Trichloroethylene causes generalized hypersensitivity skin disorders complicated by hepatitis

Area of Science:

• Occupational Health
• Toxicology
• Dermatology

Background:

• Workers exposed to trichloroethylene (TCE) in China develop skin disorders and hepatitis.
• The cause of these hypersensitivity reactions, whether TCE itself or its impurities, has been debated.

Purpose of the Study:

• To investigate the exposure levels of hospitalized patients with TCE-related disorders and their healthy colleagues.
• To determine if TCE itself is the causative agent for these hypersensitivity reactions.

Main Methods:

• Urine samples from 19 patients were analyzed for TCE metabolites, specifically trichloroacetic acid (TCA).
• On-site surveys were conducted in factories with and without reported disorders to assess worker exposure.
• TCE and its impurities in the factories were analyzed.

Main Results:

• All patients had detectable urinary TCA, with an average end-of-shift concentration of 206 mg/l.
• Healthy exposed workers showed maximum urinary TCA concentrations of 318-1,617 mg/l and TCE exposure of 164-2,330 mg/m(3).
• No common TCE impurities were identified, suggesting TCE is the direct cause.

Conclusions:

• Trichloroethylene (TCE) itself is likely the cause of idiosyncratic skin disorders and hepatitis in exposed workers.
• High TCE metabolite accumulation, potentially due to long working hours, correlates with disorder occurrence.
• Urinary TCA levels should be controlled below 50 mg/l to mitigate occupational disease risk.