Abstract
BackgroundWhile 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.MethodsA 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.ResultsNo 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.ConclusionsThe 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.
Highlights
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
27.4% of subjects (N = 414) changed their status during the detailed exposure assessment either because (1) their birth address was further downstream from a Vinyl-lined asbestos-cement (VL/AC) pipe than was considered exposed in the preliminary visual assessment, (2) their modeled assessment indicated a different water flow direction than was originally assumed, (3) their questionnaire data indicated that they used a private wells, or (4) their questionnaire data indicated that they lived in an affected residence during childhood
When exposure levels were examined, subjects in the highest exposure tertile had further increases in the risk ratios for bipolar disorder (RR 2.7, 95% Confidence Interval (CI): 1.3-5.6) and post-traumatic stress disorder (RR: 1.7, 95% CI: 0.9-3.2)
Summary
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. From the late 1960s through early 1980 public water companies in Massachusetts installed vinyl-lined (VL) asbestos-cement (AC) water pipes to solve alkalinity problems in dead end sections of their distribution systems [1]. More than a decade lapsed before government officials learned that large quantities of PCE had remained in the liner and were leaching into the public drinking water supplies
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