title: Mortality and end-stage renal disease incidence among dry cleaning workers.
abstract: OBJECTIVE
  Perchloroethylene (PCE) is a known animal carcinogen and probable human carcinogen. Dry cleaning exposures, particularly PCE, are also associated with renal toxicity. The objective was to follow-up a cohort of dry cleaners to evaluate mortality and assess end-stage renal disease (ESRD) morbidity.
  
  
  METHODS
  This study adds 8 years of mortality follow-up for 1704 dry cleaning workers in four cities. Employees eligible for inclusion worked for ≥1 year before 1960 in a shop using PCE as the primary solvent. Life table analyses for mortality and ESRD morbidity were conducted. Only employees alive on 1 January 1977 were included in ESRD analyses.
  
  
  RESULTS
  Overall cancer deaths were in significant excess in this cohort (standardised mortality ratio (SMR) 1.22, 95% CI 1.09 to 1.36). Oesophageal, lung and tongue cancers had significant excesses of deaths. Oesophageal cancer risk was highest among those employed in a PCE-using shop for ≥5 years with ≥20 years' latency since first such employment. Deaths from non-malignant underlying diseases of the stomach and duodenum were in significant excess. Hypertensive ESRD morbidity was significantly elevated in the entire cohort (standardised incidence ratio (SIR) 1.98, 95% CI 1.11 to 3.27), and among workers employed only in PCE-using dry cleaning shops for ≥5 years.
  
  
  CONCLUSIONS
  Employment in the dry cleaning industry and occupational exposure to PCE are associated with an increased risk for ESRD and for cancer at several sites. The employment duration findings for oesophageal cancer and hypertensive ESRD further support an association with PCE exposure instead of lifestyle or socioeconomic factors.
authors.affiliation: Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, 4676 Columbia Parkway, R-17, Cincinnati, OH 45226, USA. jac6@cdc.gov
authors.forename: Geoffrey M
authors.initials: GM
authors.lastname: Calvert
authors.forename: Avima M
authors.initials: AM
authors.lastname: Ruder
authors.forename: Martin R
authors.initials: MR
authors.lastname: Petersen
mesh_terms: D000328:Adult; D004378:Duodenal Diseases / Q000139:chemically induced / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000139:chemically induced / Q000401:mortality; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000139:chemically induced / Q000453:epidemiology*; D007846:Laundering; D008297:Male; D009017:Morbidity; D009784:Occupational Diseases / Q000139:chemically induced / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D012997:Solvents / Q000633:toxicity*; D013272:Stomach Diseases / Q000139:chemically induced / Q000401:mortality; D013750:Tetrachloroethylene / Q000633:toxicity*; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D012997:Solvents; D013750:Tetrachloroethylene