Prenatal and early childhood exposure to tetrachloroethylene (PCE)-contaminated drinking water and sleep quality in adulthood: a retrospective cohort study

Charlotte R Doran,Ann Aschengrau

doi:10.1186/s12940-021-00819-7

Abstract

BackgroundCommunities in Cape Cod, Massachusetts were exposed to tetrachloroethylene (PCE) through contaminated drinking water from 1969 to 1983. PCE exposure during adulthood has well-established neurotoxic effects; however, long-term impacts stemming from early life exposure, especially adverse effects on sleep quality, are not well understood.MethodsThe present analysis was based on data from the Cape Cod Health Study, a retrospective cohort study of the long-term neurotoxic impacts of early-life exposure to PCE-contaminated drinking water. Exposure to PCE-contaminated water was estimated using a validated leaching and transport model. Measures of sleep quality were obtained from self-administered questionnaires. Generalized estimating equations were used to generate risk ratios and 95% confidence intervals to estimate the association between early-life PCE exposure and sleep quality among 604 participants.ResultsCompared to unexposed participants, any PCE exposure during early life was associated with 1.57 times the risk of reporting breathing pauses during sleep (95% CI 0.92–2.68). Low-level exposure to PCE was associated with 1.50 times the risk of reporting sleep apnea or other sleep disorders (95% CI 0.78–2.89), while high levels of exposure had comparable risk compared to no exposure (RR = 0.94, 95% CI 0.50–1.79). Weak or no associations were observed for other sleep quality outcomes. In stratified analyses participants with mental illness and/or substance use disorder had increased risk ratios for short sleep duration associated with PCE exposure.ConclusionThese findings suggest that early-life exposure to PCE may be associated with a moderate increase in the risk of reporting breathing pauses during sleep in adulthood and that a history of mental illness and/or substance use disorder may exacerbate the risk of short sleep duration.

Highlights

Tetrachloroethylene, known as perchloroethylene (PCE), is a common organic solvent most often used in dry cleaning and metal degreasing
Study population Individuals were eligible for inclusion in the Cape Cod Health Study (CCHS) if they were born during 1969–1983 to married women living in any of eight Cape Cod, Massachusetts towns known to have some VL/asbestos cement (AC) water pipes installed in some parts of their water distribution system
Demographic and health characteristics were examined by 3-level exposure status in analyses not shown, and all exposure groups were similar with respect to these characteristics

Summary

Introduction

Tetrachloroethylene, known as perchloroethylene (PCE), is a common organic solvent most often used in dry cleaning and metal degreasing. Workers in these industries are often exposed to high levels of PCE [1]. Exposure to PCE and other organic solvents in occupational settings have been shown to have neurotoxic effects, including adverse effects on color vision, visuospatial memory, cognition, and other neuropsychological functions [1,2,3]. In the past two decades, there has been increasing interest in the long-term neurotoxic effects of PCE exposure, including the effects of early-life PCE exposure. PCE exposure during adulthood has well-established neurotoxic effects; long-term impacts stemming from early life exposure, especially adverse effects on sleep quality, are not well understood

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