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Occurrence of mental illness following prenatal and early childhood exposure to tetrachloroethylene (PCE)-contaminated drinking water: a retrospective cohort study

Ann Aschengrau1*, Janice M Weinberg2, Patricia A Janulewicz1, Megan E Romano13, Lisa G Gallagher4, Michael R Winter5, Brett R Martin5, Veronica M Vieira4, Thomas F Webster4, Roberta F White46 and David M Ozonoff4

Author Affiliations

1 Department of Epidemiology, Boston University School of Public Health, Talbot 3E, 715 Albany Street, Boston, MA 02118, USA

2 Department of Biostatistics, Boston University School of Public Health, Crosstown, 715 Albany Street, Boston, MA 02118, USA

3 Department of Epidemiology, University of Washington, Box 357236, Seattle WA, 98195, USA

4 Department of Environmental Health, Boston University School of Public Health, Talbot 4W, 715 Albany Street, Boston, MA 02118, USA

5 Data Coordinating Center, Boston University School of Public Health, Crosstown, 715 Albany Street, Boston MA 02118, USA

6 Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Boston MA 02118, USA

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Environmental Health 2012, 11:2  doi:10.1186/1476-069X-11-2

Published: 20 January 2012

Abstract

Background

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.

Methods

A 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.

Results

No 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.

Conclusions

The 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.