Ruckart Perri Zeitz, Bove Frank J, Maslia Morris
Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, 4770 Buford Highway, MS F-58, Atlanta, GA 30341, USA.
Environ Health. 2013 Dec 4;12:104. doi: 10.1186/1476-069X-12-104.
Drinking water supplies at Marine Corps Base Camp Lejeune were contaminated with trichloroethylene, tetrachloroethylene, benzene, vinyl chloride and trans-1,2-dichloroethylene during 1968 through 1985.
We conducted a case control study to determine if children born during 1968-1985 to mothers with residential exposure to contaminated drinking water at Camp Lejeune during pregnancy were more likely to have childhood hematopoietic cancers, neural tube defects (NTDs), or oral clefts. For cancers, exposures during the first year of life were also evaluated. Cases and controls were identified through a survey of parents residing on base during pregnancy and confirmed by medical records. Controls were randomly sampled from surveyed participants who had a live birth without a major birth defect or childhood cancer. Groundwater contaminant fate and transport and distribution system models provided estimates of monthly levels of drinking water contaminants at mothers' residences. Magnitude of odds ratios (ORs) was used to assess associations. Confidence intervals (CIs) were used to indicate precision of ORs. We evaluated parental characteristics and pregnancy history to assess potential confounding.
Confounding was negligible so unadjusted results were presented. For NTDs and average 1st trimester exposures, ORs for any benzene exposure and for trichloroethylene above 5 parts per billion were 4.1 (95% CI: 1.4-12.0) and 2.4 (95% CI: 0.6-9.6), respectively. For trichloroethylene, a monotonic exposure response relationship was observed. For childhood cancers and average 1st trimester exposures, ORs for any tetrachloroethylene exposure and any vinyl chloride exposure were 1.6 (95% CI: 0.5-4.8), and 1.6 (95% CI: 0.5-4.7), respectively. The study found no evidence suggesting any other associations between outcomes and exposures.
Although CIs were wide, ORs suggested associations between drinking water contaminants and NTDs. ORs suggested weaker associations with childhood hematopoietic cancers.
1968年至1985年期间,勒琼营海军陆战队基地的饮用水供应受到三氯乙烯、四氯乙烯、苯、氯乙烯和反式-1,2-二氯乙烯的污染。
我们进行了一项病例对照研究,以确定1968年至1985年期间出生的儿童,其母亲在怀孕期间居住在勒琼营且接触受污染的饮用水,是否更有可能患儿童造血系统癌症、神经管缺陷(NTDs)或唇腭裂。对于癌症,还评估了生命第一年的接触情况。病例和对照通过对怀孕期间居住在基地的父母进行调查确定,并由医疗记录证实。对照从调查参与者中随机抽取,这些参与者生育的孩子没有严重出生缺陷或儿童癌症。地下水污染物归宿和迁移以及分配系统模型提供了母亲住所饮用水污染物每月水平的估计值。比值比(ORs)的大小用于评估关联。置信区间(CIs)用于表明ORs的精确性。我们评估了父母特征和妊娠史以评估潜在的混杂因素。
混杂因素可忽略不计,因此呈现未调整的结果。对于NTDs和孕早期平均接触情况,任何苯接触以及三氯乙烯含量高于十亿分之五时的ORs分别为4.1(95%CI:1.4 - 12.0)和2.4(95%CI:0.6 - 9.6)。对于三氯乙烯,观察到单调的接触反应关系。对于儿童癌症和孕早期平均接触情况,任何四氯乙烯接触和任何氯乙烯接触的ORs分别为1.6(95%CI:0.5 - 4.8)和1.6(95%CI:0.5 - 4.7)。该研究未发现任何其他结果与接触之间存在关联的证据。
尽管置信区间较宽,但比值比表明饮用水污染物与NTDs之间存在关联。比值比表明与儿童造血系统癌症的关联较弱。