Amelia K Wesselink1, Elizabeth E Hatch2, Lauren A Wise2, Kenneth J Rothman3, Veronica M Vieira4, Ann Aschengrau2. 1. Boston University School of Public Health, Department of Epidemiology, Boston, MA, USA. Electronic address: akw23@bu.edu. 2. Boston University School of Public Health, Department of Epidemiology, Boston, MA, USA. 3. Boston University School of Public Health, Department of Epidemiology, Boston, MA, USA; RTI International, Research Triangle Park, NC, USA. 4. University of California, Irvine, Program in Public Health, Susan and Henry Samueli College of Health Sciences, Irvine, CA, USA.
Abstract
BACKGROUND: The synthetic solvent tetrachloroethylene (PCE), commonly used in dry cleaning operations, is a human neurotoxicant and carcinogen. However, its effect on reproduction is poorly understood, as prior studies have been limited to small occupational cohorts. We examined the association between PCE exposure from contamination of the public drinking water supply and time-to-pregnancy (TTP) in a cohort of mothers from Cape Cod, Massachusetts. METHODS: The Cape Cod Family Health Study is a retrospective cohort study designed to examine the reproductive and developmental health effects of exposure to PCE-contaminated drinking water. Our analysis included 1565 women who reported 3826 planned pregnancies from 1949 to 1990. Women completed self-administered questionnaires that ascertained TTP for each of her pregnancies, regardless of the outcome, as well as residential history and demographic information. We utilized EPANET water distribution system modeling software and a leaching and transport model to assess PCE exposure for each pregnancy. We used log-binomial regression models to estimate relative risks (RR) and 95% confidence intervals (CI), adjusting for potential confounders. We performed a probabilistic bias analysis to examine the effect of outcome misclassification on our results. RESULTS: Any cumulative PCE exposure before pregnancy was associated with a 15% reduction in risk of TTP > 12 months (RR = 0.85, 95% CI: 0.70, 1.03). However, women with the highest average monthly PCE exposure around the time of the pregnancy attempt (≥ 2.5 g) had increased risk of TTP > 12 months (RR = 1.36, 95% CI: 1.06, 1.76). CONCLUSIONS: We found little evidence for long-term, cumulative adverse effects of PCE exposure on TTP, but high levels of PCE exposure around the time of the pregnancy attempt were associated with longer TTP. These associations may be underestimated due to the exclusion of unsuccessful pregnancy attempts from our study population, and may be biased by outcome and exposure misclassification given the long-term recall of TTP and use of a leaching and transport model to estimate PCE exposure.
BACKGROUND: The synthetic solvent tetrachloroethylene (PCE), commonly used in dry cleaning operations, is a humanneurotoxicant and carcinogen. However, its effect on reproduction is poorly understood, as prior studies have been limited to small occupational cohorts. We examined the association between PCE exposure from contamination of the public drinking water supply and time-to-pregnancy (TTP) in a cohort of mothers from Cape Cod, Massachusetts. METHODS: The Cape Cod Family Health Study is a retrospective cohort study designed to examine the reproductive and developmental health effects of exposure to PCE-contaminated drinking water. Our analysis included 1565 women who reported 3826 planned pregnancies from 1949 to 1990. Women completed self-administered questionnaires that ascertained TTP for each of her pregnancies, regardless of the outcome, as well as residential history and demographic information. We utilized EPANET water distribution system modeling software and a leaching and transport model to assess PCE exposure for each pregnancy. We used log-binomial regression models to estimate relative risks (RR) and 95% confidence intervals (CI), adjusting for potential confounders. We performed a probabilistic bias analysis to examine the effect of outcome misclassification on our results. RESULTS: Any cumulative PCE exposure before pregnancy was associated with a 15% reduction in risk of TTP > 12 months (RR = 0.85, 95% CI: 0.70, 1.03). However, women with the highest average monthly PCE exposure around the time of the pregnancy attempt (≥ 2.5 g) had increased risk of TTP > 12 months (RR = 1.36, 95% CI: 1.06, 1.76). CONCLUSIONS: We found little evidence for long-term, cumulative adverse effects of PCE exposure on TTP, but high levels of PCE exposure around the time of the pregnancy attempt were associated with longer TTP. These associations may be underestimated due to the exclusion of unsuccessful pregnancy attempts from our study population, and may be biased by outcome and exposure misclassification given the long-term recall of TTP and use of a leaching and transport model to estimate PCE exposure.
Authors: Maureen A Cooney; Germaine M Buck Louis; Rajeshwari Sundaram; Bridget M McGuiness; Courtney D Lynch Journal: Epidemiology Date: 2009-01 Impact factor: 4.822
Authors: Jonathan A C Sterne; Ian R White; John B Carlin; Michael Spratt; Patrick Royston; Michael G Kenward; Angela M Wood; James R Carpenter Journal: BMJ Date: 2009-06-29
Authors: Ann Aschengrau; Michael R Winter; Lisa G Gallagher; Veronica M Vieira; Lindsey J Butler; M Patricia Fabian; Jenny L Carwile; Amelia K Wesselink; Shruthi Mahalingaiah; Patricia A Janulewicz; Janice M Weinberg; Thomas F Webster; David M Ozonoff Journal: Environ Sci Process Impacts Date: 2020-02-13 Impact factor: 4.238
Authors: Diana M Ceballos; Katie M Fellows; Ashley E Evans; Patricia A Janulewicz; Eun Gyung Lee; Stephen G Whittaker Journal: Front Public Health Date: 2021-03-05