Childhood residential proximity to the radiologically contaminated Coldwater Creek and later-life cardiovascular disease in the St. Louis Baby Tooth study.

Since the 1940s, Coldwater Creek-located in St. Louis, Missouri's northern suburbs-has been contaminated by radioactive waste produced by the Manhattan Project's effort to refine uranium for the first atomic bomb. Here, we used the St. Louis Baby Tooth-Later Life Health Study (SLBT) to evaluate whether residential proximity to Coldwater Creek during childhood was associated with cardiovascular disease (CVD) incidence. Among 4209 eligible SLBT participants, we fit Cox models to estimate hazard ratios (HRs) and 95% CIs between our CVD outcomes (any CVD, atherosclerotic CVD, and hypertension) and proximity of childhood residential addresses to Coldwater Creek (≤1 km, >1-5 km, >5-20 km, and > 20 km), adjusting for sociodemographics. Among participants ≤1 km from Coldwater Creek (~3% of our study population), the HR was 1.45 (95% CI: 1.14, 1.85) for any CVD and 1.81 (95% CI: 1.00, 3.25) for atherosclerotic CVD compared to those living >20 km from the creek. Despite more imprecision in the estimate, there was suggestive evidence of an association with hypertension (HR = 1.27; 95% CI: 0.98, 1.64). Our study suggests that living near Coldwater Creek as a child is associated with a higher risk of developing CVD, where our data suggests that associations were strongest with atherosclerotic subtypes.