Exposure to perchloroethylene (PCE) occurs in a number of occupational settings in which organic solvents are used, and, in particular, is widely prevalent in the dry-cleaning industry. This review summarizes the results of studies of the occurrence of the individual types of cancer in dry cleaners. Two of those cancers of greatest a priori concern (because of results in PCE-exposed experimental animals)-liver cancer and leukemia-have not occurred with increased frequency among persons employed in the dry-cleaning industry. Rates were elevated by about a factor of two for esophageal and bladder cancers, but not increased clearly for any other site. The excess mortality from esophageal cancer was well beyond the limits of chance, based on a total of 23 deaths that occurred in the two principal cohort-studies of dry cleaners. There was some indication of a particularly high risk associated with prolonged employment and a long interval since first employment. However, the possible confounding effect of the combination of cigarette smoking and heavy alcohol consumption, a very strong risk factor for the development of esophageal cancer, could be taken into account only partially in these studies. With regard to bladder cancer, the limited data available suggest that the observed increased risk could be due to exposure to other solvents than PCE used in dry cleaning. The potential influence of occupational exposure to PCE on the occurrence of esophageal and bladder cancer needs continued examination in further follow-up of existing cohorts of dry cleaners, the assembly of additional cohorts, and in large case-control studies that ascertain occupational exposures in some detail.
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References
Ruder AM, Ward EM, Brown DP. Cancer mortality in female and male dry-cleaning workers. J Occup Med 1994; 36: 867–74.
US National Cancer Institute. Bioassay of Tetrachloroethylene for Possible Carcinogenicity. Research Triangle Park, NC (USA): NCI, 1977; TR13.
US National Toxicology Program. Toxicology and Carcinogenesis Tetrachloroethylene (Perchloroethylene) in F344/N Rats and B6C3F1 Mice (Inhalation Studies). Research Triangle Park, NC (USA): NTP, 1986; NTPTR 311.
UK Health and Safety Executive. Toxicity Review N17, Tetrachloroethylene (Perchloroethylene). London, UK: HMSO, 1987.
International Agency for Research on Cancer. Overall Evaluations of Carcinogenicity; an Updating of IARC Monographs. Lyon, France: IARC, 1987; IARC Monogr Eval Carcinog Risks Humans, Vols 1–42.
Blair A, Stewart PA, Tolbert PE, et al. Cancer and other causes of death among a cohort of dry cleaners. Brit J Ind Med 1990; 47: 162–8.
Katz RM, Jowett D. Female laundry and dry cleaning workers in Wisconsin: a mortality analysis. Am J Public Health 1981; 71: 305–7.
Nakamura K. Mortality patterns among cleaning workers. Jpn J Ind Health 1985; 27: 24–37.
Duh R, Asal NR. Mortality among laundry and dry cleaning workers in Oklahoma. Am J Public Health 1984; 74: 1278–80.
Blair A, Decoufle P, Grauman DJ. Causes of death among laundry and dry cleaning workers. Am J Public Health 1979; 69: 508–11.
Lynge E, Thygesen L. Primary liver cancer among women in laundry and dry-cleaning work in Denmark. Scand J Work Environ Health 1990; 16: 108–12.
Aschengrau A, Ozonoff D, Paulu C, et al. Cancer risk and tetrachloroethylene (PCE) contaminated drinking water in Massachusetts. Arch Env Health 1993; 48: 284–92.
Brown DP, Kaplan SD. Retrospective cohort mortality study of dry cleaner workers using perchloroethylene. J Occup Med 1987; 29: 535–41.
Percy C, Stanek E, Gloeckler L. Accuracy of cancer death certificates and its effect on cancer mortality statistics. Am J Public Health 1981; 71: 242–50.
Slemiatycki J, Wacholder S, Dewar R, Cardis E, Greenwood C, Richardson L. Degree of confounding bias related to smoking, ethnic group, and socioeconomic status in estimates of the associations between occupation and cancer. J Occup Med 1988; 30: 617–25.
Sternhagen A, Slade J, Altman R, Bill J. Occupational risk factors and liver cancer. Am J Epidemiol 1983; 177: 443–54.
McLaughlin JK, Malker HSR, Stone BJ, et al. Occupational risks for renal cancer in Sweden. Brit J Ind Med 1987; 44: 119–23.
McCredie M, Stewart JH. Risk factors for kidney cancer in New South Wales. IV. Occupation. Brit J Ind Med 1993; 50: 349–54.
Mellemgaard A, Enghold G, McLaughlin JK, Olsen JH. Occupational risk factors for renal-cell carcinoma in Denmark. Scand J Work Environ Health 1994; 20: 160–5.
Sharpe CR, Rochon JE, Adam JM, Suissa S. Case-control study of hydrocarbon exposures in patients with renal cell carcinoma. CMAJ 1989; 140: 1309–18.
Silverman DT, Levin LI, Hoover RN. Occupational risks of bladder cancer in the United States: II. Nonwhite men. JNCI 1989; 81: 1480–3.
Smith EM, Miller ER, Woolson RF, Brown CK. Bladder cancer risk among laundry workers, dry cleaners, and others in chemically-related occupations. J Occup Med 1985; 27: 295–7.
Schoenberg JB, Stemhagen A, Mogielnicki AP, Altman R, Abe T, Mason TJ. Case-control study of bladder cancer in New Jersey. 1. Occupational exposures in white males. JNCI 1984; 72: 973–81.
Silverman DT, Hoover RN, Albert S, Graff KM. Occupation and cancer of the lower urinary tract in Detroit. JNCI 1983; 70: 237–45.
Spirtas R, Stewart PA, Lee JS, et al. Retrospective cohort mortality study of workers at an aircraft maintenance facility. I. Epidemiological results. Brit J Ind Med 1991; 48 515–30.
Odum J, Green T, Foster JR, Next PM. The role of trichloroacetic acid peroxisome proliferation in the differences in carcinogenicity of perchloroethylene in the mouse and rat. Toxicol Appl Pharmacol 1988; 92: 103–112.
Herren-Freund SL, Pereira MA, Olson G. The carcinogenicity of trichloroethylene and its metabolites, trichloroacetic acid and dichloroacetic, in mouse liver. Toxicol Appl. Pharmacol 1987; 90: 183–9.
Elcombe CR. Species differences in carcinogenicity and peroxisome proliferation due to trichloroethylene: A biochemical human hazard assessment. Arch Toxicol 1985; Suppl 8: 6–17.
Green T, Odum J, Nash JA, Foster JR. Perchloroethylene-induced rat kidney tumors: an investigation of the mechanisms involved and their relevance to humans. Toxicol Appl Pharmacol 1990; 103: 77–89.
European Chemical Industry Ecology and Toxicology Centre. Tetrachlorethylene: Assessment of Human Carcinogenic Hazard. Brussels, Belgium: ECETOC, May 1990; Technical Report Number 37.
Sterling TD, Weinkam JJ. Smoking characteristics by type of employment. J Occup Med 1976; 18: 743–54.
Pottern LN, Morris LE, Blot WJ, Ziegler RG, Fraumeni JFJr. Esophageal cancer among black men in Washington, D.C. 1. Alcohol, tobacco, and other risk factors. JNCI 1981; 67: 777–83.
Yu MC, Garabrant DH, Peters JM, Mack TM. Tobacco, alcohol, diet, occupations, and carcinoma of the esophagus. Cancer Res 1988; 48: 3843–8.
International Agency for Research on Cancer. Preamble. Lyon, France: IARC, 1994; IARC Monogr Eval Carcinog Risk Humans: 22.
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Dr Weiss is with the University of Washington and the Fred Hutchinson Cancer Research Center, Seattle, WA. Address correspondence to Dr Weiss, University of Washington, Department of Epidemiology, SC36 Seattle, WA 98195, USA. This work was supported by the Halogenated Solvents Industry Alliance.
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Weiss, N.S. Cancer in relation to occupational exposure to perchloroethylene. Cancer Causes Control 6, 257–266 (1995). https://doi.org/10.1007/BF00051797
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DOI: https://doi.org/10.1007/BF00051797