Tetrachloroethylene Exposure and Primary Liver Cancer

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In the 1960s Tetrachloroethylene (TCE), also known as perchloroethylene, became the organic solvent of choice for dry cleaners1. Approximately half of the TCE produced in the United States (US) in 1990 was used for dry cleaning and in Nordic countries, TCE use reached its peak around 1970 when it was the primary dry cleaning solvent1,2. The National Institute for Occupational Safety and Health (NIOSH) estimated that in the early 1980s about 500,000 dry cleaners may have been exposed to TCE3. From the early 1970s to the 1980s primary liver cancer incidence increased in several countries4. Over the years, the association between TCE and liver cancer has been inconsistent among human epidemiologic studies with associations seen among animal experiments4. Motivated by the inconsistencies in previous literature and animal experiment evidence this paper reviews published epidemiologic studies presenting results on Tetrachloroethylene exposure and human liver cancer.
Results
Two case-control 4,5, two nested case-control2,6 and two cohort1,7 studies reported estimates for the association between Tetrachloroethylene (TCE) exposure and primary liver cancer. A non-significant association was found between occupational solvent exposure and primary liver cancer among one case-control study, while the other observed a significant association. Hemberg et al. found the odds ratio (OR) for heavy/moderate exposure compared with little/no exposure was 2.3 (95% CI: 0.8, 7.0). The association was confined to women (exact Fisher’s chi-square p=0.007) with the men having a non-significant odds ratio of 0.5. Stemhagen et al. found that among men, the OR for working laundry or dry cleaning compared to not working in that occupation was 2.50 (95% CI: 1.02,...

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...tal Health Perspectives. 2006;114(2):213-219.
3. NIOSH. National Occupational Exposure Survey (1981-1983). Cincinnati, OH1994.
4. Hernberg S, Korkala ML, Asikainen U, Riala R. Primary liver cancer and exposure to solvents. International archives of occupational and environmental health. 1984;54(2):147-153.
5. Stemhagen A, Slade J, Altman R, Bill J. Occupational risk factors and liver cancer. A retrospective case-control study of primary liver cancer in New Jersey. American journal of epidemiology. Apr 1983;117(4):443-454.
6. Lynge E, Carstensen B, Andersen O. Primary liver cancer and renal cell carcinoma in laundry and dry-cleaning workers in Denmark. Scandinavian journal of work, environment & health. Aug 1995;21(4):293-295.
7. Ruder AM, Ward EM, Brown DP. Mortality in dry-cleaning workers: an update. American journal of industrial medicine. Feb 2001;39(2):121-132.

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