Environment and Breast Cancer: Science Review

Evidence From Humans
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Perchloroethylene-contaminated drinking water and the risk of breast cancer: additional results from Cape Cod, Massachusetts, USA
Aschengrau, A., Rogers, S., Ozonoff, D. Environ Health Perspect. 2003. 111:2, 167-73.
Topic area
Environmental pollutant - Organic solvent
Study design
Population based case-control
Funding agency
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number of Controls
Controls: 616
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Women diagnosed in 1987-1993 who were residents of 8 Cape Cod, MA, towns affected by PCE leaching from vinyl-lined drinking water distribution pipes.
Exposure Investigated
Exposures investigated
"Relative delivered dose" (RDD) of perchloroethylene: ordinal estimate from model of water flow and pipe characteristics and residence location in the water distribution system
How exposure was measured
Questionnaire, by telephone GIS/geographic location Other: Environmental model
Exposure assessment comment
Unvalidated model of PCE transport in water distribution system Limited information about exposure-related behaviors: bathing, bottled water and water filter use
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
Confounders considered
Other breast cancer risk factors, such as family history, age at first birth, and hormone replacement therapy use, that were taken into account in the study.
Confounders were extensively evaluated
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Description of major analysis
Logistic regression. Latency 0 to 19 years Effect modification: bathing, bottled water and water filter use
Strength of associations reported
Adjusted odds ratio (CI) [n cases/controls]
PCE exposure > 75th percentile 1.6 (1.1-2.4) [59/54]
PCE exposure > 90th percentile 1.3 (0.7-2.6) [18/21]

Similar results for 0-15 years latency, analysis limited to post menopausal women, present study combined with previous study. Reduced risk for ever-exposed women who took only baths or used a water treatment device at their exposed residence. No effect for bottled water use.
In 1998 we published the results of a study suggesting an association between breast cancer and perchloroethylene (PCE; also called tetrachloroethylene) exposure from public drinking water. The present case-control study was undertaken to evaluate this association further. The cases were composed of female residents of eight towns in the Cape Cod region of Massachusetts who had been diagnosed with breast cancer from 1987 through 1993 (n = 672). Controls were composed of demographically similar women from the same towns (n = 616). Women were exposed to PCE when it leached from the vinyl lining of water distribution pipes from the late 1960s through the early 1980s. A relative delivered dose of PCE that entered a home was estimated using an algorithm that took into account residential history, water flow, and pipe characteristics. Small to moderate elevations in risk were seen among women whose exposure levels were above the 75th and 90th percentiles when 0-15 years of latency were considered (adjusted odds ratios, 1.5-1.9 for > 75th percentile, 1.3-2.8 for > 90th percentile). When data from the present and prior studies were combined, small to moderate increases in risk were also seen among women whose exposure levels were above the 75th and 90th percentiles when 0-15 years of latency were considered (adjusted odds ratios, 1.6-1.9 for > 75th percentile, 1.3-1.9 for > 90th percentile). The results of the present study confirm those of the previous one and suggest that women with the highest PCE exposure levels have a small to moderate increased risk of breast cancer.Environmental pollutant
Author address
Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA. aaschen@bu.edu