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How to assess possible health effects of solvent exposure: the Perchloroethylene Pilot Project I.
Ruder AM; Butler MA; Levine AJ; Forrester CL; Taylor L
Med Lav 2002 Sep; 93(5):403
Background: Epidemiological studies consistently show increased risk for cervical cancer among women dry-cleaning workers. Over 90% of an estimated 50,000 U.S. drycleaning shops currently use perchloroethylene (PCE) as their primary dry cleaning solvent. PCE is a recognized animal carcinogen classified by the International Agency for Research on Cancer (IARC) as a probable human carcinogen. Increased risk in dry cleaners has been attributed to life-style or medical access risk factors in previous epidemiological studies of cervical cancer in solvent-exposed workers. PCE might increase the risk of cervical cancer by acting as a tumor growth promoter, or reactive PCE metabolites might interact directly with components of cervical cells to initiate tumors. Methods: The pilot project was designed to explore the feasibility of and refine the methods to be used in a full-scale study. The experimental design, review of epidemiologic studies, and sample collection success rates are presented here. Eighteen women working in dry cleaning were compared with 20 women working in industrial laundries, matched by age, race, and smoking status. Results: In the field, we succeeded in following the complex schedule of collections of environmental samples and biological specimens and in processing and distributing samples and specimens to laboratories. We collected 97% of scheduled blood specimens, 95% of gynecological specimens, 100% of four core urine specimens requested from each participant and 86% of urine specimens requested from exposed participants to analyze variability over a three-week exposure period, and sent aliquots to 15 laboratories across the United States. Over thirty biomarkers of exposure, effect, and susceptibility were analyzed. Conclusion: It was not expected with a group of this size to find significant health status differences between dry-cleaning and laundry workers. However, there were results (significantly more recent infections in dry cleaners) suggestive of an effect of PCE on health. These results, as well as the findings of multiple lifestyle risk factors, warrant a full-scale study, for which changes in study design have been suggested. A similar study design could be used to investigate a group exposed to another solvent.
Solvents; Solvent-vapors; Exposure-levels; Epidemiology; Statistical-analysis; Dry-cleaning-industry; Dry-cleaning-solvents; Cancer; Cancer-rates; Women; Reproductive-system-disorders; Biomarkers
Issue of Publication
La Medicina del Lavoro
Page last reviewed: October 26, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division