Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA.
Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, 85 East Newton Street, Boston, MA, 02118, USA.
Environ Health. 2020 Sep 17;19(1):99. doi: 10.1186/s12940-020-00638-2.
Many studies of adults with occupational exposure to solvents such as tetrachloroethylene (PCE) have shown adverse effects on cognition, mood and behavioral problems. Much less is known about neurotoxic effects in early life at lower exposure levels seen in community settings. We recently reported that illicit drug use was more frequent among adults from Cape Cod, Massachusetts who were exposed to PCE-contaminated drinking water during gestation and early childhood than their unexposed counterparts. Using newly collected data from this population-based retrospective cohort study, the current analysis examines whether early life PCE exposure is also associated with drug use disorder over the life course.
Three-hundred and sixty-three subjects with prenatal and early childhood PCE exposure and 255 unexposed subjects were studied. These individuals (median age: 40-41 years) completed self-administered questionnaires on the eleven established diagnostic criteria for drug use disorder and confounding variables. A validated leaching and transport model was used to estimate exposure to PCE-contaminated water.
Overall, 23.3% of subjects reported having at least one criterion for drug use disorder over their lifetime. Early life PCE exposure was associated with a modest increase in the lifetime presence of one or more diagnostic criteria for drug use disorder (adjusted RR: 1.4, 95% CI: 1.0-1.8). Compared to unexposed subjects, PCE-exposed subjects were more likely to report having most diagnostic criteria of drug use disorder, including neglecting major roles due to drug use, physical and psychological problems related to drug use, and giving up activities due to drug use. No dose-response relationships were observed with increasing levels of PCE exposure.
These results suggest that exposure to PCE-contaminated drinking water during early life modestly increases the risk of developing diagnostic criteria for drug use disorder later in life. Because this study has several limitations, these findings should be confirmed in follow-up investigations of other exposed populations with more diverse racial and socioeconomic characteristics.
许多研究表明，接触四氯乙烯（PCE）等溶剂的成年人的认知、情绪和行为问题存在不良影响。但在社区环境中，接触较低水平的 PCE 对生命早期的神经毒性影响则知之甚少。我们最近报告说，马萨诸塞州科德角的成年人在胎儿期和幼儿期接触受 PCE 污染的饮用水，比未接触的成年人更频繁地使用非法药物。利用这项基于人群的回顾性队列研究中最新收集的数据，当前分析检查了生命早期的 PCE 暴露是否也与一生中的药物使用障碍有关。
对 363 名产前和幼儿期接触 PCE 的个体和 255 名未接触的个体进行了研究。这些个体（中位年龄：40-41 岁）完成了关于药物使用障碍的 11 项既定诊断标准和混杂变量的自我管理问卷调查。使用经过验证的浸出和传输模型来估计接触受 PCE 污染的水。
总体而言，23.3%的受试者报告一生中至少有一个药物使用障碍的诊断标准。生命早期的 PCE 暴露与一生中存在一个或多个药物使用障碍的诊断标准略有增加有关（调整后的 RR：1.4，95%CI：1.0-1.8）。与未暴露的个体相比，PCE 暴露的个体更有可能报告存在大多数药物使用障碍的诊断标准，包括因使用药物而忽视主要角色、与使用药物相关的身体和心理问题以及因使用药物而放弃活动。没有观察到 PCE 暴露水平增加与剂量反应关系。
这些结果表明，生命早期接触受 PCE 污染的饮用水会适度增加以后发生药物使用障碍诊断标准的风险。由于这项研究存在一些局限性，这些发现应该在对具有更多不同种族和社会经济特征的其他暴露人群进行的后续调查中得到证实。
