Abstract
BackgroundMany studies of adults with occupational exposure to solvents such as tetrachloroethylene (PCE) have shown adverse effects on cognition, mood and behavioral problems. Much less is known about neurotoxic effects in early life at lower exposure levels seen in community settings. We recently reported that illicit drug use was more frequent among adults from Cape Cod, Massachusetts who were exposed to PCE-contaminated drinking water during gestation and early childhood than their unexposed counterparts. Using newly collected data from this population-based retrospective cohort study, the current analysis examines whether early life PCE exposure is also associated with drug use disorder over the life course.MethodsThree-hundred and sixty-three subjects with prenatal and early childhood PCE exposure and 255 unexposed subjects were studied. These individuals (median age: 40–41 years) completed self-administered questionnaires on the eleven established diagnostic criteria for drug use disorder and confounding variables. A validated leaching and transport model was used to estimate exposure to PCE-contaminated water.ResultsOverall, 23.3% of subjects reported having at least one criterion for drug use disorder over their lifetime. Early life PCE exposure was associated with a modest increase in the lifetime presence of one or more diagnostic criteria for drug use disorder (adjusted RR: 1.4, 95% CI: 1.0–1.8). Compared to unexposed subjects, PCE-exposed subjects were more likely to report having most diagnostic criteria of drug use disorder, including neglecting major roles due to drug use, physical and psychological problems related to drug use, and giving up activities due to drug use. No dose-response relationships were observed with increasing levels of PCE exposure.ConclusionsThese results suggest that exposure to PCE-contaminated drinking water during early life modestly increases the risk of developing diagnostic criteria for drug use disorder later in life. Because this study has several limitations, these findings should be confirmed in follow-up investigations of other exposed populations with more diverse racial and socioeconomic characteristics.
Highlights
Many studies of adults with occupational exposure to solvents such as tetrachloroethylene (PCE) have shown adverse effects on cognition, mood and behavioral problems
Higher risk ratio (RR) were generally observed for PCE levels less than the median as compared to PCE levels greater than or equal to the median (Table 3). When these data were stratified by sex, we found that early life PCE exposure remained associated with a modest increase in the lifetime presence of one or more diagnostic criteria for drug use disorder among females but not males
Compared to subjects without any criteria for drug use disorder, those with at least one criterion were more likely to use/misuse multiple drugs (73.5% vs. 28.4%), including cannabis (93.2% vs. 70.2%), crack/cocaine (52.8% vs. 12.6%), hallucinogens (60.9% vs. 21.7%), inhalants (28.4% vs. 6.6%), methamphetamine (11.9% vs. 1.1%), heroin (11.9% vs. 0.4%), prescription pain relievers (42.0% vs. 5.8%), prescription tranquilizers (24.7% vs. 3.8%), and prescription stimulants (30.9% vs. 4.3%). These results suggest that there is a modest increase in the risk of meeting one or more criteria for drug use disorder among adults with any exposure to PCEcontaminated drinking water during gestation and early childhood
Summary
Many studies of adults with occupational exposure to solvents such as tetrachloroethylene (PCE) have shown adverse effects on cognition, mood and behavioral problems. Because PCE is volatile, it was expected to evaporate by the time the pipes were installed; water samples taken in 1980 revealed that substantial quantities of PCE remained in the liner and were leaching into public drinking water supplies. This source of contamination was remediated by flushing and bleeding the affected pipes in the 1980s, other public water supplies across the United States have been contaminated by PCE from landfills and underground storage tanks [3], industrial waste disposal sites [4], and dry cleaning facilities [5]. Studies have linked occupational exposure to increases in anxiety and depression [8, 9, 11, 16,17,18]
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