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PCE exposure during adulthood has well-established neurotoxic effects; however, long-term impacts stemming from early life exposure, especially adverse effects on sleep quality, are not well understood.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The present analysis was based on data from the Cape Cod Health Study, a retrospective cohort study of the long-term neurotoxic impacts of early-life exposure to PCE-contaminated drinking water. Exposure to PCE-contaminated water was estimated using a validated leaching and transport model. Measures of sleep quality were obtained from self-administered questionnaires. Generalized estimating equations were used to generate risk ratios and 95% confidence intervals to estimate the association between early-life PCE exposure and sleep quality among 604 participants.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Compared to unexposed participants, any PCE exposure during early life was associated with 1.57 times the risk of reporting breathing pauses during sleep (95% CI 0.92\u20132.68). Low-level exposure to PCE was associated with 1.50 times the risk of reporting sleep apnea or other sleep disorders (95% CI 0.78\u20132.89), while high levels of exposure had comparable risk compared to no exposure (RR\u2009=\u20090.94, 95% CI 0.50\u20131.79). Weak or no associations were observed for other sleep quality outcomes. In stratified analyses participants with mental illness and\/or substance use disorder had increased risk ratios for short sleep duration associated with PCE exposure.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>These findings suggest that early-life exposure to PCE may be associated with a moderate increase in the risk of reporting breathing pauses during sleep in adulthood and that a history of mental illness and\/or substance use disorder may exacerbate the risk of short sleep duration.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12940-021-00819-7","type":"journal-article","created":{"date-parts":[[2022,1,15]],"date-time":"2022-01-15T07:03:09Z","timestamp":1642230189000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prenatal and early childhood exposure to tetrachloroethylene (PCE)-contaminated drinking water and sleep quality in adulthood: a retrospective cohort study"],"prefix":"10.1186","volume":"21","author":[{"given":"Charlotte R.","family":"Doran","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8153-7712","authenticated-orcid":false,"given":"Ann","family":"Aschengrau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,1,15]]},"reference":[{"key":"819_CR1","volume-title":"Toxicological profile for tetrachloroethylene","author":"Agency for Toxic Substances Disease Registry","year":"2019","unstructured":"Agency for Toxic Substances Disease Registry. 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