Abstract
Background/Aims: Between 1968 and 1983, public drinking water supplies of Cape Cod, Massachusetts were contaminated with tetrachloroethylene (PCE), an established neurotoxicant. We previously found an affinity for risk-taking behaviors, including the use of illicit drugs, following early-life exposure to PCE. Using newly collected data, we investigated the risk of misusing prescription drugs following early life PCE exposure. Methods: Participants were identified from a retrospective cohort study ("Cape Cod Health Study”) via cross-matching birth certificates and water system data. The original self-administered questionnaire gathered data on demographics, work and medical history, and alcohol and illicit drug use from 615 individuals (361 with early-life exposure and 254 unexposed). The follow-up survey added questions on misuse of prescription pain relievers, tranquillizers, stimulants and sedatives. A validated leaching and transport model was used to estimate exposure to PCE exposure in drinking water. Results: One hundred and thirty-four (19.3%) participants misused at least one type of prescription drug. Pain relievers were the most commonly misused prescription drug (14.3%). Compared to unexposed subjects, individuals with early-life exposure to PCE were 93% more likely to misuse prescription drugs (Adjusted relative risk (RR)1.93, 95% CI: 1.31, 2.83), after adjusting for maternal education, father occupation and participant age. Similar increases in risk were seen for pain relievers, tranquillizers and stimulants (Adjusted RRs:1.82-2.17) and for misusing only 1 or 2 or more prescription drugs [Adjusted RRs 1.97 and 2.12, respectively]. Participants exposed to PCE levels >= median had a slightly higher risk of misusing prescription drugs than those exposed to levels < median [Adjusted RRs: 2.06 (95% CI: 1.34, 3.17) and 1.83 (95% CI: 1.20, 2.79), respectively]. Conclusions: Results suggest early life exposure to PCE increases the risk of misusing several types of prescription drugs.
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