Occupational solvent exposure and adult chronic lymphocytic leukemia: No risk in a population-based case-control study in four Nordic countries.

The aim of this study was to assess the effect of occupational solvent exposure on the risk of adult chronic lymphocytic leukemia (CLL). The current case-control study was nested in the Nordic Occupational Cancer Study (NOCCA) cohort. 20,615 CLL cases diagnosed in 1961-2005 in Finland, Iceland, Norway, and Sweden, and 103,075 population-based controls matched by year of birth, sex, and country were included. Occupational histories for cases and controls were obtained from census records in 1960, 1970, 1980/1981, and 1990. Exposure to selected solvents was estimated by using the NOCCA job-exposure matrix (NOCCA-JEM). Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated by using conditional logistic regression models. Overall, nonsignificant CLL risk elevations were observed for methylene chloride, perchloroethylene, and 1,1,1-trichloroethane. Compared to unexposed, significantly increased risks were observed for cumulative perchloroethylene exposure ≤13.3 ppm-years (OR = 1.85, 95% CI 1.16-2.96) and average life-time perchloroethylene exposure ≤2.5 ppm (1.61, 95% CI 1.01-2.56) among women, and cumulative methylene chloride exposure ≤12.5 ppm-years (OR = 1.19, 95% CI 1.01-1.41) and 12.5-74.8 ppm-years (OR = 1.23, 95% CI 1.01-1.51) among men in an analysis with 5 years lag-time, though without dose-response pattern. Decreased CLL risk was observed for aliphatic and alicyclic hydrocarbon solvents and toluene. This study did not support associations for solvent exposure and CLL. Observed weak associations for methylene chloride, perchloroethylene, 1,1,1-trichloroethane exposures, aliphatic and alicyclic hydrocarbons and toluene were not consistent across sexes, and showed no gradient with amount of exposure.

[1,1, 1-trichloroethane-induced chronic active hepatitis]. / Hépatite chronique active probablement induite par le 1,1, 1-trichloroéthane.

1,1, 1-trichloroéthane is derived from carbon tetrachloride and has been widely used as an industrial solvent since 1954, because of its supposed lack of toxicity. However, several cases of central nervous system toxicity and heart disorders due to intoxication by 1,1, 1-trichloroéthane have been reported. Cases of liver injury are infrequent, with less than 10 cases, unlike 1,1, 2-trichloroéthane that it replaced. We report a case of hepatotoxicity probably due to 1,1, 1-trichloroéthane exposure, characterized by an original pathologic feature of chronic active hepatitis.

Is neurotoxicity associated with environmental trichloroethylene (TCE)?

Individuals who lived near 2 electronic manufacturing plants were exposed to odorous chlorinated solvents by inhalation (directly) and by out gassing from well water. An exposure zone was defined by concentrations of trichloroethylene, 1,1,1-trichloroethane, tetrachloroethylene, and vinyl chloride in groundwater. The author adopted trichloroethylene as a "shorthand" for the exposure designation. Residents complained of impaired recall and concentration, and of dizziness; therefore, the focus of this investigation was brain functions. Neurobehavioral functions, Profile of Mood States, frequencies of 35 symptoms, and questionnaire responses provided by 236 residents from exposure zones were compared with responses provided by 161 unexposed regional referents and by 67 Phoenix residents who lived outside the exposure zone areas. Pulmonary functions were measured with spirometry. Residents of the exposure zones were compared with regional referents, and the former had significantly (p < .05) delayed simple and choice reaction times, impaired balance, delayed blink reflex latency R-1, and abnormal color discrimination. In addition, these individuals had impaired (1) cognitive functions, (2) attention and perceptual motor speed, and (3) recall. Individuals who lived in exposure zones had airway obstructions. Adverse mood state scores and frequencies of 33 of 35 symptoms were elevated. In conclusion, individuals who lived in the exposure zones had neurobehavioral impairments, reduced pulmonary functions, elevated Profile of Mood State scores, and excessive symptom frequencies.

A national survey of regional poison control centers' management of occupational exposure calls.

Regional poison control centers (PCCs) were surveyed nationally to assess their policies and practices in handling work-related exposures. A 24-item survey was mailed to the executive directors of 44 American Association of Poison Control Centers' certified PCCs nationwide. The survey also requested permission to call the PCC to conduct a blinded role-playing exercise of a case of work-related trichloroethane exposure. Responses on the management questionnaire were compared with the actual responses provided by information specialists in the role-playing exercise. Seventy-five percent of PCCs completed the survey; 43% completed the telephone role-playing exercise. Survey respondents generally overestimated what they thought was routinely done to assess work-related calls, compared with what actually occurred at the time of the work-related call in the role-playing exercise. For example, 32% indicated that their PCC asked about the activities of nearby workers, but none of the PCC staff actually did so. Eighty-nine percent of the PCC executive directors surveyed thought that their staff routinely advised callers to notify their employer about work-related exposure concerns, but this occurred in only 11% of the calls. We concluded that PCCs' responses to work-related calls are inadequate. Given the public health impact of work-related calls, PCCs should develop, implement, and monitor written protocols to better address the public health issues of workplace poisonings.

Acute lung injury after inhalation of water-proofing spray while smoking a cigarette.

A 34-year-old Japanese woman developed acute lung injury soon after inhaling a water-proofing spray which she applied onto her ski suit while smoking a cigarette at the same time. She initially demonstrated arterial hypoxemia (PaO2 = 59 mm Hg) and ground-glass opacities in both lung fields on the CT scan, which both returned to normal without any medication. Several water-proofing sprays, which are easily obtainable in Japan, contain 1,1,1-trichloroethane, liquefied petroleum gas and fluoride resin. Although these components have not been reported to be toxic to the lung yet, high concentrations of these components and/or the pyrolytic products of fluoride resin may have caused acute lung injury in this case.

Fatal inhalation of 1,1,1-trichloroethane.

A 13-year-old male was found dead in the woods subsequent to 1,1,1-trichloroethane (TCE) inhalation. Autopsy findings included tissue congestion of lung, liver and kidney. Certain precautions were taken in collecting and storing biological samples in order to prevent loss of TCE by evaporation. The availability of volatile solvents coupled with the increase of volatile substance abuse makes it easy for abusers to obtain.

MR in trichloroethane poisoning.

We present a case of acute trichloroethane intoxication caused by inhalation of typewriter correction fluid. CT and MR findings revealed lesions in the basal ganglia and cortex similar to those observed in patients with methanol and carbon monoxide poisoning.

Liver disease following occupational exposure to 1,1,1-trichloroethane: a case report.

A patient with a progressive liver disease whose job involved substantial exposure to 1,1,1-trichloroethane (TCE) was seen. A comprehensive work-up ruled out nonoccupational etiologies for his liver condition. Neither the patient's history nor his liver histology suggested alcoholic cirrhosis. Removal of the patient from exposure to TCE led to significant improvement of his impaired liver function over a 3-month period. We conclude that this was a case of occupational liver disease induced by chronic exposure to TCE. This report joins other reports concerning hepatotoxicity of TCE which is considered the least toxic among the halogenated hydrocarbon solvents.

Pregnancy outcomes in women potentially exposed to solvent-contaminated drinking water in San Jose, California.

During 1980-1981, solvents leaked from an underground storage tank of a semiconductor firm in southern Santa Clara County, California, contaminating local drinking water. The contaminated well was closed in December 1981. An epidemiologic study conducted in 1983 confirmed statistically significant excesses of adverse pregnancy outcomes in an exposed community compared with an unexposed community, but could not establish a causal connection between the leak and the adverse outcomes. This study expanded the first study; adverse pregnancy outcomes occurring in 1980-1985 were studied in two communities exposed to the contaminated drinking water and in two demographically comparable but unexposed communities. The period 1980-1981 was the time period in which the well was considered to have been contaminated and 1982-1985 was considered the postcontamination time period. Both exposed and unexposed communities were considered unexposed during the latter period (1982-1985). Out of 10,055 households surveyed, interviews were conducted with 1,105 women who reported one or more eligible pregnancies. Miscarriages and birth defects were validated by medical record review or physician reports. Although the authors again observed statistically significant excesses of spontaneous abortions and birth defects in the originally studied exposed area in 1980-1981, they observed deficits of these outcomes in the second exposed study area. Adjustment for potential confounders did not alter these findings. Analyses of pregnancy outcomes during 1981 in relation to exposure estimates based on hydrogeologic modeling of water and contaminant distribution within the exposed areas also indicated that the leak was not likely to have caused the observed excesses of adverse pregnancy outcomes in the originally studied area.

Neonatal exposure to methyl chloroform in tape remover.

Methyl chloroform (MC) is commonly used solvent found in some adhesive tape remover products used in intensive care nurseries. Since volatile substances can accumulate inside an infant incubator, we measured levels of MC following simulated use of 2 commercially available adhesive tape remover pads. Readily detectable levels of MC could be found in incubator air for several minutes. Although adult occupational neurotoxic thresholds are higher, increased toxic susceptibility of the neonate CNS indicates caution should be observed.

A case of an accidental exposure to a veterinary insecticide product formulation.

A veterinary technician while opening a package was accidentally exposed to a commercial canned product formulation containing insecticides and solvents. The patient was twice briefly treated and released as an outpatient from 2 different hospitals on the first and second day after the exposure. However, on the fourth day, as some of the symptoms (headache, nausea, vomiting, diarrhea, difficult breathing) persisted, the patient was admitted to another hospital. The patient was treated for exposure to organophosphates and solvents and was released after 13 days. The patient developed diabetes insipidus, a condition which lasted for approximately 1 year. The cause of the temporary development of diabetes insipidus is not understood. There is a need to prevent and minimize such accidental exposures in future.

Additional deaths associated with the intentional inhalation of typewriter correction fluid.

The previously published literature contains at least 27 deaths associated with the intentional concentration and inhalation of typewriter correction fluid (TCF). The solvent systems of TCF products include volatile halogenated hydrocarbons such as 1,1,1-trichloroethane and trichloroethylene. This report describes 3 additional deaths resulting from TCF abuse, including 1 case in which the addition of mustard oil to the product failed to deter abuse.

[Biochemical mechanisms of the effect of low molecular weight organochlorine aliphatic compounds on humans and animals (review)]. / Biokhimicheskie mekhanizmy deistviia nizkomolekuliarnykh khlororganicheskikh alifaticheskikh soedinenii na organizm cheloveka i zhivotnykh (obzor).

Data on the effects of 1,1,1-trichlorethane and tetrachlorethylene on human and animal organisms are reviewed. These compounds are used in industry and in homeservice. The review deals with some aspects of the action of these organic solvents at the subcellular level.