Perchloroethylene in Alveolar Air, Blood, and Urine as Biologic Indices of Low-Level Exposure

Evaluation of Occupational Exposure to Perchlorethylene in a Group of Italian Dry Cleaners Using Noninvasive Exposure Indices

Recent data suggest a general trend in decreased occupational exposure to perchlorethylene (PCE) in the dry-cleaning sector. The aims of this study were to confirm this trend to lower exposure levels in a group of Italian dry cleaners and to evaluate the current occupational PCE exposure in these works using noninvasive biological indices. Environmental exposure was assessed by personal sampling in 60 operators working in 21 dry cleaning shops in North Italy. PCE in the exhaled alveolar air (PCEalv), urinary concentration of PCE and of trichloroacetic acid (TCA) (PCEu and TCAu respectively), were measured as biological exposure indices. Median PCE environmental concentration in the whole sample was 10.6 mg/m3 (i.e., less than the 25% of the levels measured in the same area in a previous study). All values were less than 10% of the occupational limits. PCEu measured in samples collected at the end of the work shift resulted the biological markers having the strongest correlation with environmental PCE (r = 0.81). PCEalv also resulted in a high correlation (r = 0.66), while a lower correlation was found for TCAu measured at the end shift (r = 0.32). According to our results, PCEu can be proposed as a valid, noninvasive, and easily reliable exposure index to evaluate PCE exposure at the low levels currently observed in dry cleaners, therefore representing a promising alternative to invasive blood sample collections needed to determine PCE blood concentration.

Use of exhaled air as an improved biomonitoring method to assess perchloroethylene short-term exposure

This paper shows the use of exhaled air as a biomonitoring method to assess perchloroethylene (PERC) environmental and occupational exposure. A sensitive, fast, and solvent free analytical method was developed to determine PERC in ambient and exhaled air of individuals occupationally exposed. The developed method used cold fiber solid phase microextraction (CF-SPME) as the sampling technique, and a standard permeation method to simulation of air matrix. The analysis were conducted by gas chromatography coupled to mass spectrometry (GC/MS). The methods were validated and were found to be precise, linear and sensitive for environmental and biological monitoring. The developed methods were applied to twenty-seven sampling points spread across Belo Horizonte city, Brazil, twenty four dry cleaners, an electroplating industry, a research laboratory, and an automotive paint preparation shop. The results of ambient air analyses ranging from 14.0 to 3205.0µgm^-3 with median concentration of 599.0µgm^-3. Furthermore, sampling of exhaled air of individuals occupationally exposed presented results ranging from 6.0 to 2635.0µgm^-3 with median concentration of 325.0µgm^-3. The strong correlation observed between ambient and exhaled air (r =0.930) demonstrates that exhaled air is a suitable biomarker for evaluating occupational exposure to PERC.

Assessment of Exposure to Perchloroethylene and its Clinical Repercussions for 50 Dry-Cleaning Employees

The purpose of this article is the assessment of occupational exposure to perchloroethylene (PCE) and its clinical repercussions for dry-cleaning employees. The authors measured atmospheric levels of PCE and blood levels in a population of 50 exposed employees then conducted a study of clinical symptomatology in exposed and non-exposed subjects linked with this solvent. Fifty employees and 95 controls were studied. The median value of atmospheric PCE was 7 ppm (0.22-33), and the median blood level of PCE was 73.6 μg/l (11.8-144). These levels were correlated statistically to the action of sludge scraping and to the existence of automatic scrapers (p < 0.01). Eight percent of PCE blood levels were higher than the biological levels recently set in France. The exposed population did not show excessive signs of drowsiness nor of pre-narcotic syndrome or other symptoms studied. Dry-cleaning employees were exposed to PCE at atmospheric levels lower than the French and American chronic recommended exposure levels but some results were higher than recommended values. For PCE blood levels for the general working population, results were respectively lower than French and American national recommended levels in 92% and 94% cases. Risk should be considered, however, carefully in women of childbearing age, as 64% exceeded the recommended blood levels for pregnant women. This exposure did not generate any studied neurobehavioral symptomatology.

Socioeconomic disparities in indoor air, breath, and blood perchloroethylene level among adult and child residents of buildings with or without a dry cleaner

In many cities, dry cleaners using perchloroethylene are frequently located in multifamily residential buildings and often cause elevated indoor air levels of perchloroethylene throughout the building. To assess individual perchloroethylene exposures associated with co-located dry cleaners, we measured perchloroethylene in residential indoor air, and in blood and breath of adults and children residing in buildings with a dry cleaner as part of the New York City (NYC) Perc Project. We also measured perchloroethylene in indoor air, and in blood and breath of residents of buildings without a dry cleaner for comparison. Here, we evaluate whether an environmental disparity in perchloroethylene exposures is present. Study participants are stratified by residential building type (dry cleaner or reference) and socioeconomic characteristics (race/ethnicity and income); measures of perchloroethylene exposure are examined; and, the influence of stratified variables and other factors on perchloroethylene exposure is assessed using multivariate regression. All measures of perchloroethylene exposure for residents of buildings with a dry cleaner indicated a socioeconomic disparity. Mean indoor air perchloroethylene levels were about five times higher in minority (82.5 ug/m(3)) than in non-minority (16.5 ug/m(3)) households, and about six times higher in low-income (105.5 ug/m(3)) than in high income (17.8 ug/m(3)) households. Mean blood perchloroethylene levels in minority children (0.27 ng/mL) and adults (0.46 ng/mL) were about two and three times higher than in non-minority children (0.12 ng/mL) and adults (0.15 ng/mL), respectively. Mean blood perchloroethylene levels in low income children (0.34 ng/mL) and adults (0.62 ng/mL) were about three and four times higher than in high income children (0.11 ng/mL) and adults (0.14 ng/mL), respectively. A less marked socioeconomic disparity was observed in perchloroethylene breath levels with minority and low income residents having slightly higher levels than non-minority and high income residents. Multivariate regression affirmed that indoor air perchloroethylene level in dry cleaner buildings was the single most important factor determining perchloroethylene in blood and breath. Neither age, gender, nor socioeconomic status significantly influenced perchloroethylene levels in breath or blood. We previously reported that increased indoor air, breath, and blood perchloroethylene levels among NYC Perc Project child participants were associated with an increased risk for slightly altered vision. Thus, the disproportionately elevated perchloroethylene exposures of minority and low-income child residents of buildings with a dry cleaner shown here constitutes an environmental exposure disparity with potential public health consequences. Among residents of buildings without a dry cleaner, we observed some small increases in perchloroethylene breath and blood levels among non-minority or high income residents compared to minority or low income residents. These differences were not attributable to differences in indoor air levels of perchloroethylene which did not differ across socioeconomic categories, but appear to be associated with more frequent exposures dry cleaned garments.

Visual contrast sensitivity in children exposed to tetrachloroethylene

This study examined relationships between indoor air, breath, and blood tetrachloroethylene (perc) levels and visual contrast sensitivity (VCS) among adult and child residents of buildings with or without a colocated dry cleaner using perc. Decreasing trends in proportions of adults or children with maximum VCS scores indicated decreased VCS at a single spatial frequency (12 cycles per degree [cpd]) among children residing in buildings with colocated dry cleaners when indoor air perc level averaged 336 μg/m³; breath perc level averaged 159.5 μg/m³; and blood perc level averaged 0.51 μg/L. Adjusted logistic regression indicated that increases in indoor air, breath, and blood perc levels among all child participants significantly increased the odds for decreased VCS at 12 cpd. Adult VCS was not significantly decreased by increasing indoor air, breath, or blood perc level. These results suggest that elevated residential perc exposures may alter children's VCS, a possible subclinical central nervous system effect.

Systematic literature review of uses and levels of occupational exposure to tetrachloroethylene

Tetrachloroethylene has been one of the most widely used chlorinated solvents in the United States. This review provides a basis for tetrachloroethylene exposure assessment in population-based case-control studies. We performed literature searches in MEDLINE, TOXLINE, NIOSHTIC, and the NIOSH Health Hazard Evaluation databases using relevant search terms. We calculated weighted arithmetic means from the measurement data and compiled these into three summary tables by type of operation: (1) dry cleaning, (2) degreasing, and (3) other operations. We identified 258 relevant documents, of which 179 (69%) contained useful descriptive information. Within the dry cleaning industry, the overall arithmetic mean (AM) for personal tetrachloroethylene exposures was 59 ppm (range: 0-4636, n = 1395). Machine operators who transferred wet garments to a dryer had the highest levels (AM = 150 ppm [range: 0-1000, n = 441]) of the jobs in this industry. The AM for personal measurements associated with degreasing was 95 ppm (range: 0-1800, n = 206). In addition, we identified several other sources of substantial tetrachloroethylene exposure, including cleaning mining equipment, testing coal, cleaning animal coats in taxidermy, and cleaning and duplicating film. Exposure assessment in population-based, case-control studies is a complex process requiring substantial resources. Researchers conducting these types of studies will be able to use results of the measurements to quantify tetrachloroethylene exposure levels for various jobs.

Biological exposure assessment to tetrachloroethylene for workers in the dry cleaning industry

BACKGROUND

The purpose of this study was to assess the feasibility of conducting biological tetrachloroethylene (perchloroethylene, PCE) exposure assessments of dry cleaning employees in conjunction with evaluation of possible PCE health effects.

METHODS

Eighteen women from four dry cleaning facilities in southwestern Ohio were monitored in a pilot study of workers with PCE exposure. Personal breathing zone samples were collected from each employee on two consecutive work days. Biological monitoring included a single measurement of PCE in blood and multiple measurements of pre- and post-shift PCE in exhaled breath and trichloroacetic acid (TCA) in urine.

RESULTS

Post-shift PCE in exhaled breath gradually increased throughout the work week. Statistically significant correlations were observed among the exposure indices. Decreases in PCE in exhaled breath and TCA in urine were observed after two days without exposure to PCE. A mixed-effects model identified statistically significant associations between PCE in exhaled breath and airborne PCE time weighted average (TWA) after adjusting for a random participant effect and fixed effects of time and body mass index.

CONCLUSION

Although comprehensive, our sampling strategy was challenging to implement due to fluctuating work schedules and the number (pre- and post-shift on three consecutive days) and multiplicity (air, blood, exhaled breath, and urine) of samples collected. PCE in blood is the preferred biological index to monitor exposures, but may make recruitment difficult. PCE TWA sampling is an appropriate surrogate, although more field intensive. Repeated measures of exposure and mixed-effects modeling may be required for future studies due to high within-subject variability. Workers should be monitored over a long enough period of time to allow the use of a lag term.

Gases and organic solvents in urine as biomarkers of occupational exposure: a review

A brief review of urine analysis in studies of occupational exposure to volatile organic compounds and gases is provided. Analysis of exhaled breath for volatile compounds does not have a long history in occupational medicine. A number of studies has been undertaken since the 1980s, and the methods are well enough accepted to be put forward as biological equivalents of threshold limit values (TLVs) for some volatile organic compounds (VOCs) such as acetone; methanol; methyl ethyl ketone (MEK); methyl isobutyl ketone (MIBK); tetrahydrofurane; dichloromethane. In the last 20 years many scientific articles have shown that the urinary concentrations of unchanged solvents are correlated with environmental exposure and could be used for biological monitoring. The use of urine analysis of unchanged solvents in occupational applications is not yet widespread. Nonetheless, in the short time since its application, a number of important discoveries has been made, and the future appears bright for this branch of analysis. In this paper, the basic concepts and methodology of urine analysis are briefly presented with a critical revision of the literature on this matter. The excretion mechanisms of organic solvents in urine are discussed, with regard to biological variability, and the future directions of research are described.