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Background: The involvement of Perchloroethylene (PCE) in the development of autoimmune diseases has been reported. However, few studies investigated immunotoxicity in PCE-exposed workers., Objective: To study changes in the oxidative stress and cytokine profile of young female dry-cleaning workers exposed to PCE., Methods: Thirty-eight exposed workers and 38 unexposed controls were recruited. All the participants were young nonsmoker females. Individual interviews were conducted by a physician. Blood samples were collected and hematological tests were performed by an automated Coulter Counter. Plasma PCE levels were determined using gas chromatography/flame ionization detection. Plasma total antioxidant capacity (TAC), Catalase (CAT), Superoxide dismutase (SOD), and Malondialdehyde (MDA) levels were measured using the colorimetric method. The levels of plasma cytokines interleukin-1β (IL-1β), IL-2, IL-4, IL-6, IL-8, tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) were measured by commercially kits., Results: The levels of plasma PCE averaged 561±96 ng/ml in the exposed group compared with 1.3±0.5 ng/ml in the controls. The hematological tests failed to find abnormalities in the exposed workers. Exposed workers presented significantly increased plasma levels of MDA, SOD and CAT. There were no significant differences between the two groups for level of plasma TAC. Significantly increased plasma IL-1β and TNF-α and decreased IL-2 and IL-8 levels were seen in the exposed workers. There were no significant differences between the two groups for IL-4, IL-6, and IFN-γ., Conclusion: PCE exposure resulted in changed cytokine profile in dry-cleaning workers, suggesting the potential immunotoxicity of PCE at low exposure levels.

Background: The laundry and dry cleaning industries are critical for maintaining cleanliness and hygiene in our daily lives. However, they have also been identified as sources of hazardous chemical exposure for workers, leading to potentially severe health implications. Despite mounting evidence that solvents like perchloroethylene and trichloroethylene are carcinogenic, they remain commonly used in the industry. Additionally, while alternative solvents are increasingly being utilized in response to indications of adverse health and environmental effects, there remains a significant gap in our understanding of the potential risks associated with exposure to these new agents., Methods: This study aims to identify gaps in the literature concerning worker exposure to contemporary toxic chemicals in the laundry and dry cleaning industry and their associated carcinogenic risks. A scoping review of peer-reviewed publications from 2012 to 2022 was conducted to achieve this objective, focusing on studies that detailed chemical exposures, sampling methods, and workers within the laundry and dry cleaning sector., Results: In this scoping review, 12 relevant papers were assessed. A majority (66%) examined perchloroethylene exposure, with one notable finding revealing that biomarkers from dry cleaners had significant micronuclei frequency and DNA damage, even when exposed to PCE at levels below occupational exposure limits. Similarly, another study supported these results, finding an increase in early DNA damage among exposed workers. Separate studies on TCE and benzene presented varied exposure levels and health risks, raising concern due to their IARC Group 1 carcinogen classification. Information on alternative solvents was limited, highlighting gaps in health outcome data, exposure guidelines, and carcinogenic classifications., Conclusion: Research on health outcomes, specifically carcinogenicity from solvent exposure in dry cleaning, is limited, with 66% of studies not monitoring health implications, particularly for emerging solvents. Further, findings indicated potential DNA damage from perchloroethylene, even below set occupational limits, emphasizing the need to reevaluate safety limits. As alternative solvents like butylal and high-flashpoint hydrocarbons become more prevalent, investigations into the effects of their exposure are necessary to safeguard workers' health. This scoping review is registered with the Open Science Framework, registration DOI: https://doi.org/10.17605/OSF.IO/Q8FR3 ., (© 2023. The Author(s).)

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 (PCE alv ), urinary concentration of PCE and of trichloroacetic acid (TCA) (PCE u and TCA u respectively), were measured as biological exposure indices. Median PCE environmental concentration in the whole sample was 10.6 mg/m 3 (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. PCE u 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). PCE alv also resulted in a high correlation (r = 0.66), while a lower correlation was found for TCA u measured at the end shift (r = 0.32). According to our results, PCE u 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.

Background: Perchloroethylene (PERC) is a widely spread cleaning solvent, used in nearly all dry-cleaning facilities. It has been declared as "probable human carcinogen" by the International Agency for Research on Cancer (IARC) due to its hazardous and toxic effects on human health. The study aimed at assessing the exposure of PERC among dry-cleaning workers at four different dry-cleaning facilities in the UAE., Methods: The four dry-cleaning facilities, using PERC in one of the cities of the UAE, were selected. Draeger perchloroethylene 10/b detector tubes along with a Draeger accuro pump were used to estimate the levels of PERC exposure in three main selected positions in each of the facilities., Results: The results showed that the second selected position had the highest amounts of PERC exposure above the international and local standards in 3 out of 4 selected facilities. The workers at position 2, who were not using any of the provided personal protective equipment, were at the highest risk of developing PERC-related health problems., Conclusion: It is important to install local exhaust ventilation systems and monitoring devices of PERC concentrations in these facilities, along with raising the awareness of workers about the health effects of PERC and the importance of using personal protective equipment (PPE) while performing their job.

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., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Objectives: Trichloroethylene, a chlorinated solvent widely used for metal degreasing, is classified by the International Agency for Research on Cancer as a kidney carcinogen. Other chlorinated solvents are suspected carcinogens, most notably the cleaning solvent perchloroethylene, although it is unclear whether they are associated with kidney cancer. We investigated kidney cancer associations with occupational exposure to 6 chlorinated solvents (trichloroethylene, perchloroethylene, 1,1,1-trichloroethane, carbon tetrachloride, chloroform, and methylene chloride) within a case-control study using detailed exposure assessment methods., Methods: Cases (n=1217) and controls (n=1235) provided information on their occupational histories and, for selected occupations, on tasks involving potential exposure to chlorinated solvents through job-specific interview modules. Using this information, an industrial hygienist assessed potential exposure to each solvent. We computed ORs and 95% CIs for different exposure metrics, with unexposed participants as the referent group., Results: 1,1,1-trichloroethane, carbon tetrachloride, chloroform, and methylene chloride were not associated with kidney cancer. Among jobs with high exposure intensity, high cumulative hours exposed to perchloroethylene was associated with increased risk, both overall (third tertile vs unexposed: OR 3.1, 95% CI 1.3 to 7.4) and after excluding participants with ≥50% exposure probability for trichloroethylene (OR 3.0, 95% CI 0.99 to 9.0). A non-significant association with high cumulative hours exposed to trichloroethylene was observed (OR 1.7, 95% CI 0.8 to 3.8)., Conclusions: In this study, high exposure to perchloroethylene was associated with kidney cancer, independent of trichloroethylene. Additional studies are needed to further investigate this finding., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

Perchloroethylene (PERC) is a compound commonly used as a solvent in dry cleaning, despite its severe health and environmental impacts. In recent times chemicals such as hydrocarbons, GreenEarth(®), acetal and liquid carbon dioxide have emerged as less damaging substitutes for PERC, and an even more sustainable water-based wet cleaning process has been developed. We employed a systematic review approach to provide a comprehensive overview of the existing research evidence in the area of sustainable and safe apparel cleaning methods and care. Our review describes traditional professional dry cleaning methods, as well as those that utilise solvents other than PERC, and their ecological attributes. In addition, the new professional wet cleaning process is discussed. Finally, we address the health hazards of the various solvents used in dry cleaning and state-of-the-art solvent residue trace analysis techniques., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Equilibrated vapor concentrations at 25°C of the tetrachloroethylene-chlorobenzene system were obtained in the presence of air to establish a method for estimating vapor concentrations in work environments where multicomponent organic solvents are used. The experimental data were correlated by introducing activity coefficients calculated by the UNIFAC (Universal Quasichemical Functional Group Activity Coefficient) model. There were four interaction parameters between groups in this solution system, and three had already been determined.However, the fourth parameter--the interaction parameter between ACCl and Cl-(C=C) groups--remains unknown. Therefore, this parameter was determined by a nonlinear least-squares method to obtain the best fit for the experimental data. The calculated values were found to be in good agreement with the experimental values.

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.

Background: Recent studies suggest that occupational exposures such as noise and organic solvents may affect blood pressure. The aim of this study was to investigate interaction of noise and mixed organic solvents on blood pressure., Methods: Four hundred seventy-one workers of a car manufacturing plant were divided into four groups: group one or G1 workers exposed to noise and mixed organic solvents in the permitted limit or control group, G3 exposed to noise only, G2 exposed to solvents only, and G4 workers exposed to noise and mixed organic solvents at higher than the permitted limit or co-exposure group. Biological interaction of two variables on hypertension was calculated using the synergistic index., Results: The workers of co-exposure group (G4), noise only group (G3), and solvents only group (G2) had significantly higher mean values of SBP and DBP than workers of control group (G1) or office workers (P < 0.05). Also logistic regression analysis showed a significant association between hypertension and exposure to noise and mixture of organic solvents. Odds ratio for hypertension in the co-exposure group and the noise only and solvents only exposed groups was 14.22, 9.43, and 4.38, respectively, compared to control group. In this study, the estimated synergism index was 1.11., Conclusions: Our results indicate that exposure to noise or a mixture of organic solvents may be associated with the prevalence of hypertension in car manufacturing company workers and co-exposure to noise and a mixture of solvents has an additive effect in this regard. Therefore appropriate preventive programs in these workers recommended., (Copyright © 2012 Wiley Periodicals, Inc.)

Perchloroethylene (PCE) is the main solvent used in the dry cleaning industry worldwide. The aim of the present work was to evaluate the genotoxic potential of occupational exposure to PCE in dry cleaning workers. The study was carried out in 59 volunteers (30 workers, 29 controls). The genotoxic effect was evaluated by analyzing chromosome aberrations (CAs), and micronuclei (MN) and DNA damage (assessed by the comet assay) in peripheral blood lymphocytes. Environmental monitoring of exposure was carried out on personal breathing zone air samples collected during two consecutive working days by measuring the concentration of PCE air levels. The mean PCE concentration in workplace air of dry cleaning workers was 31.40 mg/m(3). There were no significant differences in CA frequency between dry cleaning workers and the controls, but analysis showed a significant association of CA frequency with employment duration and frequency of exposure to PCE. The MN frequency and DNA damage detected by alkaline comet assay were significantly increased in dry cleaning workers compared to the controls. The results suggest that (a) chronic occupational exposure to dry cleaning solvents below permissible occupational exposure limit of 70 mg/m(3) (i.e., ~10.3 ppm) may lead to an increased risk of genetic damage among dry cleaning workers, and (b) CA, MN tests, and comet assay are useful to monitor populations exposed to low doses of PCE.

Background: Perchloroethylene (PCE) is the most widely used solvent in dry cleaning., Objectives: The aim was to evaluate PCE pollution and to identify the most reliable biological indicators for the assessment of workers' exposure., Methods: The study was performed in 40 dry cleaning shops covering a total of 71 subjects. Environmental monitoring was carried out with personal diffusive samplers (Radiello) for the entire work shift; biological monitoring was performed by measuring PCE in urine and blood and trichloroacetic acid (TCA) in urine on Thursday evening at end-of shift and on Friday morning pre-shift., Results: The mean concentration of PCE in air was 52.32 mg/m3, about 30% of the TLV-TWA and the mean value of the PCE inpre-shift blood samples was 0.304 mg/l, slightly more than 50% of the BEI. In dry cleaning shops employing less than 3 persons PCE in air exceeded the TLV-TWA in 7.8% of cases; the size of the shops was inversely related to pollution. Statistically significant correlations were found between PCE exposure and PCE in blood end-of-shift (r = 0.67) and pre-shift (r = 0.70), and PCE in urine end-of-shift (r = 0.68); no correlation was found between exposure and PCE in urine pre-shift and urinary TCA., Conclusions: Dry cleaning shops still register conditions of exposure and pollution by PCE, although to a lesser extent than in the past. The most reliable indicators for biological monitoring are CE in end-of-shift urine and PCE in blood both at end-of-shift and pre-shift at the end of the workweek.

Objectives: Tetrachloroethylene is the dominant solvent used in dry cleaning worldwide and many workers are potentially exposed. We report here on results of 1296 measurements of tetrachloroethylene undertaken in Nordic dry cleaning shops 1947-2001., Methods: We searched documents and files in the Nordic institutes of occupational health for air measurements of tetrachloroethylene. Repeated measurements from the same facility during a short time interval were registered only once using the time-weighted average. We registered also changes over time in occupational exposure limits (OELs) to tetrachloroethylene., Results: Only scattered measurements were available from the early years, and the exposure level seemed fairly stable up until the mid 1970s. The median exposure level was 20 p.p.m. in 1976 and decreased to 3 p.p.m. in 2000. Exposure levels in the four Nordic countries followed similar trends. In the late 1960s, the OELs varied between the Nordic countries from 30 to 100 p.p.m. Sweden was first to lower the limit, but limits gradually converged over time. At present, Denmark, Finland, and Sweden use 10 p.p.m., while Norway uses 6 p.p.m. Over time, the average observed exposure level was lower than the OEL in all countries, but in Denmark and Sweden, up to one-third of measured exposures exceeded the OEL. Overall, the stationary measurements for maintenance work showed 36 p.p.m., while the personal measurements showed 7.5 p.p.m. for dry cleaners and 6.25 p.p.m. for shop assistants., Conclusion: The Nordic data illustrate that it is possible over time to control chemical exposures even in an industry consisting of many small and scattered work places.

Perchloroethylene and trichloroethylene are two particular organochloro compounds, are often used for dry-cleaning. In the present study the excretion of urinary Perchloroethylene and trichloroethylene were evaluated as biomarkers of exposure to these compounds. The mean value of Perchloroethylene in breathing zone and the total Perchloroethylene uptake during the work shift of the three groups of dry-cleaning workers according to the capacity of the dry-cleaning machine (8, 12 and 18 kg) were 31.04, 50.87 and 120.99 mg m(-3) and 11.46, 22.6 and 41.6 μg L(-1), respectively, which were significantly greater than the occupationally nonexposed groups. A good correlation (r = 0.907) between the mean values of Perchloroethylene in breathing zone and the urinary concentrations was observed.

Perchloroethylene, the most widely used solvent in dry cleaning, is toxic to the liver, kidneys and central nervous system and may be a human carcinogen. An exposure assessment was carried out in 69 dry-cleaning shops using perchloroethylene in Tehran city, Iran. The 8-h time weighted average (TWA) breathing zone air samples and end-exhaled air samples were obtained from 179 workers who worked as the job titles included machine operator (n=71), presser (n=63) and counter area (clerk) (n=45). The mean perchloroethylene concentrations in breathing zone air were 11.5 ppm, 9.6 ppm and 7.2 ppm respectively. The mean perchloroethylene concentrations in end-exhaled air of the same participants in Saturday morning (prior to shift of workweek) were 1.7 ppm, 1.5 ppm and 1.1 ppm, but in Thursday evening (end of shift at end of workweek) were 2.4 ppm, 2.0 ppm and 1.5 ppm respectively. This study found that, the mean perchloroethylene concentrations in breathing zone air and end-exhaled air in the dry-cleaning workers were lower than the TLV (25 ppm) and BEI (5 ppm) recommended by ACGIH. Regression analysis showed that the concentration of perchloroethylene in breathing zone air (TWA) was highly and significantly correlated with the concentration of perchloroethylene in end-exhaled air in Saturday morning with a regression equation Y=0.147X + 0.031 (r=0.99, p<0.001) and also in Thursday evening with a regression equation Y=0.201X + 0.072 (r=0.98, p<0.001) where X is the concentration of perchloroethylene in breathing zone air and Y is that the concentration of perchloroethylene in end-exhaled air. The results also showed the potential utility of measuring the concentration of perchloroethylene in end-exhaled air as a method for assessing relative exposure in dry cleaning shops which use it.

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.

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.

Occupational exposure to perchloroethylene (PERC) in dry cleaning is analyzed by calculating airborne concentrations for a large set of possible exposure scenarios. Different generations of dry-cleaning machines ranging from vented machines used until the 1980s to nonvented closed-loop machines used since the 1990s are investigated; the geographical scope of the study is Germany. Concentrations are calculated for diffuse emissions, release of contaminated air during loading and unloading, and residual solvent releases from cleaned garments with a dynamic two-box model for near field and far field. The concentration estimates for near field and far field agree well with measured concentrations. The airborne concentrations are compared with maximum workplace concentrations (MAK values). The full set of scenarios shows for which historical situations the workplace concentrations were near the MAK value and that the transition to newer dry-cleaning machines reduced the occupational exposure by more than one order of magnitude. In addition, numbers of exposed workers are estimated for different years. Whereas more than 25,700 workers in the near field were exposed to PERC in 1975, the number has been below 5900 since 2001, which is due mainly to a reduced amount of garments being dry cleaned and, to a lesser extent, to replacement of PERC by nonchlorinated solvents. The results from the scenario-based analysis are consistent with exposure ranges obtained from a Monte Carlo calculation using frequency distributions of key input parameters, such as emission factors, batch times, and room volumes.

Life-Cycle Assessment (LCA) aims to assess all environmental impacts "from cradle to grave". Nevertheless, existing methods for Life-Cycle Impact Assessment (LCIA) generally do not consider impacts from chemical exposure at the workplace. This is a severe drawback, because neglecting occupational health effects may result in product or process optimizations at the expense of workers' health. We adapt an existing LCIA method to consider occupational health effects from the use of perchloroethylene (PCE) and trichloroethylene (TCE) in dry cleaning and metal degreasing. The results show that, in applications such as metal degreasing and dry cleaning, long-term (steady-state) concentrations at the workplace are up to 6 orders of magnitude higher than ambient air levels. Legal threshold values may be exceeded, depending on machine technology, size, and surrounding working conditions. The impact from workplace exposure to the total human-toxicity potential of the complete life cycle of PCE and TCE (including use, production, and disposal) is accordingly high. We therefore conclude that occupational health effects need to be considered in LCA to prevent overlooking key environmental-health impacts in LCA.

The field method for near real-time analysis of perchloroethylene (Perc) in breath is simple, fast, and reproducible for Perc breath analysis in field settings and should prove useful in industrial hygiene practice. The method allows Perc monitoring with good specificity to the sub-part per million (ppm) level within minutes of exposure. A commercially available, portable gas chromatograph with a photoionization detector was used in these analyses. Gas chromatograph settings were optimized in the laboratory for measurement of Perc in Tedlar bags. Laboratory development of the method included evaluation of the sensitivity, specificity, precision, and speed of analysis for Perc. Replicate aliquots of Perc at concentrations ranging from 0.01 to 100 ppm were used to construct a calibration curve. The mean retention time for Perc was 238 sec. The impact of potential interference by acetone, toluene, isoprene, methanol, ethanol, acetaldehyde, carbon tetrachloride, benzene, or chloroform was evaluated by mixing Perc with each compound and performing analyses. Measurements of Perc in human breath samples collected in Tedlar bags in a workplace setting were made and compared to measurements of the same samples made by an established analytical method using charcoal tubes (National Institute of Occupational Safety and Health [NIOSH] Method 1003). The accuracy, precision, and speed of the gas chromatograph method were determined. Measurements made with the new method were within a margin of +/- 8.8% (95% CI, n = 6) of measurements made according to NIOSH Method 1003 for field samples in the range of 0.9 to 6 ppm. Method precision was determined by calculating the pooled coefficient of variation for all measurements (replicates = 3) made in the field and was found to be 5.8%.

We studied the reliability of biologic indices for monitoring perchlorethylene (PCE) exposure at low environmental solvent concentrations. Environmental monitoring was performed by personal sampling, biologic monitoring by measuring PCE in alveolar air (PCE-Alv), blood (PCE-B), and urine (PCE-U) in 26 low-exposed dry-cleaners. Correlation coefficients (r) between environmental PCE and PCE-B, PCE-Alv, and PCE-U were 0.94, 0.81, and 0.67 respectively. A high correlation was also found among biologic indices: r value was 0.96 between PCE-B and PCE-Alv, 0.95 between PCE-B and PCE-U, and 0.87 between alveolar PCE-Alv and PCE-U. The examined biologic indices proved sensitive enough for biologic monitoring of low exposure to PCE and can give substantially similar information in terms of exposure evaluation. PCE-Alv offers some advantages because it correlated better with exposure and is analytically simpler.

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.

Real-time monitoring was used to evaluate the ability of engineering control devices retrofitted on two existing dry-cleaning machines to reduce worker exposures to perchloroethylene. In one dry-cleaning shop, a refrigerated condenser was installed on a machine that had a water-cooled condenser to reduce the air temperature, improve vapor recovery, and lower exposures. In a second shop, a carbon adsorber was retrofitted on a machine to adsorb residual perchloroethylene not collected by the existing refrigerated condenser to improve vapor recovery and reduce exposures. Both controls were successful at reducing the perchloroethylene exposures of the dry-cleaning machine operator. Real-time monitoring was performed to evaluate how the engineering controls affected exposures during loading and unloading the dry-cleaning machine, a task generally considered to account for the highest exposures. The real-time monitoring showed that dramatic reductions occurred in exposures during loading and unloading of the dry-cleaning machine due to the engineering controls. Peak operator exposures during loading and unloading were reduced by 60 percent in the shop that had a refrigerated condenser installed on the dry-cleaning machine and 92 percent in the shop that had a carbon adsorber installed. Although loading and unloading exposures were dramatically reduced, drops in full-shift time-weighted average (TWA) exposures were less dramatic. TWA exposures to perchloroethylene, as measured by conventional air sampling, showed smaller reductions in operator exposures of 28 percent or less. Differences between exposure results from real-time and conventional air sampling very likely resulted from other uncontrolled sources of exposure, differences in shop general ventilation before and after the control was installed, relatively small sample sizes, and experimental variability inherent in field research. Although there were some difficulties and complications with installation and maintenance of the engineering controls, this study showed that retrofitting engineering controls may be a feasible option for some dry-cleaning shop owners to reduce worker exposures to perchloroethylene. By installing retrofit controls, a dry-cleaning facility can reduce exposures, in some cases dramatically, and bring operators into compliance with the Occupational Safety and Health Administration (OSHA) peak exposure limit of 300 ppm. Retrofit engineering controls are also likely to enable many dry-cleaning workers to lower their overall personal TWA exposures to perchloroethylene.

The effectiveness of commercially available interventions for reducing workers' perchloroethylene exposures in three small dry-cleaning shops was evaluated. Depending upon machine configuration, the intervention consisted of the addition of either a refrigerated condenser or a closed-loop carbon adsorber to the existing dry-cleaning machine. These relatively inexpensive (less than $5000) engineering controls were designed to reduce perchloroethylene emissions when dry-cleaning machine doors were opened for loading or unloading. Effectiveness of the interventions was judged by comparing pre- and postintervention perchloroethylene exposures using three types of measurements in each shop: (1) full-shift, personal breathing zone, air monitoring, (2) next-morning, end-exhaled worker breath concentrations of perchloroethylene, and (3) differences in the end-exhaled breath perchloroethylene concentrations before and after opening the dry-cleaning machine door. In general, measurements supported the hypothesis that machine operators' exposures to perchloroethylene can be reduced. However, work practices, especially maintenance practices, influenced exposures more than was originally anticipated. Only owners of dry-cleaning machines in good repair, with few leaks, should consider retrofitting them, and only after consultation with their machine's manufacturer. If machines are in poor condition, a new machine or alternative technology should be considered. Shop owners and employees should never circumvent safety features on dry-cleaning machines.

Tetrachloroethylene (PCE) emissions and the exposure of workers in six commercial and three industrial dry-cleaning establishments that use dry-to-dry machines were determined. The personal samples and area samples [8-hr time-weighted average (TWA) and short-term exposure] were collected with charcoal tubes and passive monitors. The temporal variation of PCE concentration in the workplace air was monitored using a Fourier transform infrared analyzer (FTIR). The PCE emission rates were determined by multiplying the average PCE concentration in the room and the total airflow rate in the room. The PCE emissions were related to the cleaning rate in units of kg/hr. The operators' mean TWA exposure in commercial shops and industrial establishments was 28 (4.1 ppm) and 32 mg/m3 (4.6 ppm), and the pressers' exposure was 3.4 (0.5 ppm) and 7.7 mg/m3 (1.1 ppm), respectively. The customer service personnel had the lowest TWA exposure with a mean value of 0.8 mg/m3 (0.1 ppm). The highest peak concentration (2300 mg/m3; 334 ppm) was observed during cleaning of the lint and button trap, during which operation respirators were used. The PCE emission rates ranged from 4 to 118 g/hr corresponding to emission factors (mass of solvent evaporated per mass of cleaned cloths) of 0.3-3.6 g/kg. The workers' exposure to PCE was below the occupational limit values in the United States [according to the American Conference of Governmental Industrial Hygienists (ACGIH)] and in Finland. The outdoor PCE emissions were clearly below the limit values given in the European Union volatile organic compound (VOC) directive requirements.

Occupational exposure to perchloroethylene (PCE) was studied in a total of 106 workers in 78 dry cleaning shops in the province of Pavia, Northern, Italy. Environmental monitoring was performed by personal passive sampling. The median time weighted average (TWA) level of PCE was 57 mg/m3, i.e., about 30% of the current Threshold Limit Value (TLV) proposed by the American Conference of Governmental Industrial Hygienists (ACGIH). However, in 12 workers exposure exceeded this limit. Biological monitoring was performed via measurement of urinary trichloroacetic acid (TCA), i.e. the exposure index currently used in Italy, and urinary excretion of unmodified perchloroethylene (PCE-U) in samples collected at the end of the half-shift. Median levels of TCA and PCE were 1.03 mg/l and 17.7 micrograms/l respectively. The correlation coefficient between environmental TWA concentrations of perchloroethylene and PCE-U was 0.755 (0.809 after logarithmic transformation), compared to 0.660 for TCA values. The subjects were then classified as "low exposed" and "heavily exposed" according to whether personal exposure was lower or higher than 57 mg/m3, the median TWA value of the whole group. PCE-U levels were significantly correlated to exposure in both subgroups whereas TCA was correlated only in the "heavily exposed subjects", but not in those with lower exposure. The results of the study show that in the majority of dry cleaning shops exposure to PCE was well below the current occupational limits. Nevertheless surveillance of dry cleaners is recommended as nearly 10% of the workers exceeded the environmental and biological limits. Urinary excretion of unmodified PCE appears to be a very reliable indicator for biological monitoring of PCE exposure in dry cleaning and is also significantly correlated to exposure at low levels. The estimated biological equivalent exposure level (BEEL) for PCE-U, corresponding to the current TLV-TWA proposed by the ACGIH, is 55 micrograms/l. Urinary TCA seems to be less suitable for assessment of individual exposure to perchloroethylene in dry cleaners as it is poorly representative of exposure to low levels of the solvent, which is a very common occurrence in this occupational group nowadays.

Methods for monitoring personal exposure to tetrachloroethylene vapour in the dry cleaning industry have been investigated. A Draeger diffusive colorimetric gas detector tube and the Delta vapour detection system manufactured by Sabre Gas Detection were both shown to be suitable for preliminary on-site monitoring. A range of short-term pumped colorimetric tubes were also shown to perform well under a range of environmental conditions. Data on laboratory evaluations and field trials are presented.

Long-term deficits in visuospatial function and memory and disturbances in mood have been clinically identified and followed in four patients occupationally exposed to perchloroethylene (PCE). A frontal/limbic hypothesis is offered as the site of pathology. A separate study among 65 dry cleaners was conducted to provide similar evidence of impairment, suggesting a continuum between clinical and preclinical effects. Three exposure zones were identified for the counter clerks, pressers, and operators corresponding to air levels of 11.2, 23.2, and 40.8 ppm. Decrements were found for visual reproductions (14.4%), the number correct (6.7%) and the latency (10%) for pattern memory, and the number correct (3.9%) for pattern recognition. Chronic, life-long deficits appear below 50 ppm and require at least 3 years of exposure. A reexamination of the OSHA standard is recommended and shows that behavioral testing can be used as an early indicator of more serious clinical effects.

Perchloroethylene exposure in 28 dry-cleaning establishments and in 25 homes occupied by dry cleaners in Modena, Italy, was investigated. Environmental air samples and alveolar air samples from dry cleaners (n = 60) and from their family members (n = 23) were collected. The degree of perchloroethylene on the dry-cleaning premises varied widely from establishment to establishment. Spot sampling ranged from 0.6 to 75 mg/m3, whereas sampling by personal passive dosimeters ranged from 2.6 to 221.5 mg/m3 (8-h time weighted average values). Perchloroethylene in alveolar air samples collected at the end of the work day correlated closely with the 8-h time weighted average values (r = .750, p = .001), and correlated also with alveolar air samples collected at home in the evening (r = .665, p = .001) and the following morning (r = .549, p < .001). Perchloroethylene levels inside the homes of dry cleaners appeared significantly higher than in 29 houses selected as controls (Mann Whitney U test, p < .001). Perchloroethylene in alveolar air samples collected at home suggests that nonoccupational exposure to perchloroethylene for family members of dry cleaners exists.

Wallace et al. (1991a) measured elevated levels of perchloroethylene (Perc) in the homes of six dry cleaning workers who used Perc in the workplace. This paper considers the hypothesis that dry cleaning workers introduce Perc into their homes by exhaling Perc accumulated in their bodies during the work day. We simulated worker exposure considering current occupational guidelines, uptake and body burden using a physiologically-based pharmacokinetic (PBPK) model for Perc, and home concentrations using a simple model for a "typical" home. These results suggest that workers' body burdens of Perc may be sufficient to explain elevated home concentrations. The implications of these results, for design of exposure monitoring studies, are discussed, along with some other policy implications.

Large concentrations of solvents vapour were determined in occupational air. Individual monitor was effective in the assessment of personal exposure of workers to the solvents.

The purpose of this investigation was to determine the effects of perchloroethylene (PCE) exposure on human semen quality. We compared the semen quality of 34 dry cleaners with that of 48 laundry workers. We examined the relationships of 17 semen parameters to expired air levels of PCE and to an index of exposure based on job tasks in the last three months. The average sperm concentration was over 80 million for both dry cleaners and laundry workers, but approximately one-quarter of each group was oligospermic. The overall percentage of abnormal forms was similar for the two groups; however, sperm of dry cleaners were significantly more likely to be round (t = -3.29, p = 0.002) and less likely to be narrow (t = 2.35, p = 0.02) than the sperm of laundry workers. These effects were dose-related to expired air levels and to the exposure index after controlling for potential confounders (e.g., heat exposure). The average percent motile sperm for both groups was slightly over 60%; however, sperm of dry cleaners tended to swim with greater amplitude of lateral head displacement (ALH) than those of laundry workers (t = -1.73, p = 0.09), and level of PCE in expired air was a significant predictor of ALH in the multiple regression model (t = 2.00, p = 0.05). In addition, exposure index was a significant negative predictor of the sperm linearity parameter (t = -2.57, p = 0.01). These results suggest that occupational exposures to PCE can have subtle effects on sperm quality. Additional analyses are required to determine whether these effects are associated with changes in fertility.

Perchloroethylene (PCE) is a widely used dry cleaning and degreasing solvent. Although there is evidence in animals and humans for renal effects at extremely high doses, there are few studies of its potential renal toxicity at typical occupational concentrations. This study reports on the relationship of PCE in breath and estimates of chronic exposure with the urinary ratios of total urinary protein, albumin, and n-acetyl-glucosaminidase (NAG) to creatinine in dry cleaning workers exposed to PCE. Regression models including one or more exposure variables, demographic variables, mean arterial blood pressure (MAP), and the presence of diseases affecting kidney function were examined. Urine samples, breath samples, exposure histories, and medical histories were obtained from 192 dry cleaning workers. The results failed to demonstrate any consistent relationship between exposure and renal outcome variables. However, protein/creatinine and albumin/creatinine were significantly, although weakly and positively, associated with MAP; NAG/creatinine was weakly but significantly positively associated with age; mean NAG/creatinine was also higher in non-whites. The reasons why an association between exposure and renal outcome was not found are discussed.

In order to understand the health effects of tetrachloroethylene (TCE) on dry cleaning workers, we surveyed personal exposure to TCE and TCE levels in man. Personal TCE exposure levels ranged from 0.6 to 100.8 ppm (time weighted average, TWA) and in winter the values were 1.1-11 times higher than that in summer. TCE levels in expired air ranged from 0.3 to 87 ppm, in blood from 0.01 to 0.73 micrograms/g, and total trichlorinated compounds (TTC) levels in urine ranged from 0.06 to 1.92 mg/dl. Correlation was highly significant between TCE concentration in blood and TTC concentration in urine (r = 0.927, p less than 0.01), and between concentration of personal exposure to TCE and TTC concentration in urine (r = 0.815, p less than 0.01). Following a three day holiday (non-exposure duration, 90 hr) TCE level in blood decreased from 0.05 to 0.006 micrograms/g, in expired air from 1.0 to 0.3 ppm and in TTC level in urine from 0.24 to 0.08 mg/dl respectively.