling periods. Carcinogenic and mutagenic compounds were identified. The genotoxic analysis through CBMN and Trad-MCN tests showed that the frequency MCN from the intense burning period is significantly higher compared to moderate burning period. Conclusions This is the first study using human alveolar cells to show the genotoxic effects of organic PM from biomass burning samples collected in Amazon region. The genotoxicity of PM can be associated with the presence of several mutagenic and carcinogenic compounds, mainly benzo[a]pyrene. These findings have potential implications for the development of pollution abatement strategies and can minimize negative impact on health.
    Environmental Research 04/2014; 130. DOI:10.1016/j.envres.2013.12.011 · 4.37 Impact Factor
Show more