title: Occupational exposure to trichloroethylene and perchloroethylene and the risk of lymphoma, liver, and kidney cancer in four Nordic countries.
abstract: OBJECTIVE
  Trichloroethylene (TCE) and Perchloroethylene (PER) are two chlorinated solvents that are applied widely as degreasers of metal parts, and in dry cleaning and other applications. In 2012, the International Agency for Research on Cancer classified TCE as carcinogenic to humans and PER as probably carcinogenic to humans. We explored exposure-response relations for TCE and PER and non-Hodgkin's lymphoma (NHL), multiple myeloma (MM), and cancers of the kidney and liver in the Nordic Occupational Cancer cohort.
  
  
  METHODS
  The cohort was set up by linking occupational information from censuses to national cancer registry data using personal identity codes in use in all Nordic countries. Country, time period, and job-specific exposure estimates were generated for TCE, PER and potentially confounding occupational exposures with a job-exposure matrix. A conditional logistic regression was conducted for exposure groups as well as for continuous cumulative exposure.
  
  
  RESULTS
  HRs for liver cancer, NHL and MM but not kidney cancer were slightly elevated in groups with high exposure to PER (compared to occupationally unexposed subjects). HRs for liver cancer and NHL also increased with increasing continuous exposure to PER. We did not observe evidence for an association between exposure to TCE and NHL, MM or liver and kidney cancer.
  
  
  CONCLUSIONS
  Although this study was subject to limitations related to the low prevalence of exposure to PER and TCE in the Nordic population and a limited exposure assessment strategy, we observed some evidence indicative of an excess risk of cancer of the liver and NHL in subjects exposed to PER.
authors: Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France.
authors: Jelle
authors: J
authors: Vlaanderen
authors: Kurt
authors: K
authors: Straif
authors: Eero
authors: E
authors: Pukkala
authors: Timo
authors: T
authors: Kauppinen
authors: Pentti
authors: P
authors: Kyyrönen
authors: Jan Ivar
authors: JI
authors: Martinsen
authors: Kristina
authors: K
authors: Kjaerheim
authors: Laufey
authors: L
authors: Tryggvadottir
authors: Johnni
authors: J
authors: Hansen
authors: Pär
authors: P
authors: Sparén
authors: Elisabete
authors: E
authors: Weiderpass
mesh_terms: D000328:Adult; D002273:Carcinogens / Q000494:pharmacology; D015331:Cohort Studies; D005060:Europe; D005260:Female; D006801:Humans; D007221:Industry; D007680:Kidney Neoplasms / Q000209:etiology; D008113:Liver Neoplasms / Q000209:etiology; D016015:Logistic Models; D008228:Lymphoma, Non-Hodgkin / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000209:etiology; D009369:Neoplasms / Q000209:etiology*; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D012307:Risk Factors; D012997:Solvents / Q000009:adverse effects*; D013750:Tetrachloroethylene / Q000009:adverse effects*; D014241:Trichloroethylene / Q000009:adverse effects*
chemical_list: D002273:Carcinogens; D012997:Solvents; D014241:Trichloroethylene; D013750:Tetrachloroethylene
keywords: Chlorinated solvents; Multiple myeloma; Non-Hodgkin lymphoma