Tetrachloroethylene exposure and bladder cancer risk: a meta-analysis of dry-cleaning-worker studies

Cancer-Specific Mortality Odds Ratios in the Food, Accommodation, and Beverage Activities in Italy

OBJECTIVES

This study investigated cancer-specific mortality risks of workers employed in food, accommodation and beverage (FAB) activities. Methods: We performed a case-control study based on countrywide mortality and National Social Insurance data. Adjusted cancer-specific mortality odds ratios (MOR) were calculated. We modeled occupational exposure as "ever/never been employed" in FAB activities, using other sectors as reference. Analysis was performed by gender, length of employment and year of smoke banning. Results: About 20,000 cancer deaths in FAB were analyzed. Working in restaurants was positively associated with cancer of lung (MOR = 1.24), bladder (MOR = 1.24), pharynx, and larynx. Accommodation was associated with cancer of pharynx (MOR = 1.46), while beverage with cancer of liver (MOR = 1.22). Gender, length of employment and smoke banning were found effective in modifying some risks. Conclusions: Workers in FAB sectors were at risk for several cancers.

Estimate of the C-Cl photoionization cross section and absolute photoionization cross sections of chlorinated organic compounds

Chlorinated organic compounds are prominently used for industrial production, but their vapors and emission byproducts can cause detrimental effects to human health and the environment. To accurately quantify organochlorine compounds, the absolute photoionization cross section of tetrachloroethylene, chlorobenzene, 1,2-dichlorobenzene, and chloroacetone are measured using multiplexed synchrotron photoionization mass spectrometry at the Advanced Light Source at Lawrence Berkeley National Laboratory. These measurements allow for the estimation of the C-Cl photoionization cross section, increasing quantification accuracy of chlorinated emissions for kinetic modeling and pollutant mitigation. CBS-QB3 calculations of adiabatic ionization energies and thermochemical appearance energies are also presented and agree well with the experimental results.

Occupational exposures and cancer risk in commercial laundry and dry cleaning industries: a scoping review

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 .

Occupational Exposures in Commercial Laundry and Dry Cleaning Industries and their Associative Cancers: A Scoping Review

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.

Maternal long-term inhalation exposure to perchloroethylene and prenatal teratogenicity: morphometric, hormonal, and histological study

Some commonly used chemicals have teratogenic effects. Perchloroethylene (PCE) is a liquid that is widely used in various industries and drying clothes. In this study, the teratogenic effects of PCE in rat embryos were investigated. In this experimental study, 32 adult Wistar female rats in the weight range of 230-250 g were used. Female rats were randomly divided into 4 groups (n = 8). Control group (without PCE inhalation), experimental group G(I) (exposed to PCE 18 days prior to mating), experimental group G(II) (exposed to PCE 18 days after mating) and experimental group G(III) (exposed to PCE 18 days before and 18 days after mating). Pregnant rats were anesthetized on the 18th day of gestation and then serum and embryos were removed for the required studies. Embryos were examined for number, weight, sex, morphometric parameters of organs, and tissue samples were prepared for histological studies. Serum isolated from dams were evaluated for sexual and gonadal hormones. The results of this study showed that PCE has teratogenic effects on rat embryos. Infertility and reduced birth rate were other effects of PCE in rats. PCE has teratogenic effects and impairs the reproductive system of rats.

Association Between Alcohol Consumption and Risk of Bladder Cancer: A Dose-Response Meta-Analysis of Prospective Cohort Studies

Background

Controversial results of the association between alcohol consumption and risk of bladder cancer were reported by the previous meta-analyses.

Objective

To quantitatively investigate the association between alcohol consumption and risk of bladder cancer based on prospective cohort studies, and explore whether there is potential dose-response relation.

Method

PubMed, EMBASE, the Cochrane Library databases, China Biology Medicine disc (CBM), and Chinese National Knowledge Infrastructure (CNKI) were searched for relevant studies. Categorical meta-analysis was performed for risk estimates of any alcohol consumers versus non-drinkers as well as different drinking degrees (light, moderate, and heavy) versus none. And two-stage generalized least-squares regression and restricted cubic spline, as well as fixed-effects dose-response models, were used for linear and nonlinear dose-response relation exploration.

Results

9 prospective cohort studies including 1,971,396 individuals were finally included. We did not observe a significant association between alcohol intake and the risk of bladder cancer in the entire population. Linear association was detected in those who consumed alcohol from liquor or spirits (P _linear=0.02). One drink increment each day of alcohol could elevate the risk of bladder cancer by 9% (RR=1.09; 95%CI: 1.01-1.17). Alcohol was a risk factor of bladder cancer for male drinkers (RR=1.23; 95%CI: 1.13-1.35; I²=3.7%), while none linear or nonlinear relation was found.

Conclusion

No significant association between alcohol consumption and bladder cancer risk was found in the entire population, but there was a linear dose-response relation in those who consume alcohol from liquor or spirits. Alcohol may elevate the risk of bladder cancer in males in a dose-independent way.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, PROSPERO (CRD42020216195).

Literature Review: Biological Monitoring of Occupational Tetrachloroethylene Exposure in Workers

Introduction: One of the most common chlorinated solvents in the world is tetrachloroethylene (TCE) because it is widely used in various industries. Exposure to tetrachloroethylene can cause health problems so biological monitoring is necessary to do. The aim of this research is to assess which one is more feasible to use among the various types of biological monitoring for tetrachloroethylene exposure, based on the evidence-based literature. Methods: The literature searching was performed via electronic databases from PubMed, Scopus, and Proquest. The keywords used were “biological monitoring”, “biomonitoring”, “tetrachloroethylene”, “perchloroethylene”, “work” and “occupation”. The articles were chosen based on the given inclusion and exclusion criteria. Selected articles were then critically appraised. Results: Initially 29 papers were collected, but only6 cross-sectional articles were selected after the screening process and manual searching. Based on the selected evidence-based literatures, statistically meaningful associations were found between tetrachloroethylene exposure and tetrachloroethylene in blood in pre- and end-of-shift, in urine at end of shift, and in exhaled air at end-of-shift. Moreover, micronucleus frequency and DNA damages between dry cleaning workers and the controls differed significantly. Conclusion: The level of tetrachloroethylene in blood, urine, and exhaled air becomes an appropriate biological exposure index for assessing tetrachloroethylene exposure in dry-cleaning workers. In Indonesia, biomonitoring that is more feasible to be implemented is micronucleus frequency evaluation from buccal mucosal epithelial smears since it is a simpler, faster, and less expensive procedure.Keywords: biological monitoring, biomonitoring, occupational exposure, tetrachloroethylene

Perchloroethylene and Dry Cleaning: It's Time to Move the Industry to Safer Alternatives

Perchloroethylene (PERC) is the most common solvent used for dry cleaning in the United States. PERC is a reproductive toxicant, neurotoxicant, potential human carcinogen, and a persistent environmental pollutant. The Environmental Protection Agency is evaluating PERC under the Frank R. Lautenberg Chemical Safety for the 21st Century Act, which amended the Toxic Substances Control Act (amended TSCA), and has mandated that PERC dry cleaning machines be removed from residential buildings. Some local and state programs are also requiring or facilitating transitions to alternative cleaning technologies. However, the potential for these alternatives to harm human health and the environment is not well-understood. This review describes the issues surrounding the use of PERC and alternative solvents for dry cleaning while highlighting the lessons learned from a local government program that transitioned PERC dry cleaners to the safest current alternative: professional wet cleaning. Implications for future public health research and policy are discussed: (1) we must move away from PERC, (2) any transition must account for the economic instability and cultural aspects of the people who work in the industry, (3) legacy contamination must be addressed even after safer alternatives are adopted, and (4) evaluations of PERC alternatives are needed to determine their implications for the long-term health and sustainability of the people who work in the industry.

4-nitrophenol exposure in T24 human bladder cancer cells promotes proliferation, motilities, and epithelial-to-mesenchymal transition

Although health hazards of 4-nitrophenol (PNP) exposure have been reported, the adverse effects of PNP exposure on cancer biological features are still unknown. We investigated the effects of administration of PNP in T24 human bladder cancer cells. The results showed that PNP exposure promoted cellular proliferation, migration and invasion, inhibited adhesion and apoptosis in vitro. Using quantitative real-time PCR, we found that (1) the mRNA expression levels of cell-cycle regulators PCNA, cyclin D1 and COX-2 were increased in PNP-treated cells compared to controls, however, that of pro-apoptotic gene Bax was decreased; (2) the expression level of EMT-associated gene E-cadherin was decreased in PNP-treated cells, whereas those of N-cadherin, vimentin, snail, and slug were increased; (3) the expression levels of cancer-promoting genes HIF-1, IL-1β, VEGFα and K-Ras were enhanced, but those of tumor suppressors p53, PTEN and BRCA were decreased. There was a positive association between PNP exposure times and the promotion effects. Finally, we found that the expression level of PPARγ (γ1 isoform) was increased in PNP-treated T24 cells. GW9662, a specific PPARγ antagonist, attenuated PNP-induced cell migration and invasion. These findings indicate that PNP exposure may promote bladder cancer growth and progression involving PPARγ signaling. PPARγ is a potential target for development of novel intervention study on environment pollution. Environ. Mol. Mutagen. 61:316-328, 2020. © 2019 Wiley Periodicals, Inc.

Intrusion of chlorinated hydrocarbons and their degradation products from contaminated soil. Measurement of indoor air quality and biomonitoring by analysis of end-exhaled air

A historic soil contamination of chlorinated hydrocarbons from a former dry cleaning shop caused intrusion of vapors into a building currently used as bookshop. The aim of this study was to determine the indoor air quality and the uptake of soil contaminants and their degradation products. Samples of indoor air were collected over one week in the warm and one week in the cold season. Pre-shift and post-shift samples of end-exhaled air were collected from two employees. Chlorinated hydrocarbons were analyzed in indoor air and exhaled air samples using thermal desorption gas chromatography mass spectrometry (TD-GC-MS). Tetrachloroethylene (PER), and its degradation products trichloroethylene (TRI), 1,1-dichloroethylene (1,1-DCE), 1,2-cis-dichloroethylene (1,2-cis-DCE), 1,2-trans-dichloroethylene (1,2-trans-DCE), methylene chloride (MC) and vinyl chloride (VC) were determined in ambient air. PER was the prime contaminant with a week average (±sd) of 805.2 ± 598.6 μg/m³ in June 2016 and 1031 ± 499.3 μg/m³ in December 2017. MC, 1,2-cis-DCE and TRI were detected at concentrations below 2.3 μg/m³. 1,1-DCE and VC were not detected. In exhaled air PER, 1,1-DCE, and MC were detected in both June and December, whereas TRI, 1,2-cis-DCE and 1,2-trans-DCE were only detected on one or two days in the cold season. VC was not detected in exhaled air. For PER, the mean concentrations (±sd) in end-exhaled air increased from a five days (Mon-Fri) average pre-shift value of 22.2 ± 8.0 to a post-shift value of 52.6 ± 15.5 ng/L in the male shop owner (p < 0.01) and in the female cashier these values were 26.0 ± 3.6 and 63.6 ± 12.7 ng/L, respectively (p < 0.01). Intrusion of chlorinated soil contaminants resulted in contamination of indoor air above the current accepted indoor air level for PER of 250 μg/m³. For PER in end-exhaled air an accumulation over the workweek was not observed.

Extended Mortality Follow-up of a Cohort of Dry Cleaners

BACKGROUND

Dry cleaning workers are commonly exposed to tetrachloroethylene, a suspected bladder carcinogen, and other organic solvents. The health risks associated with solvent exposures in this industry are unclear.

METHODS

We extended mortality follow-up of 5,369 dry cleaning union members in St. Louis to further investigate solvent-related risks. We added 22 years of follow-up, from 1993 through 2014, via linkage to the National Death Index. Using Cox proportional hazards modeling, we computed hazard ratios (HRs) and 95% confidence intervals (CIs) relating cause-specific mortality with levels of a solvent exposure index previously developed by an industrial hygienist based on workers' job titles from union records. The models were fit adjusting for age, sex, and decade of union enrollment, and assuming different exposure lags.

RESULTS

In internal analyses of estimated solvent exposure with a 20-year lag, we observed exposure-response relationships for bladder cancer (HR medium exposure = 4.2; 95% CI = 0.7, 24.5 and HR high exposure = 9.2; 95% CI = 1.1, 76.7 vs. no exposure; Ptrend = 0.08) and kidney cancer (HR = 4.1; 95% CI = 0.7, 22.5 and 24.4; 2.9, 201.6; Ptrend = 0.004). High exposure was also associated with heart disease (HR = 1.6; 95% CI = 1.1, 2.2) and lymphatic/hematopoietic malignancies (HR = 4.3; 95% CI = 1.4, 13.6).

CONCLUSIONS

These findings are, to the best of our knowledge, the first cohort evidence relating solvent exposure levels among dry cleaners to elevated risks of selected cancers and heart disease. Additional studies employing solvent-specific exposure assessment are needed to clarify cancer risks associated with tetrachloroethylene.

Selective Polymer Distributed Bragg Reflector Vapor Sensors

We report on Flory⁻Huggins photonic sensors for the selective detection of volatile organic compounds without the use of any chemical functionalization. For this purpose, we employed periodic multilayers made of inert cellulose acetate alternated to active polystyrene films whose free volume was modified with silanized ZnO nanoparticles. The simple UV-visible (UV-vis) dynamic optical response of such polymer distributed Bragg reflectors during exposure to vapors of benzene, toluene, o-dichlorobenzene, and carbon tetrachloride allows their detection and recognition based on different chemico⁻physical affinity with the active polymer medium.

Occupational variation in incidence of bladder cancer: a comparison of population-representative cohorts from Nordic countries and Canada

OBJECTIVES

The objective of this study was to compare occupational variation of the risk of bladder cancer in the Nordic countries and Canada.

METHODS

In the Nordic Occupational Cancer study (NOCCA), 73 653 bladder cancer cases were observed during follow-up of 141.6 million person-years. In the Canadian Census Health and Environment Cohort (CanCHEC), 8170 cases were observed during the follow-up of 36.7 million person-years. Standardised incidence ratios with 95% CI were estimated for 53 occupations in the NOCCA cohort and HR with 95% CIs were estimated for 42 occupations in the CanCHEC.

RESULTS

Elevated risks of bladder cancer were observed among hairdressers, printers, sales workers, plumbers, painters, miners and laundry workers. Teachers and agricultural workers had reduced risk of bladder cancer in both cohorts. Chimney-sweeps, tobacco workers and waiters had about 1.5-fold risk in the Nordic countries; no risk estimates for these categories were given from the CanCHEC cohort.

CONCLUSION

We observed different occupational patterns in risk of bladder cancer in Nordic countries and Canada. The only occupation with similarly increased risk was observed among sales workers. Differences in smoking across occupational groups may explain some, but not all, of this variation.

Bladder Cancer Incidence and Mortality: A Global Overview and Recent Trends

CONTEXT

Bladder cancer has become a common cancer globally, with an estimated 430 000 new cases diagnosed in 2012.

OBJECTIVE

We examine the most recent global bladder cancer incidence and mortality patterns and trends, the current understanding of the aetiology of the disease, and specific issues that may influence the registration and reporting of bladder cancer.

EVIDENCE ACQUISITION

Global bladder cancer incidence and mortality statistics are based on data from the International Agency for Research on Cancer and the World Health Organisation (Cancer Incidence in Five Continents, GLOBOCAN, and the World Health Organisation Mortality).

EVIDENCE SYNTHESIS

Bladder cancer ranks as the ninth most frequently-diagnosed cancer worldwide, with the highest incidence rates observed in men in Southern and Western Europe, North America, as well in certain countries in Northern Africa or Western Asia. Incidence rates are consistently lower in women than men, although sex differences varied greatly between countries. Diverging incidence trends were also observed by sex in many countries, with stabilising or declining rates in men but some increasing trends seen for women. Bladder cancer ranks 13th in terms of deaths ranks, with mortality rates decreasing particularly in the most developed countries; the exceptions are countries undergoing rapid economic transition, including in Central and South America, some central, southern, and eastern European countries, and the Baltic countries.

CONCLUSIONS

The observed patterns and trends of bladder cancer incidence worldwide appear to reflect the prevalence of tobacco smoking, although infection with Schistosoma haematobium and other risk factors are major causes in selected populations. Differences in coding and registration practices need to be considered when comparing bladder cancer statistics geographically or over time.

PATIENT SUMMARY

The main risk factor for bladder cancer is tobacco smoking. The observed patterns and trends of bladder cancer incidence worldwide appear to reflect the prevalence of tobacco smoking.

Target Organ Metabolism, Toxicity, and Mechanisms of Trichloroethylene and Perchloroethylene: Key Similarities, Differences, and Data Gaps

Trichloroethylene (TCE) and perchloroethylene or tetrachloroethylene (PCE) are high-production volume chemicals with numerous industrial applications. As a consequence of their widespread use, these chemicals are ubiquitous environmental contaminants to which the general population is commonly exposed. It is widely assumed that TCE and PCE are toxicologically similar; both are simple olefins with three (TCE) or four (PCE) chlorines. Nonetheless, despite decades of research on the adverse health effects of TCE or PCE, few studies have directly compared these two toxicants. Although the metabolic pathways are qualitatively similar, quantitative differences in the flux and yield of metabolites exist. Recent human health assessments have uncovered some overlap in target organs that are affected by exposure to TCE or PCE, and divergent species- and sex-specificity with regard to cancer and noncancer hazards. The objective of this minireview is to highlight key similarities, differences, and data gaps in target organ metabolism and mechanism of toxicity. The main anticipated outcome of this review is to encourage research to 1) directly compare the responses to TCE and PCE using more sensitive biochemical techniques and robust statistical comparisons; 2) more closely examine interindividual variability in the relationship between toxicokinetics and toxicodynamics for TCE and PCE; 3) elucidate the effect of coexposure to these two toxicants; and 4) explore new mechanisms for target organ toxicity associated with TCE and/or PCE exposure.

Modifiable risk factors for the prevention of bladder cancer: a systematic review of meta-analyses

Each year, 430,000 people are diagnosed with bladder cancer. Due to the high recurrence rate of the disease, primary prevention is paramount. Therefore, we reviewed all meta-analyses on modifiable risk factors of primary bladder cancer. PubMed, Embase and Cochrane database were systematically searched for meta-analyses on modifiable risk factors published between 1995 and 2015. When appropriate, meta-analyses (MA) were combined in meta-meta-analysis (MMA). If not, the most comprehensive MA was selected based on the number of primary studies included. Probability of causation was calculated for individual factors and a subset of lifestyle factors combined. Of 1496 articles identified, 5 were combined in MMA and 21 were most comprehensive on a single risk factor. Statistically significant associations were found for current (RR 3.14) or former (RR 1.83) cigarette smoking, pipe (RR 1.9) or cigar (RR 2.3) smoking, antioxidant supplementation (RR 1.52), obesity (RR 1.10), higher physical activity levels (RR 0.86), higher body levels of selenium (RR 0.61) and vitamin D (RR 0.75), and higher intakes of: processed meat (RR 1.22), vitamin A (RR 0.82), vitamin E (RR 0.82), folate (RR 0.84), fruit (RR 0.77), vegetables (RR 0.83), citrus fruit (RR 0.85), and cruciferous vegetables (RR 0.84). Finally, three occupations with the highest risk were tobacco workers (RR 1.72), dye workers (RR 1.58), and chimney sweeps (RR 1.53). The probability of causation for individual factors ranged from 4 to 68 %. The combined probability of causation was 81.8 %. Modification of lifestyle and occupational exposures can considerably reduce the bladder cancer burden. While smoking remains one of the key risk factors, also several diet-related and occupational factors are very relevant.

Gene-specific promoter methylation is associated with micronuclei frequency in urothelial cells from individuals exposed to organic solvents and paints

Sufficient epidemiologic evidence has established an etiologic link between bladder cancer risk and occupational exposure as a painter to organic solvents. Currently, it remains to be established whether gene-specific promoter methylation contributes to bladder cancer development, including by enhancing chromosome breakage or loss. We investigated the effect of chronic exposure to organic solvents and paints on DNA methylation profiles in the promoter regions of four genes (GSTP1, p16(INK4a), APC and CDH1) and micronucleus (MN) frequency in exfoliated urothelial cells from voided urine from Colombian male non-smoking car painters and age-matched unexposed individuals. The exposed group had a higher percentage of individuals with >2 MNs/2000 cells compared with the unexposed group (P=0.04). Gene-specific analysis showed a significantly higher percentage of individuals with methylated GSTP1, p16(INK4a) and APC in the exposed group. Poisson regression analysis indicated that exposed individuals with methylated GSTP1 and p16(INK4a) promoters were more than twofold more likely to have an increase in MN frequency as compared with the reference. Finally, among exposed individuals with GSTP1 and p16(INK4a) methylated promoters, those with a greater age had a higher RR of increased MN frequency compared with younger exposed individuals with methylated promoters. These results support the conclusion that gene-specific promoter methylation may increase MN frequency in a dependent or independent interaction with occupational exposure to organic solvents.

Levels of selected urinary metabolites of volatile organic compounds among children aged 6-11 years

Data from National Health and Nutrition Examination Survey for the years 2011-2012 were used to evaluate variability in the observed levels of 20 urinary metabolites of volatile organic compounds (VOCs) by age, gender, and race/ethnicity among children aged 6-11 years. Exposure to environmental tobacco smoke was positively associated with the levels of selected metabolites of acrylonitrile, 1,3-butadiene, cyanide, and propylene oxide in a dose-response manner. Levels of the selected metabolites of acrolein, acrylonitrile, 1,3-butadiene, styrene, toluene, and xylene decreased with increase in age. Levels of 1-bromopropane decreased with number of rooms in the house but the reverse was true for 1,3-butadiene, carbon-disulfide, and N,N-dimethylformamide. Levels of most of the 20 metabolites did not vary with gender. Non-Hispanic white children had higher adjusted levels of N-Acetyl-S-(3,4-dihydroxybutyl)-L-cysteine (DHBMA), N-Acetyl-S-(N-methylcarbamoyl)-L-cysteine (AMCC), and phenylglyoxylic acid (PGA) than non-Hispanic black children. Non-Hispanic white children had statistically significantly higher adjusted levels of N-Acetyl-S-(2-carbamoyl-2-hydroxyethyl)-L-cysteine (GAMA), trans, trans-Muconic acid (MU), and N-Acetyl-S-(N-methylcarbamoyl)-L-cysteine (AMCC) than non-Hispanic Asian children but statistically significantly lower levels of N-Acetyl-S-(n-propyl)-L-cysteine (BPMA) than non-Hispanic Asian children. Non-Hispanic Asian children had the lowest levels of 13 of the 20 metabolites among four major racial/ethnic groups but highest levels for three metabolites. For selected metabolites of acrolein, acrylamide, acrylonitrile-vinyl chloride-ethylene oxide, benzene, 1,3-butadien, crotonaldehyde, cyanide, ethylbenzene-styrene, and toluene, children had statistically significantly higher levels than nonsmoking adults. These results demonstrate how vulnerable children are to being exposed to harmful chemicals like VOCs in their own homes.

Human health effects of tetrachloroethylene: key findings and scientific issues

BACKGROUND

The U.S. Environmental Protection Agency (EPA) completed a toxicological review of tetrachloroethylene (perchloroethylene, PCE) in February 2012 in support of the Integrated Risk Information System (IRIS).

OBJECTIVES

We reviewed key findings and scientific issues regarding the human health effects of PCE described in the U.S. EPA's Toxicological Review of Tetrachloroethylene (Perchloroethylene).

METHODS

The updated assessment of PCE synthesized and characterized a substantial database of epidemiological, experimental animal, and mechanistic studies. Key scientific issues were addressed through modeling of PCE toxicokinetics, synthesis of evidence from neurological studies, and analyses of toxicokinetic, mechanistic, and other factors (tumor latency, severity, and background rate) in interpreting experimental animal cancer findings. Considerations in evaluating epidemiological studies included the quality (e.g., specificity) of the exposure assessment methods and other essential design features, and the potential for alternative explanations for observed associations (e.g., bias or confounding).

DISCUSSION

Toxicokinetic modeling aided in characterizing the complex metabolism and multiple metabolites that contribute to PCE toxicity. The exposure assessment approach-a key evaluation factor for epidemiological studies of bladder cancer, non-Hodgkin lymphoma, and multiple myeloma-provided suggestive evidence of carcinogenicity. Bioassay data provided conclusive evidence of carcinogenicity in experimental animals. Neurotoxicity was identified as a sensitive noncancer health effect, occurring at low exposures: a conclusion supported by multiple studies. Evidence was integrated from human, experimental animal, and mechanistic data sets in assessing adverse health effects of PCE.

CONCLUSIONS

PCE is likely to be carcinogenic to humans. Neurotoxicity is a sensitive adverse health effect of PCE.