Department of Epidemiology, Boston University School of Public Health, 710 Albany Street, Boston, MA 02118, USA.
Environ Sci Process Impacts. 2020 Mar 1;22(3):555-566. doi: 10.1039/c9em00590k. Epub 2020 Feb 13.
Tetrachloroethylene (PCE) is a common contaminant in both occupational and community settings. High exposure levels in the workplace have been shown to have adverse impacts on reproduction and development but few epidemiological studies have examined these effects at the lower levels commonly seen in community settings. We were presented with a unique opportunity to examine the reproductive and developmental effects of prenatal exposure to PCE-contaminated drinking water resulting from the installation of vinyl-lined water pipes in Massachusetts and Rhode Island from the late 1960s through 1980. This review describes the methods and findings of two community-based epidemiological studies, places their results in the context of the existing literature, and describes the strengths and challenges of conducting epidemiological research on a historical pollution episode. Our studies found that prenatal exposure to PCE-contaminated drinking water is associated with delayed time-to-pregnancy, and increased risks of placental abruption, stillbirths stemming from placental dysfunction, and certain birth defects. No associations were observed with pregnancy loss, birth weight, and gestational duration. Important strengths of this research included the availability of historical data on the affected water systems, a relatively high exposure prevalence and wide range of exposure levels, and little opportunity for recall bias and confounding. Challenges arose mainly from the retrospective nature of the exposure assessments. This research highlights the importance of considering pregnant women and their developing fetuses when monitoring, regulating, and remediating drinking water contaminants.
四氯乙烯（PCE）是职业和社区环境中常见的污染物。高暴露水平已被证明对生殖和发育有不良影响，但很少有流行病学研究在社区环境中常见的较低水平下检查这些影响。我们有机会研究由于 20 世纪 60 年代末至 80 年代在马萨诸塞州和罗得岛州安装乙烯衬里的水管导致的产前暴露于 PCE 污染饮用水对生殖和发育的影响。这篇综述描述了两项基于社区的流行病学研究的方法和发现，将其结果置于现有文献的背景下，并描述了对历史污染事件进行流行病学研究的优势和挑战。我们的研究发现，产前暴露于 PCE 污染饮用水与妊娠时间延迟、胎盘早剥风险增加、胎盘功能障碍引起的死产以及某些出生缺陷有关。未观察到与流产、出生体重和妊娠持续时间有关的关联。这项研究的重要优势包括有关受影响供水系统的历史数据的可用性、相对较高的暴露流行率和广泛的暴露水平，以及回忆偏倚和混杂的机会很小。挑战主要来自于暴露评估的回顾性。这项研究强调了在监测、监管和修复饮用水污染物时，考虑孕妇及其发育中的胎儿的重要性。
