Tetrachloroethylene exposure and neurobehavioral performance among children living near multiple contamination sites.

Background: Tetrachloroethylene (PCE) is a known neurotoxicant mainly observed in populations with high level occupational exposure. Health effects of low-level community exposure are poorly understood. This study evaluated PCE exposure and neurobehavioral performance in 6 to 11-year-old children living in a community with multiple PCE contamination sites.

Methods: This cross-sectional study recruited eighty-nine children who attended public schools in Martinsville, Indiana. PCE was measured in exhaled breath using proton transfer reaction mass spectrometry. Children were classified into three exposure groups: 'Level 1' (≤ 0.75 μg/m), 'Level 2' (>0.75-1.90 μg/m), and 'Level 3' (>1.90 μg/m). A battery of tests assessed children's neurobehavioral performance related to their cognition, behavior, and academic achievement and a questionnaire collected demographic and exposure characteristics. Adjusted regression models estimated associations of PCE exposure with neurobehavioral outcomes.

Results: Seventy-three participants completed data collection. The average scores for all participants on the Fluid, Total, Early Childhood Composites, Behavioral Symptoms Index, and Math Computation were significantly lower than standard scores of normative sample, with 30 % of participants having one or more scores two standard deviations worse than the standard scores. Compared to children having the lowest PCE exposure, significant inverse associations were identified for PCE exposure with Fluid Composite for Level 2 (β = -12.0 (95 % CI = -23.4, -0.6)) and Level 3 (-12.2 (-23.4, -1.0)) exposure groups, Total Composite for Level 2 (-10.1 (-19.2, -1.1)) and Level 3 (-11.8 (-20.4, -3.2)) exposure groups, and Early Childhood Composite for Level 3 exposure group (-11.0 (-18.7, -3.4)).

Conclusions: This study identified associations of PCE in exhaled breath with lower cognitive functioning, problem-solving abilities, and adaptive functioning in children. Mainly, working memory, episodic memory, processing speed, and executive function-cognitive flexibility were associated with PCE exposure. These results underscore the need for further investigations, considering the impact of low-level environmental exposure on children's neurobehavioral outcomes.