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International Archives of Occupational and Environmental Health

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01-09-2003 | Review

Critical review of the epidemiological literature on occupational exposure to perchloroethylene and cancer

Authors: Kenneth A. Mundt, Thomas Birk, Margaret T. Burch

Published in: International Archives of Occupational and Environmental Health | Issue 7/2003

Abstract

Objectives

Of an estimated 500,000 workers in the USA potentially exposed to perchloroethylene (PCE), the largest share is employed in the dry-cleaning industry. PCE, a non-flammable solvent, has commercial applications as a chemical intermediate, metal degreaser and, since the 1950s, primary solvent in the dry-cleaning industry. The International Agency for Research on Cancer (IARC) currently finds sufficient evidence to designate PCE as carcinogenic in animals, with limited evidence in humans. With regard to occupational exposure through dry-cleaning, PCE is considered to be possibly carcinogenic to humans. This review was conducted to assess the current epidemiological literature on PCE and specific cancers.

Methods

A comprehensive search was conducted to identify all available epidemiological literature pertaining to the carcinogenic effects of PCE. Forty-four papers that provided reasonable data on up to 17 cancer sites were critically reviewed in the context of the available background literature for each cancer site and were assessed on the basis of specified methodological and scientific quality criteria.

Results

While all the epidemiological studies selected for review investigated similar exposure–health outcome relationships, there was a broad diversity of proxy measurements of exposure to PCE, as well as numerous specific cancer outcomes of interest. The widespread lack of valid exposure measurements or other adequate indicators of potential for exposure were consistent limitations. We found no evidence of an association between breast, prostate, skin or brain cancer and exposure to PCE. A relationship between PCE and cancer of the following sites was considered unlikely: oral cavity, liver, pancreas, cervix lung. Scientific evidence was inadequate for laryngeal, kidney, esophageal and bladder cancers.

Conclusions

The current epidemiological evidence does not support a conclusion that occupational exposure to PCE is a risk factor for cancer of any specific site. Priority areas in which additional data are most needed include cancers of the esophagus and bladder.

Anderson KE, Potter JD, Mack TM (1996) Pancreatic Cancer. In: Shottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention. Oxford University Press, New York, pp 725–771

Andersen A, Barlow L, Engeland A, Kjaerheim K, Lynge E, Pukkala E (1999) Work-related cancer in the Nordic countries. Scand J Work Environ Health 25 [Suppl 2]:1–116

Anttila A, Pukkala E, Sallmen M, Hernberg S, Hemminki K (1995) Cancer incidence among Finnish workers exposed to halogenated hydrocarbons. J Occup Environ Med 37:797–806PubMed

Aronson KJ, Siemiatycki J, Dewar R, Gérin M (1996) Occupational risk factors for prostate cancer: Results from a case–control study in Montréal, Québec, Canada. Am J Epidemiol 143:363–373PubMed

Asal NR, Geyer JR, Risser DR, Lee ET, Kadamani S, Cherng N (1988) Risk factors in renal cell carcinoma. II. Medical history, occupation, multivariate analysis, and conclusions. Cancer Detect Prev 13:263–279PubMed

Aupérin A, Benhamou S, Ory-Paoletti, C Flamant R (1994) Occupational risk factors for renal cell carcinoma: a case–control study. Occup Environ Med 57:426–428

Austin H, Delzell E, Grufferman S, Levine R, Morrison AS, Stolley PD, et al. (1987) Case–control study of hepatocellular carcinoma, occupation, and chemical exposures. J Occup Med 29:665–669PubMed

Austin DF, Reynolds P (1996) Laryngeal cancer. In: Shottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention. Oxford University Press, New York, pp 619–636

Band PR, Le ND, Fang R, Deschamps M, Gallagher RP, Yang P (2000) Identification of occupational cancer risks in British Columbia. A population-based case–control study of 995 incident breast cancer cases by menopausal status, controlling for confounding factors. J Occup Environ Med 42:284–310PubMed

10.

Blair A, Decoufle P, Grauman D (1979) Causes of death among laundry and dry-cleaning workers. Am J Public Health 69:508–511PubMed

11.

Blair A, Tolbert P, Thomas T, Grauman D (1986) Mortality among dry cleaners (abstract). Med Lav 77:82–83

12.

Blair A, Stewart PA, Tolbert PE, Grauman D, Moran FX, Vaught J, et al. (1990) Cancer and other causes of death among a cohort of dry cleaners. Brit J Ind Med 47:162–168

13.

Blair A, Linos A, Stewart PA, Burmeister LF, Gibson R, Everett G, et al. (1992) Comments on occupational and environmental factors in the origin of non-Hodgkin's lymphoma. Cancer Res 52 [Suppl]:5501s–5502s

14.

Blair A, Linos A, Stewart PA, Burmeister LF, Gibson R, Everett G, et al. (1993) Evaluation of risks for non-Hodgkin's lymphoma by occupation and industry exposures from a case–control study. Am J Ind Med 23:301–312PubMed

15.

Blair A, Hartge P, Stewart PA, McAdams M, Lubin J (1998) Mortality and cancer incidence of aircraft maintenance workers exposed to trichloroethylene and other organic solvents and chemicals: extended follow up. Occup Environ Med 55:161–171PubMed

16.

Blair A, Petralia S, Stewart P (2003) Extended mortality follow-up of a cohort of dry cleaners. Ann Epidemiol 13:50–56CrossRefPubMed

17.

Blot WJ, Fraumeni JF (1996) Cancers of the lung and pleura. In: Shottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention. Oxford University Press, New York, pp 637–665

18.

Blot WJ, McLaughlin JK, Devesa SS, Fraumeni JF (1996) Cancers of the oral cavity and pharynx. In: Shottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention. Oxford University Press, New York, pp 666–680

19.

Boice JD, Marano DE, Fryzek JP, Sadler CJ, McLaughlin JK (1999) Mortality among aircraft manufacturing workers. Occup Environ Med 56:581–597PubMed

20.

Bond GG, McLaren EA, Sabel FL, Bodner KM, Lipps TE, Cook RR (1990) Liver and biliary tract cancer among chemical workers. Am J Ind Med 18:19–24PubMed

21.

Brown DP, Kaplan SD (1987) Retrospective cohort mortality study of dry cleaner workers using perchloroethylene. J Occup Med 29:535–541PubMed

22.

Brownson R, Alavanja M, Chang J (1993) Occupational risk factors for lung cancer among non-smoking women: a case–control study in Missouri (United States). Cancer Causes Control 4:449–454PubMed

23.

Calabrese EJ, Kenyon EM (1991) Air toxics and risk assessment. Lewis, Chelsea, Michigan, USA

24.

Chow W-H, McLaughlin JK, Malker HSR, Linet MS, Weiner JA, Stone BJ (1995) Esophageal cancer and occupation in a cohort of Swedish men. Am J Ind Med 27:749–757PubMed

25.

Clavel J, Mandereau L, Cordier S, Le Goaster C, Hémon D, Conso F, et al. (1995) Hairy cell leukaemia, occupation, and smoking. Br J Haematol 91:154–161PubMed

26.

Clavel J, Mandereau L, Conso F, Limasset J-C, Pourmier I, Flandrin G, et al. (1998) Occupational exposure to solvents and hairy cell leukaemia. Occup Environ Med 55:59–64PubMed

27.

Delahunt B, Bethwaite PB, Nacey JN (1995) Occupational risk for renal cell carcinoma. A case–control study based on the New Zealand cancer registry. Br J Urol 75:578–582PubMed

28.

Dosemeci M, Cocco P, Chow W-H (1999) Gender differences in risk of renal cell carcinoma and occupational exposures to chlorinated aliphatic hydrocarbons. Am J Ind Med 36:54–59CrossRefPubMed

29.

Døssing M, Petersen KT, Vyberg M Olsen JH (1997) Liver cancer among employees in Denmark. Am J Ind Med 32:248–254CrossRefPubMed

30.

Ellis FH, Levitan N, Lo TCM (1991) Cancer of the esophagus. In: Holleb AI, Fink DJ, Murphy GP (eds) American Cancer Society textbook of clinical oncology. American Cancer Society, Atlanta, Georgia, USA, pp 254–262

31.

Ernster VL, Cummings SR (1991) Smoking and cancer. In: Holleb AI, Fink DJ, Murphy GP (eds) American Cancer Society textbook of clinical oncology. American Cancer Society, Atlanta, Georgia, USA, pp 107–124

32.

Fredriksson M, Bengtsson N-O, Hardell L Axelson O (1989) Colon cancer, physical activity, and occupational exposures. Cancer 63:1838–1842PubMed

33.

Gallagher RP, Bajdik CD, Fincham S, Hill GB, Keefe AR, Coldman A, et al. (1996) Chemical exposures, medical history, and risk of squamous and basal cell carcinoma of the skin. Cancer Epidemiol Biomarkers Prev 5:419–424PubMed

34.

Goldberg P, Leclerc A, Luce D, Morcet J-F, Brugère J (1997) Laryngeal and hypopharyngeal cancer and occupation: results of a case–control study. Occup Environ Med 54:477–482PubMed

35.

Greenland S, Salvan A, Wegman DH, Hallock MF Smith TJ (1994) A case–control study of cancer mortality at a transformer-assembly facility. Int Arch Occup Environ Health 66:49–54PubMed

36.

Guralnick L (1963) Mortality by occupation and cause of death among men 20 to 64 years of age: United States, 1950. Vital Statistics—Special Reports 53:95–97, 100, 103, 226–228

37.

Gusberg SB, Runowicz CD (1991) Gynecologic cancers. In: Holleb AI, Fink DJ, Murphy GP (eds) American Cancer Society textbook of clinical oncology. American Cancer Society, Atlanta, Georgia, USA, pp 481–497

38.

Hardell L, Eriksson M, Lenner P, Lundgren E (1981) Malignant lymphoma and exposure to chemicals, especially organic solvents, chlorophenols and phenoxy acids: a case–control study. Br J Cancer 43:169–176PubMed

39.

Hardell L, Bengtsson NO, Honsson U, Eriksson S, Larsson LG (1984) Aetiological aspects on primary liver cancer with special regard to alcohol, organic solvents and acute intermittent porphyria—an epidemiological investigation. Br J Cancer 50:389–397PubMed

40.

Harrington JM, Whitby H, Gray CN, Reid FJ, Aw TC, Waterhouse JA (1989) Renal disease and occupational exposure to organic solvents: a case referent approach. Br J Ind Med 46:643–650PubMed

41.

Heineman EF, Cocco P, Gomez MR, Dosemeci M, Stewart PA, Hayes RB, et al. (1994) Occupational exposure to chlorinated aliphatic hydrocarbons and risk of astrocytic brain cancer. Am J Ind Med 26:155–169PubMed

42.

Hernberg S, Korkala ML, Asikainen U, Riala R (1984) Primary liver cancer and exposure to solvents. Int Arch Occup Environ Health 54:147–153PubMed

43.

Hernberg S (1998) Inconclusive cancer epidemiology. Scand J Work Environ Health 24:161–164PubMed

44.

Hernberg S, Kauppinen T, Riala R, Korkala M-L, Asikainen U (1988) Increased risk for primary liver cancer among women exposed to solvents. Scand J Work Environ Health 14:356–365PubMed

45.

Huebner WW, Schoenberg JB, Kelsey JL, Wilcox HB, McLaughlin JK, Greenberg RS, et al. (1992) Oral and pharyngeal cancer and occupation: a case–control study. Epidemiology 3:300–309PubMed

46.

International Agency for Research on Cancer (1995) IARC monographs on the evaluation of carcinogenic risks to humans. Dry cleaning, some chlorinated solvents and other industrial chemicals. IARC Press, Lyon, France

47.

Jahn I, Ahrens W, Bruske-Hohlfeld I, Kreuzer M, Mohner M, Pohlabeln H, et al. (1999) Occupational risk factors for lung cancer in women: results of a case–control study in Germany. Am J Ind Med 36:90–100CrossRefPubMed

48.

Kaerlev L, Teglbjaerg PS, Sabroe S, Kolstad HA, Ahrens W, Eriksson M, et al. (2000) Occupation and small bowel adenocarcinoma: a European case–control study. Occup Environ Med 57:760–766CrossRefPubMed

49.

Kaplan SD (1980) Dry cleaner workers exposed to perchloroethylene—a retrospective cohort mortality study (PB81-231367). National Technical Information Service, Springfield, Virginia, USA

50.

Kreuzer M, Pohlabeln H, Ahrens W, Kreienbrock L, Bruske-Hohlfeld I, Jockel KH (1999) Occupational risk factors for lung cancer among young men. Scand J Work Environ Health 25:422–429PubMed

51.

Lin RS, Kessler II (1981) A multifactorial model for pancreatic cancer in man. JAMA 245:147–152CrossRefPubMed

52.

Linet M, Cartwright R (1996) The leukemias. In: Shottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention. Oxford University Press, New York, pp 841–892

53.

London W, McGlynn K (1996) Liver cancer. In: Shottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention. Oxford University Press, New York, pp 772–793

54.

Lynge E (1994) Danish cancer registry as a resource for occupational research. J Occup Med 36:1169–1173

55.

Lynge E, Thygesen L (1990) Primary liver cancer among women in laundry and dry-cleaning work in Denmark. Scand J Work Environ Health 16:108–112PubMed

56.

Lynge E, Cartensen B, Andersen O (1995) Primary liver cancer and renal cell carcinoma in laundry and dry-cleaning workers in Denmark. Scand J Work Environ Health 21:293–295PubMed

57.

Mabuchi K, Bross DS, Kessler II (1985) Epidemiology of cancer of the vulva. Cancer 55:1843–1848PubMed

58.

Mack TM, Peters JM, Yu MC, Hanisch R, Wright WE, Henderson BE (1985) Pancreas cancer is unrelated to the workplace in Los Angeles. Am J Ind Med 7:253–266PubMed

59.

Malker HSR, Weiner JA (1984) Cancer environment register. Examples of use of register-based epidemiology in occupational health (in Swedish). Arbete Hälsa 9:1–107

60.

Mandel JS, McLaughlin JK, Schlehofer B, Mellemgaard A, Helmert U, Lindblad P, et al. (1995) International renal-cell cancer study. IV. Occupation. Int J Cancer 61:601–605PubMed

61.

McCredie M, Stewart JH (1993) Risk factors for kidney cancer in New South Wales. IV. Occupation. Br J Ind Med 50:349–354PubMed

62.

McLaughlin JK, Lipworth L (2000) Epidemiologic aspects of renal cell cancer. Semin Oncol 27:115–123PubMed

63.

McLaughlin JK, Malker HSR, Stone BJ, Weiner JA, Malker BK, Ericsson JLE, et al. (1987) Occupational risks for renal cancer in Sweden. Br J Ind Med 44:119–123PubMed

64.

McLaughlin JK, Malker HSR, Malker BK, Stone BJ, Ericcson JLE, Blot WJ, et al. (1987) Registry-based analysis of occupational risks for primary liver cancer in Sweden. Cancer Res 47:287–291PubMed

65.

McLaughlin J, Blot W, Devesa S, Fraumeni JF (1996) Renal cancer. In: Shottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention. Oxford University Press, New York, pp 1142–1155

66.

Mellemgaard A, Engholm G, McLaughlin JK, Olsen JH (1994) Occupational risk factors for renal-cell carcinoma in Denmark. Scand J Work Environ Health 20:160–165PubMed

67.

Miligi L, Costantini AS, Crosignani P, Fontana A, Masala G, Nanni O, et al. (1999) Occupational, environmental, and life-style factors associated with the risk of hematolymphopoietic malignancies in women. Am J Ind Med 36:60–69CrossRefPubMed

68.

Morton W, Marjanovic D (1984) Leukemia incidence by occupation in the Portland–Vancouver metropolitan area. Am J Ind Med 6:185–205PubMed

69.

Muñoz N, Day N (1996) Esophageal cancer. In: Shottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention. Oxford University Press, New York, pp 681–706

70.

Muscat JE, Stellman SD, Richie JP, Jr., Wynder EL (1998) Lung cancer risk and workplace exposures in black men and women. Environ Res 76:78–84CrossRefPubMed

71.

Olsen GW, Hearn S, Cook RR, Currier MF, Allen S (1989) Mortality experience of a cohort of Louisiana chemical workers. J Occup Med 31:32–34PubMed

72.

Parent ME, Siemiatycki J, Fritschi L (2000) Workplace exposures and oesophageal cancer. Occup Environ Med 57:325–334CrossRefPubMed

73.

Parent ME, Hua Y Siemiatycki J (2000) Occupational risk factors for renal cell carcinoma in Montreal. Am J Ind Med 38:609–618CrossRefPubMed

74.

Partanen T, Heikkilä P, Hernberg S, Kauppinen T, Moneta G, Ojajärvi A (1991) Renal cell cancer and occupational exposure to chemical agents. Scand J Work Environ Health 17:231–239PubMed

75.

Pesch B, Haerting J, Ranft U, Klimpel A, Oelschlagel B, Schill W (2000) Occupational risk factors for urothelial carcinoma: agent-specific results from a case–control study in Germany. MURC Study Group. Multicenter Urothelial and Renal Cancer. Int J Epidemiol 29:238–247CrossRefPubMed

76.

Pohlabeln H, Boffetta P, Ahrens W, Merletti F, Agudo A, Benhamou E, et al. (2000) Occupational risks for lung cancer among nonsmokers. Epidemiology 11:532–538CrossRefPubMed

77.

Pukkala E (1995) Cancer risk by social class and occupation. A survey of 109,000 cancer cases among Finns of working age. In: Wahrendorf J (ed) Contributions to epidemiology and biostatistics. Karger, pp 62–77

78.

Ruder AM, Ward EM, Brown DP (1994) Cancer mortality in female and male dry-cleaning workers. J Occup Med 36:867–874PubMed

79.

Ruder AM, Ward EM, Brown DP (2001) Mortality in dry-cleaning workers: an update. Am J Ind Med 39:121–132CrossRefPubMed

80.

Schlehofer B, Heuer C, Blettner M, Niehoff D, Wahrendorf J (1995) Occupation, smoking and demographic factors, and renal cell carcinoma in Germany. Int J Epidemiol 24:51–57PubMed

81.

Schoenberg JB, Stemhagen A, Moglelnicki AP, Altman R, Abe T, Mason T (1984) Case–control study of bladder cancer in New Jersey. I. Occupational exposures in white males. J Natl Cancer Inst 72:973–981PubMed

82.

Sharpe CR, Rochon JE, Adam JM, Suissa S (1989) Case–control study of hydrocarbon exposures in patients with renal cell carcinoma. CMAJ 140:1309–1318PubMed

83.

Siemiatycki J (1991) Risk factors for cancer in the workplace. CRC Press, Boca Raton, Florida, USA

84.

Silverman DT, Hoover RN, Albert S, Graff KM (1983) Occupation and cancer of the lower urinary tract in Detroit. J Natl Cancer Inst 70:237–245PubMed

85.

Silverman DT, Levin LI, Hoover RN (1989) Occupational risks of bladder cancer in the United States: II. Nonwhite men. J Natl Cancer Inst 81:1480–1483PubMed

86.

Silverman DT, Levin LI, Hoover RN (1990) Occupational risks of bladder cancer among white women in the United States. Am J Epidemiol 132:453–461PubMed

87.

Silverman DT, Morrison AS, Devesa S (1996) Bladder cancer. In: Shottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention. Oxford University Press, New York, pp 1156–1179

88.

Smith EM, Miller ER, Woolson RF, Brown CK (1985) Bladder cancer risk among laundry workers, dry-cleaners, and other chemically related occupations. J Occup Med 27:295–297PubMed

89.

Spirtas R, A SP, S LJ, et al. (1991) Retrospective cohort mortality study of workers at an aircraft maintenance facility. I Epidemiological results. Br J Ind Med 48:515–530PubMed

90.

Stemhagen A, Slade J, Altman R, Bill J (1983) Occupational risk factors and liver cancer. A retrospective case–control study of primary liver cancer in New Jersey. Am J Epidemiol 117:443–454PubMed

91.

Stewart PA, Lee JS, Marano DE, Spirtas R, Forbes CD, Blair A (1991) Retrospective cohort mortality study of workers at an aircraft maintenance facility. II. Exposures and their assessment. Br J Ind Med 48:531–537PubMed

92.

Swanson GM, Brissette Burns P (1995) Cancer incidence among women in the workplace: a study of the association between occupation and industry and 11 cancer sites. J Occup Environ Med 37:282–287PubMed

93.

Teschke K, Morgan MS, Checkoway H, Franklin G, Spinelli JJ, van Belle G, et al. (1997) Surveillance of nasal and bladder cancer to locate sources of exposure to occupational carcinogens. Occup Environ Med 54:443–451PubMed

94.

US Environmental Protection Agency (1998) Cleaner technologies substitutes assessment: Professional fabric care processes. Environmental Protection Agency, Washington, DC, USA

95.

US Department of Health and Human Services (1997) ATSDR's toxicological profiles (book or CD-ROM). Lewis, CRC Press, Boca Raton, Florida, USA

96.

Vamvakas S, Bruning T, Thomasson B, Lammert M, Baumuller A, Bolt HM, et al. (1998) Renal cell cancer correlated with occupational exposure to trichloroethene. J Cancer Res Clin Oncol 124:374–382CrossRefPubMed

97.

Vasama-Neuvonen K, Pukkala E, Paakkulainen H, Mutanen P, Weiderpass E, Boffetta P, et al. (1999) Ovarian cancer and occupational exposures in Finland. Am J Ind Med 36:83–89CrossRefPubMed

98.

Vaughan TL, Stewart PA, Davis S, Thomas DB (1997) Work in dry cleaning and the incidence of cancer of the oral cavity, larynx, and oesophagus. Occup Environ Med 54:692–695PubMed

Title: Critical review of the epidemiological literature on occupational exposure to perchloroethylene and cancer
Authors: Kenneth A. Mundt
Thomas Birk
Margaret T. Burch
Publication date: 01-09-2003
Publisher: Springer-Verlag
Published in: International Archives of Occupational and Environmental Health / Issue 7/2003
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-003-0457-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Critical review of the epidemiological literature on occupational exposure to perchloroethylene and cancer

Abstract

Objectives

Methods

Results

Conclusions

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Abstract

Objectives

Methods

Results

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