A case-control study of early-life residential exposure to tetrachloroethylene and risks of childhood cancer and birth defects

Abstract

Background: Residential buildings with a co-located dry-cleaning facility (CL-DC) can have substantially higher indoor tetrachloroethylene concentrations than buildings without a CL-DC. We conducted a case-control study to investigate associations between early-life indoor tetrachloroethylene exposure from CL-DCs and risks of childhood cancers (overall, acute lymphoblastic leukemia) and birth defects.

Methods: We linked records between the New York City (NYC) Bureau of Vital Statistics and the New York State Cancer Registry and Birth Defects Registry to identify cases of childhood cancers (n = 5,334) and birth defects (n = 171,553) diagnosed among children born in NYC between 1988 and 2016, and controls without these conditions (n = 596,599). We identified CL-DC exposure by mapping addresses from birth certificates and DC permits involving tetrachloroethylene use to building footprints, and modeled tetrachloroethylene concentrations using measurement data from a survey of NYC CL-DCs. Using unconditional logistic regression, we computed odds ratios (ORs) and 95 % confidence intervals (CIs) relating study endpoints to CL-DC exposure.

Findings: Living in a building with a CL-DC at birth was associated with aortic valve stenosis (AVS; OR = 3.1, 95 % CI = 1.6, 5.9), with an exposure-response effect for predicted tetrachloroethylene concentration (≤44 μg/m³: OR = 2.7, 95 % CI = 1.0, 7.4; >44 μg/m³: OR = 3.9, 95 % CI = 1.6, 9.5) and stronger associations for children whose mother was non-White, less than college-educated, or lived at birth in majority non-White or poorer neighborhoods. We observed null findings for other endpoints.

Conclusions: In this first-ever case-control study, early-life tetrachloroethylene exposure from CL-DCs in residential buildings was associated with increased AVS risk. These findings warrant further investigation.

Keywords: Aortic valve stenosis; Birth defects; Childhood cancer; Dry-cleaning facility; Tetrachloroethylene.

Fig. 1.

Associations between early-life residence in a building with a co-located dry cleaning facility and selected birth defects (n = 23).

Fig. 2.. Distribution of controls exposed to high (>44 μg/m³) vs. low (≤44 μg/m³) by socioeconomic factors.

Other in mother’s race and ethnicity includes American Indian and Alaska Native, Native Hawaiian and other Pacific Islander, some other race, and two or more races.