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Landskroner EA, Tsai CSJ. Occupational exposures and cancer risk in commercial laundry and dry cleaning industries: a scoping review. BMC Public Health 2023; 23:2561. [PMID: 38129859 PMCID: PMC10740271 DOI: 10.1186/s12889-023-17306-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND The laundry and dry cleaning industries are critical for maintaining cleanliness and hygiene in our daily lives. However, they have also been identified as sources of hazardous chemical exposure for workers, leading to potentially severe health implications. Despite mounting evidence that solvents like perchloroethylene and trichloroethylene are carcinogenic, they remain commonly used in the industry. Additionally, while alternative solvents are increasingly being utilized in response to indications of adverse health and environmental effects, there remains a significant gap in our understanding of the potential risks associated with exposure to these new agents. METHODS This study aims to identify gaps in the literature concerning worker exposure to contemporary toxic chemicals in the laundry and dry cleaning industry and their associated carcinogenic risks. A scoping review of peer-reviewed publications from 2012 to 2022 was conducted to achieve this objective, focusing on studies that detailed chemical exposures, sampling methods, and workers within the laundry and dry cleaning sector. RESULTS In this scoping review, 12 relevant papers were assessed. A majority (66%) examined perchloroethylene exposure, with one notable finding revealing that biomarkers from dry cleaners had significant micronuclei frequency and DNA damage, even when exposed to PCE at levels below occupational exposure limits. Similarly, another study supported these results, finding an increase in early DNA damage among exposed workers. Separate studies on TCE and benzene presented varied exposure levels and health risks, raising concern due to their IARC Group 1 carcinogen classification. Information on alternative solvents was limited, highlighting gaps in health outcome data, exposure guidelines, and carcinogenic classifications. CONCLUSION Research on health outcomes, specifically carcinogenicity from solvent exposure in dry cleaning, is limited, with 66% of studies not monitoring health implications, particularly for emerging solvents. Further, findings indicated potential DNA damage from perchloroethylene, even below set occupational limits, emphasizing the need to reevaluate safety limits. As alternative solvents like butylal and high-flashpoint hydrocarbons become more prevalent, investigations into the effects of their exposure are necessary to safeguard workers' health. This scoping review is registered with the Open Science Framework, registration DOI: https://doi.org/10.17605/OSF.IO/Q8FR3 .
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Affiliation(s)
- Emma Ann Landskroner
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, 650 Charles E. Young Drive S., MC 177220, 90095-1735, 90095-1735, Los Angeles, California, United States
| | - Candace Su-Jung Tsai
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, 650 Charles E. Young Drive S., MC 177220, 90095-1735, 90095-1735, Los Angeles, California, United States.
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Westra S, Goldberg MS, Labrèche F, Baumgartner J, Ho V. The association between the incidence of postmenopausal breast cancer and occupational exposure to selected organic solvents, Montreal, Canada, 2008-2011. Am J Ind Med 2023; 66:911-927. [PMID: 37565624 DOI: 10.1002/ajim.23525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/17/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Breast cancer is the most diagnosed cancer among women and recognized risk factors explain 25%-47% of cases. Organic solvents are used widely in the workplace and exposure may increase the risk of developing breast cancer, yet there are insufficient data to confirm this hypothesis. We sought to determine whether past occupational exposures to selected organic solvents were associated with the incidence of invasive breast cancer in postmenopausal women in Montréal, Canada. METHODS From a population-based case-control study (2008-2011), using in-depth interviews we elicited information on risk factors and lifetime occupational histories. Industrial hygienists and chemists translated job descriptions into specific chemical and physical exposures. We assessed 11 individual solvents and four solvent groups. Unconditional logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for metrics of past exposures to selected solvents. Exposure metrics included any previous exposure, average frequency in hours per week, duration in years, and average cumulative concentration weighted by hours per workweek exposed. RESULTS We enrolled 695 cases and 608 controls. We found increased ORs for average cumulative concentration of exposure to mononuclear aromatic hydrocarbons (OR: 1.52, 95% CI: 1.04, 2.28), chlorinated alkanes (OR: 2.42, 95% CI: 1.23, 5.68), toluene (OR: 1.59, 95% CI: 1.02, 2.59), and a group of organic solvents with reactive metabolites (OR: 1.53, 95% CI: 1.08, 2.24). Positive associations were found across all exposure metrics and were higher among women with estrogen-positive/progesterone-negative tumors. CONCLUSION Our findings suggest occupational exposure to certain organic solvents may increase the risk of incident postmenopausal breast cancer.
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Affiliation(s)
- Sydney Westra
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Mark S Goldberg
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
- Department of Medicine, McGill University, Montréal, Québec, Canada
| | - France Labrèche
- Department of Environmental and Occupational Health, School of Public Health and Centre de recherche en santé publique (CReSP), University of Montréal and CIUSSS Centre-Sud, Montréal, Québec, Canada
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail, Montréal, Québec, Canada
| | - Jill Baumgartner
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
- Department of Ethics, Equity and Policy, McGill University, Montréal, Québec, Canada
| | - Vikki Ho
- Health Innovation and Evaluation Hub Université de Montréal Hospital Research Centre (CRCHUM), Montréal, Québec, Canada
- Department of Social and Preventive Medicine, Université de Montréal School of Public Health (ESPUM), Montréal, Québec, Canada
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Turner MC, Cogliano V, Guyton K, Madia F, Straif K, Ward EM, Schubauer-Berigan MK. Research Recommendations for Selected IARC-Classified Agents: Impact and Lessons Learned. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:105001. [PMID: 37902675 PMCID: PMC10615125 DOI: 10.1289/ehp12547] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 09/27/2023] [Accepted: 10/03/2023] [Indexed: 10/31/2023]
Abstract
BACKGROUND The International Agency for Research on Cancer (IARC) Monographs program assembles expert working groups who publish a critical review and evaluation of data on agents of interest. These comprehensive reviews provide a unique opportunity to identify research needs to address classification uncertainties. A multidisciplinary expert review and workshop held in 2009 identified research gaps and needs for 20 priority occupational chemicals, metals, dusts, and physical agents, with the goal of stimulating advances in epidemiological studies of cancer and carcinogen mechanisms. Overarching issues were also described. OBJECTIVES In this commentary we review the current status of the evidence for the 20 priority agents identified in 2009. We examine whether identified Research Recommendations for each agent were addressed and their potential impact on resolving classification uncertainties. METHODS We reviewed the IARC classifications of each of the 20 priority agents and identified major new epidemiological and human mechanistic studies published since the last evaluation. Information sources were either the published Monograph for agents that have been reevaluated or, for agents not yet reevaluated, Advisory Group reports and literature searches. Findings are described in view of recent methodological developments in Monographs evidence evaluation processes. DISCUSSION The majority of the 20 priority agents were reevaluated by IARC since 2009. The overall carcinogen classifications of 9 agents advanced, and new cancer sites with either "sufficient" or "limited" evidence of carcinogenicity were also identified for 9 agents. Examination of published findings revealed whether evidence gaps and Research Recommendations have been addressed and highlighted remaining uncertainties. During the past decade, new research addressed a range of the 2009 recommendations and supported updated classifications for priority agents. This supports future efforts to systematically apply findings of Monograph reviews to identify research gaps and priorities relevant to evaluation criteria established in the updated IARC Monograph Preamble. https://doi.org/10.1289/EHP12547.
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Affiliation(s)
- Michelle C. Turner
- Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Vincent Cogliano
- California Environmental Protection Agency Office of Environmental Health Hazard Assessment, Oakland, California, USA
| | - Kathryn Guyton
- National Academies of Sciences, Engineering, and Medicine, Washington, District of Columbia, USA
| | - Federica Madia
- International Agency for Research on Cancer, Lyon, France
| | - Kurt Straif
- Barcelona Institute for Global Health, Barcelona, Spain
- Boston College, Massachusetts, USA
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Purdue MP, Ward MH. Invited Perspective: How Far Have We Come? Revisiting a 2009 Report on Occupational Cancer Research Recommendations. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:101303. [PMID: 37902674 PMCID: PMC10615124 DOI: 10.1289/ehp13883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/05/2023] [Accepted: 10/03/2023] [Indexed: 10/31/2023]
Affiliation(s)
- Mark P. Purdue
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, Maryland, USA
| | - Mary H. Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, Maryland, USA
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Landskroner E, Tsai CSJ. Occupational Exposures in Commercial Laundry and Dry Cleaning Industries and their Associative Cancers: A Scoping Review. RESEARCH SQUARE 2023:rs.3.rs-3250169. [PMID: 37790391 PMCID: PMC10543511 DOI: 10.21203/rs.3.rs-3250169/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Background The laundry and dry cleaning industries are critical for maintaining cleanliness and hygiene in our daily lives. However, these industries have also been identified as sources of hazardous chemical exposure for workers, leading to potentially severe health implications. Despite mounting evidence that solvents like perchloroethylene and trichloroethylene are carcinogenic to humans, they remain the most commonly used solvents in the industry. In addition, while alternative solvents are increasingly being utilized in response to evidence of adverse health and environmental effects, there remains a significant gap in our understanding of the potential risks associated with exposure to these new agents. Methods A systematic scoping review was conducted to identify prevalent toxic substances in the commercial laundry and dry cleaning industries that workers are exposed to and, further, to identify gaps in the existing literature regarding those exposures and related cancer development. Reported study exposure values were compared with current occupational exposure limits and biological exposure indices. Results Most studies examined perchloroethylene exposure in the dry cleaning industry, with one notable finding being that genotoxic effects were found even below current occupational exposure limits. Separate studies on TCE and benzene presented varied exposure levels and health risks, raising concern due to their IARC Group 1 carcinogen classification. Lastly, data on alternative solvents was limited, with a lack of health outcome data and gaps in their exposure guidelines and carcinogenic classifications. Conclusion A gap in research exists regarding health outcomes, particularly cancer development, from solvent exposure in the dry cleaning industry. Most studies (66%) overlooked health implications, especially for emerging solvents. Further, results showed potential DNA damage from the established solvent, perchloroethylene, even below current occupational exposure limits, emphasizing the need to reevaluate safety limits. As alternative solvents like butylal and high-flashpoint hydrocarbons become more prevalent, investigations into the effects of their exposure are necessary to safeguard workers' health. This scoping review is registered with the Open Science Framework, registration DOI: https://doi.org/10.17605/OSF.IO/Q8FR3.
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Enhancing Human Biomonitoring Studies through Linkage to Administrative Registers-Status in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095678. [PMID: 35565076 PMCID: PMC9103287 DOI: 10.3390/ijerph19095678] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 02/06/2023]
Abstract
Record linkage of human biomonitoring (HBM) survey data with administrative register data can be used to enhance available datasets and complement the possible shortcomings of both data sources. Through record linkage, valuable information on medical history (diagnosed diseases, medication use, etc.) and follow-up information on health and vital status for established cohorts can be obtained. In this study, we investigated the availability of health registers in different EU Member States and EEA countries and assessed whether they could be linked to HBM studies. We found that the availability of administrative health registers varied substantially between European countries as well as the availability of unique personal identifiers that would facilitate record linkage. General protocols for record linkage were similar in all countries with ethical and data protections approval, informed consent, approval by administrative register owner, and linkage conducted by the register owner. Record linkage enabled cross-sectional survey data to be used as cohort study data with available follow-up and health endpoints. This can be used for extensive exposure-health effect association analysis. Our study showed that this is possible for many, but not all European countries.
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Gaston SA, Birnbaum LS, Jackson CL. Synthetic Chemicals and Cardiometabolic Health Across the Life Course Among Vulnerable Populations: a Review of the Literature from 2018 to 2019. Curr Environ Health Rep 2020; 7:30-47. [PMID: 32037478 PMCID: PMC7187897 DOI: 10.1007/s40572-020-00265-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE OF REVIEW Although vulnerable populations are disproportionately exposed to synthetic chemicals with endocrine disrupting properties, few recent reviews have summarized the impact of synthetic chemicals on cardiometabolic health among these groups. RECENT FINDINGS Of 37 eligible epidemiological studies among vulnerable populations published between January 2018 and April 2019 in which over half were prospective, the most investigated populations were pregnant women and children. Racial/ethnic minorities, individuals of low socioeconomic status (SES), and those occupationally exposed were studied the least. The most studied persistent organic pollutants (POPs) were per-/poly-fluoroalkyl substances (PFAS), and the most studied non-POPs were phenols. Across chemical classes, studies found certain POPs (e.g., PFAS) and non-POPs (i.e., phenols, phthalates, and parabens) to be associated with gestational diabetes and dysregulated glucose metabolism. Results for other cardiometabolic health outcomes were inconsistent but suggested certain chemicals may negatively affect cardiometabolic health. Synthetic chemicals likely adversely affect cardiometabolic health, but current findings were inconclusive. Few recent studies focused on racial/ethnic minorities, low SES, and occupationally exposed populations. To address poor cardiometabolic health and related disparities, more studies across vulnerable populations are warranted.
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Affiliation(s)
- Symielle A Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, Department of Health and Human Services, National Institutes of Health, 111 TW Alexander Drive, MD A3-05, Research Triangle Park, NC, 27709, USA
| | - Linda S Birnbaum
- Office of the Director, National Institute of Environmental Health Sciences and the National Toxicology Program, Department of Health and Human Services, National Institutes of Health, Research Triangle Park, NC, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Department of Health and Human Services, National Institutes of Health, 111 TW Alexander Drive, MD A3-05, Research Triangle Park, NC, 27709, USA.
- Intramural Program, National Institute on Minority Health and Health Disparities, Department of Health and Human Services, National Institutes of Health, Bethesda, MD, USA.
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Marks DH, Hagigeorges D, Manatis-Lornell AJ, Foreman RK, Senna MM. Development of Lichen Planopilaris-Like Alopecia following Occupational Exposure to Trichloroethylene and Tetrachloroethylene. Skin Appendage Disord 2019; 5:374-378. [PMID: 31799267 PMCID: PMC6883445 DOI: 10.1159/000501173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/24/2019] [Indexed: 12/13/2023] Open
Abstract
BACKGROUND We report a case of acute and severe lichen planopilaris (LPP)-like alopecia in a 35-year-old male construction worker following occupational exposure to trichloroethylene (TCE) and tetrachloroethylene (PCE). CASE REPORT Two weeks after initiating ground-intrusive construction at a previous dry-cleaning facility site, the patient developed sudden scalp pruritus and associated patchy hair loss. As subsequent scalp biopsies revealed LPP, he was started on hydroxychloroquine at 200 mg twice daily and clobetasol solution once daily. Despite treatment, the patient's hair loss rapidly progressed to involve >95% of his scalp within 3 years. An official "work clean" policy report revealed high-concentration exposure to TCE and PCE. CONCLUSION Although causation cannot be proven, the close temporal relationship and rapid progression of LPP-like alopecia in an atypical patient demographic support a strong correlation between chemical exposure to TCE/PCE and scarring hair loss.
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Affiliation(s)
- Dustin H. Marks
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Dina Hagigeorges
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Ruth K. Foreman
- Dermatopathology Service, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Maryanne M. Senna
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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