Common everyday chemical possibly linked to liver cancer
In this DML Report…
Tetrachloroethylene (PCE), a solvent used in dry cleaning and products like craft adhesives, stain removers, and stainless steel polish, evaporates into air for inhalation exposure. Dry cleaning workers face high chronic exposure from contaminated air, while general public encounters low levels from PCE residues in dry-cleaned fabrics and plastic wrapping that leach into home, car, or closet environments for days. PCE also contaminates drinking water near industrial sites or waste areas and was historically in consumer items like paint strippers and spot removers, allowing skin or lung absorption. A study from Keck Medicine at the University of Southern California, published in Liver International, analyzed National Health and Nutrition Examination Survey data from 2017-2020 involving over 1,600 U.S. adults aged 20 and older. It measured PCE in blood and assessed liver stiffness via ultrasound, finding detectable PCE in 7.4% of participants.
The study revealed PCE presence in blood is associated with over three times higher risk of significant liver scarring, or fibrosis, which can lead to liver cancer, failure, or death. A dose-response effect showed that for every unit increase in PCE levels, fibrosis risk rises more than fivefold, accounting for 27.7% of liver disease cases after adjusting for alcohol use and obesity-related factors. PCE metabolizes into byproducts like trichloroacetic acid (TCA), which disrupts liver cell function in fat and sugar processing, while others bind to glutathione and become toxic to liver and kidneys. Classified as a probable carcinogen by the International Agency for Research on Cancer, PCE is also linked to bladder cancer, multiple myeloma, and non-Hodgkin lymphoma. Higher PCE levels appear in wealthier individuals from frequent dry cleaning and in workers with prolonged exposure. Liver disease affects an estimated 80-100 million U.S. adults, with 4.5 million diagnosed, often without symptoms; hospital visits for liver conditions rose from 2018-2022, led by alcohol-related issues and cirrhosis.
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Lead author Dr. Brian P. Lee, a liver transplant specialist at Keck Medicine, noted: "This study, the first to examine the association between PCE levels in humans and significant liver fibrosis, underscores the underreported role environmental factors may play in liver health." He added: "The findings suggest that exposure to PCE may be the reason why one person develops liver disease while someone with the exact same health and demographic profile does not." Lee recommended screening for liver fibrosis in those with PCE exposure to catch issues early for potential recovery of liver function. The research highlights PCE's undetectable nature, as it cannot be smelled, seen, or tasted, emphasizing the need for awareness of environmental contributors to liver conditions.