Exposure of Danish workers to trichloroethylene, 1947-1989

Effects of Trichloroethylene on the Expression of Long Intergenic Noncoding RNAs in B6C3F1 Mouse Liver

Trichloroethylene (TCE), a widely used industrial solvent, is a common environmental contaminant. We previously reported that TCE-induced changes in DNA methylation and miRNA expression contributed to the development of a liver tumor in mice. In this study, we investigated the role of long intergenic noncoding RNA (LincRNA), another type of epigenetic modification, in TCE hepatocarcinogenesis. Male B6C3F1 mice were gavaged with TCE at dose levels of 0, 100, 500, and 1000 mg/kg b.w. for 5 days. The expression changes of LincRNAs in liver samples from control and TCE-exposed mice were screened by microarray. When compared to the control group, 21 and 29 LincRNAs were upregulated and downregulated, respectively, in the liver of mice exposed to TCE at 1000 mg/kg b.w. In addition, TCE treatment increased the expression levels of LincRNA-GM8704 but decreased the expression levels of LiverLincs_chr17_4383_2 in a dose-dependent manner. We further found that the mRNAs that are highly correlated with the expression of LiverLincs_chr17_4383_2 are involved in a number of cancer-related signaling pathways including PPARs, cell cycle, and ErbB and p53 signaling pathways. Among the expression-correlated mRNAs, Cdkn1a was found to be a downstream target gene of LiverLincs_chr17_4383_2. To follow up on that, we also found that miR-182-5p might mediate the association between downregulation of LiverLincs_chr17_4383_2 and upregulation of Cdkn1a, leading to increased cell proliferation in TCE exposed liver cells. In conclusion, TCE induced extensive LincRNA expression changes in mouse liver, and the downregulation of LiverLincs_chr17_4383_2 might contribute to TCE hepatocarcinogenesis by interacting with miR-182-5p and Cdkn1a.

Occupational variation in bladder cancer in Nordic males adjusted with approximated smoking prevalence

BACKGROUND

Occupational exposure has been identified as the most important risk factor for bladder cancer second to smoking. The objective of this study was to estimate the occupational variation in risk of bladder cancer that is not attributable to smoking.

MATERIAL AND METHODS

In the Nordic Occupational Cancer study (NOCCA), 111,458 cases of bladder cancer and 208,297 cases of lung cancer cases were observed among men in Denmark, Finland, Iceland, Norway and Sweden during 1961-2005. Relative smoking prevalence in an occupation was estimated based on standardized incidence ratio (SIR) for lung cancer in the given occupation. Crude and smoking-adjusted SIRs with 95% confidence intervals (CI) for bladder cancer were calculated for each occupation.

RESULTS

The smoking-adjusted SIR for most of the occupations was closer to 1.00 than the unadjusted SIR. The highest statistically significant smoking-adjusted SIRs were observed among chimney sweeps (SIR 1.29, 95% CI 1.05-1.56), waiters (1.22, 1.07-1.38) hairdressers (1.14, 1.02-1.26), cooks and stewards (1.12, 1.01-1.25), printers (1.11, 1.04-1.18) and seamen (1.09, 1.03-1.14).

CONCLUSIONS

Smoking is a strong risk factor for bladder cancer but there may also be other factors in some specific occupations in addition to smoking. The occupational variation in risk of bladder cancer is small when adjusted for smoking, but risk increasing factors are indicated in some occupations.

Evaluation of mortality among marines and navy personnel exposed to contaminated drinking water at USMC base Camp Lejeune: a retrospective cohort study

BACKGROUND

Two drinking water systems at U.S. Marine Corps Base Camp Lejeune, North Carolina were contaminated with solvents during 1950s-1985.

METHODS

We conducted a retrospective cohort mortality study of Marine and Naval personnel who began service during 1975-1985 and were stationed at Camp Lejeune or Camp Pendleton, California during this period. Camp Pendleton's drinking water was uncontaminated. Mortality follow-up was 1979-2008. Standardized Mortality Ratios were calculated using U.S. mortality rates as reference. We used survival analysis to compare mortality rates between Camp Lejeune (N = 154,932) and Camp Pendleton (N = 154,969) cohorts and assess effects of cumulative exposures to contaminants within the Camp Lejeune cohort. Models estimated monthly contaminant levels at residences. Confidence intervals (CIs) indicated precision of effect estimates.

RESULTS

There were 8,964 and 9,365 deaths respectively, in the Camp Lejeune and Camp Pendleton cohorts. Compared to Camp Pendleton, Camp Lejeune had elevated mortality hazard ratios (HRs) for all cancers (HR = 1.10, 95% CI: 1.00, 1.20), kidney cancer (HR = 1.35, 95% CI: 0.84, 2.16), liver cancer (HR = 1.42, 95% CI: 0.92, 2.20), esophageal cancer (HR = 1.43 95% CI: 0.85, 2.38), cervical cancer (HR = 1.33, 95% CI: 0.24, 7.32), Hodgkin lymphoma (HR = 1.47, 95% CI: 0.71, 3.06), and multiple myeloma (HR = 1.68, 95% CI: 0.76, 3.72). Within the Camp Lejeune cohort, monotonic categorical cumulative exposure trends were observed for kidney cancer and total contaminants (HR, high cumulative exposure = 1.54, 95% CI: 0.63, 3.75; log10 β = 0.06, 95% CI: -0.05, 0.17), Hodgkin lymphoma and trichloroethylene (HR, high cumulative exposure = 1.97, 95% CI: 0.55, 7.03; β = 0.00005, 95% CI: -0.00003, 0.00013) and benzene (HR, high cumulative exposure = 1.94, 95% CI: 0.54, 6.95; β = 0.00203, 95% CI: -0.00339, 0.00745). Amyotrophic Lateral Sclerosis (ALS) had HR = 2.21 (95% CI: 0.71, 6.86) at high cumulative vinyl chloride exposure but a non-monotonic exposure-response relationship (β = 0.0011, 95% CI: 0.0002, 0.0020).

CONCLUSION

The study found elevated HRs at Camp Lejeune for several causes of death including cancers of the kidney, liver, esophagus, cervix, multiple myeloma, Hodgkin lymphoma and ALS. CIs were wide for most HRs. Because <6% of the cohort had died, long-term follow-up would be necessary to comprehensively assess effects of drinking water exposures at the base.

Risk of cancer among workers exposed to trichloroethylene: analysis of three Nordic cohort studies

BACKGROUND

Trichloroethylene (TCE) is a widely used chlorinated solvent with demonstrated carcinogenicity in animal assays. Some epidemiologic studies have reported increased risk of cancer of the kidney, cervix, liver and biliary passages, non-Hodgkin lymphoma, and esophageal adenocarcinoma.

METHODS

We established a pooled cohort, including 5553 workers with individual documented exposure to TCE in Finland, Sweden, and Denmark. Study participants were monitored for the urinary TCE metabolite trichloroacetic acid from 1947 to 1989 and followed for cancer. Standardized incidence ratios (SIRs) were calculated based on cancer incidence rates in the three national populations. Cox proportionate hazard analyses were used for internal comparisons. Tests of statistical significance are two-sided.

RESULTS

Overall, 997 cases of cancer (n = 683 in men; n = 314 in women) were identified during 154 778 person-years of follow-up. We observed statistically significant elevated standardized incidence ratios for primary liver cancer (1.93; 95% confidence interval [CI] = 1.19 to 2.95) and cervical cancer (2.31; 95% CI = 1.32 to 3.75). The standardized incidence ratio for kidney cancer was 1.01 (95% CI = 0.70 to 1.42) based on 32 cases; we did not observe a statistically significant increased risk of non-Hodgkin's lymphoma (SIR = 1.26; 95% CI = 0.89 to 1.73) or esophageal adenocarcinoma (SIR = 1.84; 95% CI = 0.65 to 4.65). Tobacco- and alcohol-associated cancers were not statistically significantly increased.

CONCLUSIONS

Our results suggest TCE exposure is possibly associated with an increased risk for liver cancer. The relationship between TCE exposure and risks of cancers of low incidence and those with confounding by lifestyle and other factors not known in our cohort require further study.

A meta-analysis of occupational trichloroethylene exposure and liver cancer

OBJECTIVE

Findings from epidemiologic studies of trichloroethylene (TCE) exposure and liver cancer have been inconsistent. To quantitatively evaluate this association and to examine sources of heterogeneity, we conducted a meta-analysis of occupational studies of TCE exposure and liver/biliary tract cancer.

METHODS

We identified 14 occupational cohort studies of TCE exposed workers and one case-control study that met our inclusion criteria. Nine studies specifically identified TCE as a workplace exposure, and were classified as Group I cohort studies. Subcohorts of workers, identified within eight of these studies as more likely exposed to TCE than the total cohort, were analyzed separately.

RESULTS

The combined liver/biliary cancer summary relative risk estimate (SRRE) for all studies was 1.08 (95% CI 0.91-1.29; heterogeneity (H)-P-value=0.12). For the total study populations in the Group I cohorts, the SRRE was 1.14 (95% CI 0.93-1.39; H-P-value=0.05) and for the subcohorts, the SRRE was 1.30 (95% CI 1.09-1.55). Within this subcohort analysis, the association for the European studies of workers from various industries (SRRE=1.38; based on four studies) was higher than the association for the US studies of aerospace and aircraft workers (SRRE=0.97, based on four studies).

CONCLUSION

Although positive associations were observed for some analyses, results were inconsistent across occupational groups (aerospace/aircraft vs. other industries combined), study location, and incidence versus mortality endpoints. In addition, exposure-response trends were not observed consistently across studies. Interpretation is also limited by the potential impact of uncontrolled confounding by other occupational or lifestyle exposures such as smoking or alcohol consumption. Given these limitations, the currently available epidemiologic data are not sufficient to support a causal relation between occupational TCE exposure and liver/biliary cancer.

Uses of and exposure to trichloroethylene in U.S. industry: a systematic literature review

This article describes a systematic review of the industrial hygiene literature for uses of trichloroethylene (TCE) in industry for the exposure assessment of two population-based case control studies of brain cancer in the United States. Papers and reports that address uses of and exposures to TCE were identified from MEDLINE, TOXLINE, NIOSHTIC, the NIOSH Health Hazard Evaluation database (keywords: chlorinated solvents and trichloroethylene), and in other reviews. This search was complemented by reviewing the reference lists from the identified literature. The collected information was systematized by the Standard Industrial Classification (SIC) system, and measurement data reported in the literature were summarized in a database. TCE use was extensive from the early 1920s through the 1970s mainly as a degreasing agent in metal-fabricating operations. After the 1970s it became less popular because of environmental concerns. TCE historically has had a multitude of uses in many other industries, e.g., dry cleaning, textile, electronics, leather, and rubber. Also, many products like adhesives, drugs, paints, inks, and various industrial products have contained TCE. It was banned as a food additive and in cosmetics in 1977. The arithmetic mean (AM) of the measurements across all industries and decades was 38.2 ppm. The highest personal and area air levels were reported in vapor degreasing (AM of 44.6 ppm). Most TCE measurements were performed in the 1950s, 1970s, and 1980s. The data described here could be used by exposure assessors as is to identify the presence and approximate levels of exposure. Using the same information as a basis should increase the reliability of the assessments, making it easier to compare both the exposure assessment methods and the epidemiologic results across different studies.

Potential health effects of occupational chlorinated solvent exposure

Based on toxicology, metabolism, animal studies, and human studies, occupational exposure to chlorinated aliphatic solvents (methanes, ethanes, and ethenes) has been associated with numerous adverse health effects, including central nervous system, reproductive, liver, and kidney toxicity, and carcinogenicity. However, many of these solvents remain in active, large-volume use. This article reviews the recent occupational epidemiology literature on the most widely used solvents, methylene chloride, chloroform, trichloroethylene, and tetrachloroethylene, and discusses other chlorinated aliphatics. The impact of studies to date has been lessened because of small study size, inability to control for confounding factors, particularly smoking and mixed occupational exposures, and the lack of evidence for a solid pathway from occupational exposure to biological evidence of exposure, to precursors of health effects, and to health effects. International differences in exposure limits may provide a "natural experiment" in the coming years if countries that have lowered exposure limits subsequently experience decreased adverse health effects among exposed workers. Such decreases could provide some evidence that higher levels of adverse health effects were associated with higher levels of solvent exposure. The definitive studies, which should be prospective biomarker studies incorporating body burden of solvents as well as markers of effect, remain to be done.

Comparative metabolism and disposition of trichloroethylene in Cyp2e1-/-and wild-type mice

Trichloroethylene (TCE)1 is an important environmental contaminant, a well established rodent carcinogen, and a "probable human carcinogen". Metabolism of TCE occurs primarily via cytochrome P450 (P450)-dependent oxidation. In vitro studies suggested that CYP2E1 is the principal high-affinity enzyme responsible for TCE metabolism. The objective of the present work is to more directly assess the role of CYP2E1 in the metabolism and disposition of 1,2-14C-TCE administered at 250 or 1000 mg/kg (gavage) using Cyp2e1-/-[knockout (KO)] versus wild-type (WT) mice. After dosing, animals were individually placed in glass metabolism cages that allowed the collection of expired air, urine, and feces. Exhalation of TCE-derived 14CO2 increased in a dose-dependent manner in mice of both genotypes and was significantly higher in WT versus KO mice. A significantly greater percentage of the dose was exhaled in KO versus WT mice as organic volatiles (mainly as TCE). Urinary excretion was the major route of TCE metabolism in WT mice, and the percentage of dose eliminated in urine was significantly higher at the 250 versus 1000 mg/kg dose. Furthermore, urinary excretion and CO2 exhalation significantly decreased in KO versus WT mice. Pretreatment with 1-aminobenzotriazole clearly inhibited TCE metabolism as evident from increased exhalation of parent TCE, and decreased urinary excretion and CO2 exhalation in mice of both genotypes. In conclusion, these data showed that whereas CYP2E1 plays an important role in TCE metabolism and disposition, other P450s also play a significant role and may explain earlier results showing that TCE causes lung damage in KO and WT mice.

Occupational trichloroethylene exposure and non-Hodgkin's lymphoma: a meta-analysis and review

METHODS

Meta-analysis and review of 14 occupational cohort and four case-control studies of workers exposed to trichloroethylene (TCE) to investigate the relation between TCE exposure and the risk of non-Hodgkin's lymphoma (NHL). Studies were selected and categorised based on a priori criteria, and results from random effects meta-analyses are presented.

RESULTS

The summary relative risk estimates (SRRE) for the group of cohort studies that had more detailed information on TCE exposure was 1.29 (95% CI 1.00 to 1.66) for the total cohort and 1.59 (95% CI 1.21 to 2.08) for the seven studies that identified a specific TCE exposed sub-cohort. SRREs for three studies with cumulative exposure information were 1.8 (95% CI 0.62 to 5.26) for the lowest exposure category and 1.41 (95% CI 0.61 to 3.23) for the highest category. Comparison of SRREs by levels of TCE exposure did not indicate exposure-response trends. The remaining cohort studies that identified TCE exposure but lacked detailed exposure information had an SRRE of 0.843 (95% CI 0.72 to 0.98). Case-control studies had an SRRE of 1.39 (95% CI 0.62 to 3.10). Statistically significant findings for the Group 1 studies were driven by the results from the subgroup of multiple industry cohort studies (conducted in Europe) (SRRE = 1.86; 95% CI 1.27 to 2.71). The SRRE for single industry cohort studies was not significantly elevated (SRRE = 1.25; 95% CI 0.87 to 1.79).

CONCLUSIONS

Interpretation of overall findings is hampered by variability in results across the Group 1 studies, limited exposure assessments, lack of evidence of exposure response trends, lack of supportive information from toxicological and mechanistic data, and absence of consistent findings in epidemiologic studies of exposure and NHL. Although a modest positive association was found in the TCE sub-cohort analysis, a finding attributable to studies that included workers from multiple industries, there is insufficient evidence to suggest a causal link between TCE exposure and NHL.

A meta-analysis of occupational trichloroethylene exposure and multiple myeloma or leukaemia

BACKGROUND

Trichloroethylene (TCE) has been widely used as an industrial solvent and degreasing agent.

AIMS

We conducted a meta-analysis of epidemiologic studies of occupational TCE exposure and multiple myeloma (MM) or leukaemia.

METHODS

We identified a total of eight cohort or case-control studies that enumerated a TCE-exposed study population and presented relative risk (RR) estimates for MM (n = 7) and/or leukaemia (n = 7). The individual studies included aerospace or aircraft workers (n = 3 studies), workers from a transformer manufacturing plant (n = 1 study) and workers from numerous occupations who, based on biomonitoring or extensive industrial hygiene exposure measurements, were likely exposed to TCE (n = 4). We used random effects models to calculate summary relative risk estimates (SRRE). In addition, we examined heterogeneity across studies and the relative influence of each individual study on the overall meta-analysis.

RESULTS

No association was observed for MM (SRRE = 1.05, 95% CI: 0.80-1.38; P value for heterogeneity = 0.94) or leukaemia (SRRE = 1.11, 95% CI: 0.93-1.32; P value for heterogeneity = 0.50), based on TCE-exposed subgroup meta-analyses. Study-specific RR estimates for MM ranged between 0.57 and 1.62. RRs for leukaemia ranged between 1.05 and 1.15 in five studies, while one study reported a 2-fold increased RR and another study reported an inverse association of 0.60. All confidence intervals (CIs) for study-specific estimates included 1.0.

CONCLUSIONS

The results of this meta-analysis do not support an etiologic association between occupational TCE exposure and risk of MM or leukaemia.

From expert-based to quantitative retrospective exposure assessment at a Soderberg aluminum smelter

OBJECTIVES

Expert judgement of exposure levels is often only poorly or moderately correlated with directly measured levels. For a follow-up of a historical cohort study at a Söderberg aluminum smelter we updated an expert-based semiquantitative job exposure matrix of coal tar pitch volatiles (CTPV) to quantitative estimates of CTPV and benzo(a)pyrene (BaP).

METHODS

Mixed effects models to predict exposure for potroom operation and maintenance jobs were constructed from personal CTPV and BaP measurements. Mean exposures of jobs in non-potroom locations were directly calculated when measurements were available. Exposure estimates for jobs/time periods with no measurements were based on proportion of time spent in exposed areas compared to jobs where exposure was modeled or measured. For pre-1977, the original expert exposure assignments were calibrated using the updated 1977 estimates.

RESULTS

The rate of change in exposure levels varied by time period and was accounted for in mixed models with a linear spline time trend. Other variables significant in the models were job, potroom group and season as fixed effects, and worker as a random effect. The models for potroom operations explained 45 and 27% of the variability in the CTPV and BaP measurements, respectively. The models for maintenance jobs explained 40 and 19% of the variability in the CTPV and BaP measurements, respectively. For 1977-2000 model estimates, direct calculation of means and extrapolation from modeled/measured exposures accounted for 57, 6 and 37% of the exposed person-years, respectively.

CONCLUSIONS

The above methodology maximized the use of exposure measurements and largely replaced the original expert-based estimates. Finer discrimination between exposure levels was possible with the updated exposure assessment. The new estimates are expected to reduce exposure misclassification and help better assess the exposure-response relationships.

Reduction of occupational exposure to perchloroethylene and trichloroethylene in metal degreasing over the last 30 years: influences of technology innovation and legislation

Occupational exposure to trichloroethylene (TRIC) and perchloroethylene (PERC) in metal degreasing is analyzed by calculating airborne concentrations for a large set of possible exposure scenarios (Scenario-Based Risk Assessment, SceBRA). Different types of degreasing machines ranging from open-top machines used until the 1980s to closed-loop nonvented machines used since the 1990s are investigated; the scope of the study is Germany. Concentrations are calculated for different kinds of releases (emissions from open baths, leakage, release of contaminated air during loading and unloading) with a dynamic two-box model for the near-field and the far-field. The concentration estimates are in good agreement with measured data. The airborne concentrations are compared to maximum workplace concentrations (MAK values). The full set of scenarios shows for which situations MAK values were exceeded and how the transition to newer degreasing machines reduced the occupational exposure by more than one order of magnitude. In addition, numbers of exposed workers are estimated for different years. While more than 25,000 workers in the near-field were exposed to TRIC and PERC in 1985, the number is below 3000 since 1996, which is mainly due to technology changes, rationalization, automatization, and replacement of TRIC and PERC by nonchlorinated solvents.