Health effects of environmental contaminant exposure: An intrafile comparison of the trichloroethylene subregistry

The establishment of the National Exposure Registry represents the first major effort toward longitudinal surveillance of general populations exposed long-term to low levels of specific substances in the environment. The authors investigated the National Exposure Registry's Trichloroethylene Subregistry intrasubregistry differences with respect to health outcomes and the possible relationships with types and levels of chemical exposure. Investigators divided the 4 041 living members of the Trichloroethylene Subregistry into 4 subgroups, by type(s) of exposures (chemicals) and duration and level of exposures. The authors compared the reporting rates for 25 hearth outcomes across subgroups. The authors used logistic regression, in which age, sex, education, smoking history, and occupational history were the covariates. Statistically significant increases in reporting rates were seen with (a) increased maximum trichloroethylene exposures for the outcome stroke, (b) increased cumulative chemical exposure for respiratory allergies, and (c) duration of exposure for hearing impairment. Consistently elevated reporting rates across the exposure subgroups were seen for hearing impairment, speech impairment, asthma and emphysema, respiratory allergies, and stroke. Reporting rates for urinary tract disorders were related only to cumulative chemical levels. The authors noted that there appeared to be a relationship between trichloroethylene and reporting rates fbr speech impairment, hearing impairment, and stroke and between volatile organic compounds and asthma and emphysema, respiratory allergies, and urinary tract disorders.