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. 2000 May;108(Suppl 2):161–176. doi: 10.1289/ehp.00108s2161

Trichloroethylene and cancer: epidemiologic evidence.

D Wartenberg 1, D Reyner 1, C S Scott 1
PMCID: PMC1637753  PMID: 10807550

Abstract

Trichloroethylene is an organic chemical that has been used in dry cleaning, for metal degreasing, and as a solvent for oils and resins. It has been shown to cause liver and kidney cancer in experimental animals. This article reviews over 80 published papers and letters on the cancer epidemiology of people exposed to trichloroethylene. Evidence of excess cancer incidence among occupational cohorts with the most rigorous exposure assessment is found for kidney cancer (relative risk [RR] = 1.7, 95% confidence interval [CI] 1.1-2.7), liver cancer (RR = 1.9, 95% CI(1.0-3.4), and non-Hodgkin's lymphoma (RR = 1.5, 95% CI 0.9-2.3) as well as for cervical cancer, Hodgkin's disease, and multiple myeloma. However, since few studies isolate trichloroethylene exposure, results are likely confounded by exposure to other solvents and other risk factors. Although we believe that solvent exposure causes cancer in humans and that trichloroethylene likely is one of the active agents, we recommend further study to better specify the specific agents that confer this risk and to estimate the magnitude of that risk.

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Selected References

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  1. Anttila A., Pukkala E., Sallmén M., Hernberg S., Hemminki K. Cancer incidence among Finnish workers exposed to halogenated hydrocarbons. J Occup Environ Med. 1995 Jul;37(7):797–806. doi: 10.1097/00043764-199507000-00008. [DOI] [PubMed] [Google Scholar]
  2. Asal N. R., Geyer J. R., Risser D. R., Lee E. T., Kadamani S., Cherng N. Risk factors in renal cell carcinoma. II. Medical history, occupation, multivariate analysis, and conclusions. Cancer Detect Prev. 1988;13(3-4):263–279. [PubMed] [Google Scholar]
  3. Aupérin A., Benhamou S., Ory-Paoletti C., Flamant R. Occupational risk factors for renal cell carcinoma: a case-control study. Occup Environ Med. 1994 Jun;51(6):426–428. doi: 10.1136/oem.51.6.426. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Austin H., Delzell E., Grufferman S., Levine R., Morrison A. S., Stolley P. D., Cole P. Case-control study of hepatocellular carcinoma, occupation, and chemical exposures. J Occup Med. 1987 Aug;29(8):665–669. [PubMed] [Google Scholar]
  5. Axelson O., Andersson K., Hogstedt C., Holmberg B., Molina G., de Verdier A. A cohort study on trichloroethylene exposure and cancer mortality. J Occup Med. 1978 Mar;20(3):194–196. doi: 10.1097/00043764-197803000-00008. [DOI] [PubMed] [Google Scholar]
  6. Axelson O., Seldén A., Andersson K., Hogstedt C. Updated and expanded Swedish cohort study on trichloroethylene and cancer risk. J Occup Med. 1994 May;36(5):556–562. [PubMed] [Google Scholar]
  7. Barret L., Faure J., Guilland B., Chomat D., Didier B., Debru J. L. Trichloroethylene occupational exposure: elements for better prevention. Int Arch Occup Environ Health. 1984;53(4):283–289. doi: 10.1007/BF00380666. [DOI] [PubMed] [Google Scholar]
  8. Blair A., Decoufle P., Grauman D. Causes of death among laundry and dry cleaning workers. Am J Public Health. 1979 May;69(5):508–511. doi: 10.2105/ajph.69.5.508. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Blair A., Haas T., Prosser R., Morrissette M., Blackman K., Grauman D., van Dusen P., Moran F. Mortality among United States Coast Guard marine inspectors. Arch Environ Health. 1989 May-Jun;44(3):150–156. doi: 10.1080/00039896.1989.9935879. [DOI] [PubMed] [Google Scholar]
  10. Blair A., Hartge P., Stewart P. A., McAdams M., Lubin J. Mortality and cancer incidence of aircraft maintenance workers exposed to trichloroethylene and other organic solvents and chemicals: extended follow up. Occup Environ Med. 1998 Mar;55(3):161–171. doi: 10.1136/oem.55.3.161. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Blair A., Linos A., Stewart P. A., Burmeister L. F., Gibson R., Everett G., Schuman L., Cantor K. P. Evaluation of risks for non-Hodgkin's lymphoma by occupation and industry exposures from a case-control study. Am J Ind Med. 1993 Feb;23(2):301–312. doi: 10.1002/ajim.4700230207. [DOI] [PubMed] [Google Scholar]
  12. Blair A. Mortality among workers in the metal polishing and plating industry, 1951--1969. J Occup Med. 1980 Mar;22(3):158–162. [PubMed] [Google Scholar]
  13. Blair A., Stewart P. A., Tolbert P. E., Grauman D., Moran F. X., Vaught J., Rayner J. Cancer and other causes of death among a cohort of dry cleaners. Br J Ind Med. 1990 Mar;47(3):162–168. doi: 10.1136/oem.47.3.162. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Bloemen L. J., Tomenson J. Increased incidence of renal cell tumours in a cohort of cardboard workers exposed to trichloroethylene. Arch Toxicol. 1995;70(2):129–133. doi: 10.1007/BF02733675. [DOI] [PubMed] [Google Scholar]
  15. Boice J. D., Jr, Marano D. E., Fryzek J. P., Sadler C. J., McLaughlin J. K. Mortality among aircraft manufacturing workers. Occup Environ Med. 1999 Sep;56(9):581–597. doi: 10.1136/oem.56.9.581. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Bosch F. X., Manos M. M., Muñoz N., Sherman M., Jansen A. M., Peto J., Schiffman M. H., Moreno V., Kurman R., Shah K. V. Prevalence of human papillomavirus in cervical cancer: a worldwide perspective. International biological study on cervical cancer (IBSCC) Study Group. J Natl Cancer Inst. 1995 Jun 7;87(11):796–802. doi: 10.1093/jnci/87.11.796. [DOI] [PubMed] [Google Scholar]
  17. Brown D. P., Kaplan S. D. Retrospective cohort mortality study of dry cleaner workers using perchloroethylene. J Occup Med. 1987 Jun;29(6):535–541. [PubMed] [Google Scholar]
  18. Brownson R. C. A case-control study of renal cell carcinoma in relation to occupation, smoking, and alcohol consumption. Arch Environ Health. 1988 May-Jun;43(3):238–241. doi: 10.1080/00039896.1988.9934940. [DOI] [PubMed] [Google Scholar]
  19. Brownson R. C., Alavanja M. C., Chang J. C. Occupational risk factors for lung cancer among nonsmoking women: a case-control study in Missouri (United States). Cancer Causes Control. 1993 Sep;4(5):449–454. doi: 10.1007/BF00050864. [DOI] [PubMed] [Google Scholar]
  20. Chen R., Seaton A. A meta-analysis of mortality among workers exposed to organic solvents. Occup Med (Lond) 1996 Oct;46(5):337–344. doi: 10.1093/occmed/46.5.337. [DOI] [PubMed] [Google Scholar]
  21. Chow W. H., McLaughlin J. K., Malker H. S., Linet M. S., Weiner J. A., Stone B. J. Esophageal cancer and occupation in a cohort of Swedish men. Am J Ind Med. 1995 May;27(5):749–757. doi: 10.1002/ajim.4700270509. [DOI] [PubMed] [Google Scholar]
  22. Cohn P, Klotz J, Bove F, Berkowitz M, Fagliano J. Drinking Water Contamination and the Incidence of Leukemia and Non-Hodgkin's Lymphoma. Environ Health Perspect. 1994 Jun;102(6-7):556–561. doi: 10.1289/ehp.94102556. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Cutler J. J., Parker G. S., Rosen S., Prenney B., Healey R., Caldwell G. G. Childhood leukemia in Woburn, Massachusetts. Public Health Rep. 1986 Mar-Apr;101(2):201–205. [PMC free article] [PubMed] [Google Scholar]
  24. Devesa S. S., Silverman D. T., McLaughlin J. K., Brown C. C., Connelly R. R., Fraumeni J. F., Jr Comparison of the descriptive epidemiology of urinary tract cancers. Cancer Causes Control. 1990 Sep;1(2):133–141. doi: 10.1007/BF00053164. [DOI] [PubMed] [Google Scholar]
  25. Dosemeci M., Cocco P., Chow W. H. Gender differences in risk of renal cell carcinoma and occupational exposures to chlorinated aliphatic hydrocarbons. Am J Ind Med. 1999 Jul;36(1):54–59. doi: 10.1002/(sici)1097-0274(199907)36:1<54::aid-ajim8>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]
  26. Dubrow R., Gute D. M. Cause-specific mortality among Rhode Island jewelry workers. Am J Ind Med. 1987;12(5):579–593. doi: 10.1002/ajim.4700120511. [DOI] [PubMed] [Google Scholar]
  27. Duh R. W., Asal N. R. Mortality among laundry and dry cleaning workers in Oklahoma. Am J Public Health. 1984 Nov;74(11):1278–1280. doi: 10.2105/ajph.74.11.1278. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Fagliano J., Berry M., Bove F., Burke T. Drinking water contamination and the incidence of leukemia: an ecologic study. Am J Public Health. 1990 Oct;80(10):1209–1212. doi: 10.2105/ajph.80.10.1209. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Figgs L. W., Dosemeci M., Blair A. United States non-Hodgkin's lymphoma surveillance by occupation 1984-1989: a twenty-four state death certificate study. Am J Ind Med. 1995 Jun;27(6):817–835. doi: 10.1002/ajim.4700270606. [DOI] [PubMed] [Google Scholar]
  30. Fredriksson M., Bengtsson N. O., Hardell L., Axelson O. Colon cancer, physical activity, and occupational exposures. A case-control study. Cancer. 1989 May 1;63(9):1838–1842. doi: 10.1002/1097-0142(19900501)63:9<1838::aid-cncr2820630930>3.0.co;2-4. [DOI] [PubMed] [Google Scholar]
  31. Fritschi L., Siemiatycki J. Melanoma and occupation: results of a case-control study. Occup Environ Med. 1996 Mar;53(3):168–173. doi: 10.1136/oem.53.3.168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Fukuda K., Takemoto K., Tsuruta H. Inhalation carcinogenicity of trichloroethylene in mice and rats. Ind Health. 1983;21(4):243–254. doi: 10.2486/indhealth.21.243. [DOI] [PubMed] [Google Scholar]
  33. Garabrant D. H., Held J., Langholz B., Bernstein L. Mortality of aircraft manufacturing workers in southern California. Am J Ind Med. 1988;13(6):683–693. doi: 10.1002/ajim.4700130607. [DOI] [PubMed] [Google Scholar]
  34. Greenland S., Salvan A., Wegman D. H., Hallock M. F., Smith T. J. A case-control study of cancer mortality at a transformer-assembly facility. Int Arch Occup Environ Health. 1994;66(1):49–54. doi: 10.1007/BF00386579. [DOI] [PubMed] [Google Scholar]
  35. HILL A. B. THE ENVIRONMENT AND DISEASE: ASSOCIATION OR CAUSATION? Proc R Soc Med. 1965 May;58:295–300. doi: 10.1177/003591576505800503. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Hardell L., Bengtsson N. O., Jonsson U., Eriksson S., Larsson L. G. Aetiological aspects on primary liver cancer with special regard to alcohol, organic solvents and acute intermittent porphyria--an epidemiological investigation. Br J Cancer. 1984 Sep;50(3):389–397. doi: 10.1038/bjc.1984.188. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Hardell L., Eriksson M., Degerman A. Exposure to phenoxyacetic acids, chlorophenols, or organic solvents in relation to histopathology, stage, and anatomical localization of non-Hodgkin's lymphoma. Cancer Res. 1994 May 1;54(9):2386–2389. [PubMed] [Google Scholar]
  38. Hardell L., Eriksson M., Lenner P., Lundgren E. Malignant lymphoma and exposure to chemicals, especially organic solvents, chlorophenols and phenoxy acids: a case-control study. Br J Cancer. 1981 Feb;43(2):169–176. doi: 10.1038/bjc.1981.25. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Harrington J. M., Whitby H., Gray C. N., Reid F. J., Aw T. C., Waterhouse J. A. Renal disease and occupational exposure to organic solvents: a case referent approach. Br J Ind Med. 1989 Sep;46(9):643–650. doi: 10.1136/oem.46.9.643. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Heineman E. F., Cocco P., Gómez M. R., Dosemeci M., Stewart P. A., Hayes R. B., Zahm S. H., Thomas T. L., Blair A. Occupational exposure to chlorinated aliphatic hydrocarbons and risk of astrocytic brain cancer. Am J Ind Med. 1994 Aug;26(2):155–169. doi: 10.1002/ajim.4700260203. [DOI] [PubMed] [Google Scholar]
  41. Henschler D., Romen W., Elsässer H. M., Reichert D., Eder E., Radwan Z. Carcinogenicity study of trichloroethylene by longterm inhalation in three animal species. Arch Toxicol. 1980 Feb;43(4):237–248. doi: 10.1007/BF00366179. [DOI] [PubMed] [Google Scholar]
  42. Henschler D., Vamvakas S., Lammert M., Dekant W., Kraus B., Thomas B., Ulm K. Increased incidence of renal cell tumors in a cohort of cardboard workers exposed to trichloroethene. Arch Toxicol. 1995;69(5):291–299. doi: 10.1007/s002040050173. [DOI] [PubMed] [Google Scholar]
  43. Hernberg S., Kauppinen T., Riala R., Korkala M. L., Asikainen U. Increased risk for primary liver cancer among women exposed to solvents. Scand J Work Environ Health. 1988 Dec;14(6):356–365. doi: 10.5271/sjweh.1907. [DOI] [PubMed] [Google Scholar]
  44. Hernberg S., Korkala M. L., Asikainen U., Riala R. Primary liver cancer and exposure to solvents. Int Arch Occup Environ Health. 1984;54(2):147–153. doi: 10.1007/BF00378517. [DOI] [PubMed] [Google Scholar]
  45. Houten L., Sonnesso G. Occupational exposure and cancer of the liver. Arch Environ Health. 1980 Jan-Feb;35(1):51–53. [PubMed] [Google Scholar]
  46. Huebner W. W., Schoenberg J. B., Kelsey J. L., Wilcox H. B., McLaughlin J. K., Greenberg R. S., Preston-Martin S., Austin D. F., Stemhagen A., Blot W. J. Oral and pharyngeal cancer and occupation: a case-control study. Epidemiology. 1992 Jul;3(4):300–309. doi: 10.1097/00001648-199207000-00005. [DOI] [PubMed] [Google Scholar]
  47. Isacson P., Bean J. A., Splinter R., Olson D. B., Kohler J. Drinking water and cancer incidence in Iowa. III. Association of cancer with indices of contamination. Am J Epidemiol. 1985 Jun;121(6):856–869. doi: 10.1093/oxfordjournals.aje.a114056. [DOI] [PubMed] [Google Scholar]
  48. Katz R. M., Jowett D. Female laundry and dry cleaning workers in Wisconsin: a mortality analysis. Am J Public Health. 1981 Mar;71(3):305–307. doi: 10.2105/ajph.71.3.305. [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. Lin R. S., Kessler I. I. A multifactorial model for pancreatic cancer in man. Epidemiologic evidence. JAMA. 1981 Jan 9;245(2):147–152. [PubMed] [Google Scholar]
  50. Lowengart R. A., Peters J. M., Cicioni C., Buckley J., Bernstein L., Preston-Martin S., Rappaport E. Childhood leukemia and parents' occupational and home exposures. J Natl Cancer Inst. 1987 Jul;79(1):39–46. [PubMed] [Google Scholar]
  51. Lynge E., Anttila A., Hemminki K. Organic solvents and cancer. Cancer Causes Control. 1997 May;8(3):406–419. doi: 10.1023/a:1018461406120. [DOI] [PubMed] [Google Scholar]
  52. Lynge E., Carstensen B., Andersen O. Primary liver cancer and renal cell carcinoma in laundry and dry-cleaning workers in Denmark. Scand J Work Environ Health. 1995 Aug;21(4):293–295. doi: 10.5271/sjweh.41. [DOI] [PubMed] [Google Scholar]
  53. Lynge E. Danish Cancer Registry as a resource for occupational research. J Occup Med. 1994 Nov;36(11):1169–1173. doi: 10.1097/00043764-199411000-00001. [DOI] [PubMed] [Google Scholar]
  54. Lynge E., Thygesen L. Primary liver cancer among women in laundry and dry-cleaning work in Denmark. Scand J Work Environ Health. 1990 Apr;16(2):108–112. doi: 10.5271/sjweh.1810. [DOI] [PubMed] [Google Scholar]
  55. Mack T. M., Peters J. M., Yu M. C., Hanisch R., Wright W. E., Henderson B. E. Pancreas cancer is unrelated to the workplace in Los Angeles. Am J Ind Med. 1985;7(3):253–266. doi: 10.1002/ajim.4700070307. [DOI] [PubMed] [Google Scholar]
  56. Mallin K. Investigation of a bladder cancer cluster in northwestern Illinois. Am J Epidemiol. 1990 Jul;132(1 Suppl):S96–106. doi: 10.1093/oxfordjournals.aje.a115795. [DOI] [PubMed] [Google Scholar]
  57. Maltoni C., Lefemine G., Cotti G., Perino G. Long-term carcinogenicity bioassays on trichloroethylene administered by inhalation to Sprague-Dawley rats and Swiss and B6C3F1 mice. Ann N Y Acad Sci. 1988;534:316–342. doi: 10.1111/j.1749-6632.1988.tb30120.x. [DOI] [PubMed] [Google Scholar]
  58. McCredie M., Stewart J. H. Risk factors for kidney cancer in New South Wales. IV. Occupation. Br J Ind Med. 1993 Apr;50(4):349–354. doi: 10.1136/oem.50.4.349. [DOI] [PMC free article] [PubMed] [Google Scholar]
  59. McLaughlin J. K., Blot W. J. A critical review of epidemiology studies of trichloroethylene and perchloroethylene and risk of renal-cell cancer. Int Arch Occup Environ Health. 1997;70(4):222–231. doi: 10.1007/s004200050211. [DOI] [PubMed] [Google Scholar]
  60. McLaughlin J. K., Malker H. S., Stone B. J., Weiner J. A., Malker B. K., Ericsson J. L., Blot W. J., Fraumeni J. F., Jr Occupational risks for renal cancer in Sweden. Br J Ind Med. 1987 Feb;44(2):119–123. doi: 10.1136/oem.44.2.119. [DOI] [PMC free article] [PubMed] [Google Scholar]
  61. Mellemgaard A., Engholm G., McLaughlin J. K., Olsen J. H. Occupational risk factors for renal-cell carcinoma in Denmark. Scand J Work Environ Health. 1994 Jun;20(3):160–165. doi: 10.5271/sjweh.1413. [DOI] [PubMed] [Google Scholar]
  62. Morgan R. W., Kelsh M. A., Zhao K., Heringer S. Mortality of aerospace workers exposed to trichloroethylene. Epidemiology. 1998 Jul;9(4):424–431. [PubMed] [Google Scholar]
  63. Müller G., Spassowski M., Henschler D. Metabolism of trichloroethylene in man. III. Interaction of trichloroethylene and ethanol. Arch Toxicol. 1975;33(3):173–189. doi: 10.1007/BF00311271. [DOI] [PubMed] [Google Scholar]
  64. Olsen J. H., de Nully Brown P., Schulgen G., Jensen O. M. Parental employment at time of conception and risk of cancer in offspring. Eur J Cancer. 1991;27(8):958–965. doi: 10.1016/0277-5379(91)90258-f. [DOI] [PubMed] [Google Scholar]
  65. Olsson H., Brandt L. Occupational exposure to organic solvents and Hodgkin's disease in men. A case-referent study. Scand J Work Environ Health. 1980 Dec;6(4):302–305. doi: 10.5271/sjweh.2604. [DOI] [PubMed] [Google Scholar]
  66. Paddle G. M. Incidence of liver cancer and trichloroethylene manufacture: joint study by industry and a cancer registry. Br Med J (Clin Res Ed) 1983 Mar 12;286(6368):846–846. doi: 10.1136/bmj.286.6368.846. [DOI] [PMC free article] [PubMed] [Google Scholar]
  67. Partanen T., Heikkilä P., Hernberg S., Kauppinen T., Moneta G., Ojajärvi A. Renal cell cancer and occupational exposure to chemical agents. Scand J Work Environ Health. 1991 Aug;17(4):231–239. doi: 10.5271/sjweh.1708. [DOI] [PubMed] [Google Scholar]
  68. Persson B., Dahlander A. M., Fredriksson M., Brage H. N., Ohlson C. G., Axelson O. Malignant lymphomas and occupational exposures. Br J Ind Med. 1989 Aug;46(8):516–520. doi: 10.1136/oem.46.8.516. [DOI] [PMC free article] [PubMed] [Google Scholar]
  69. Peters F. M., Preston-Martin S., Yu M. C. Brain tumors in children and occupational exposure of parents. Science. 1981 Jul 10;213(4504):235–237. doi: 10.1126/science.7244631. [DOI] [PubMed] [Google Scholar]
  70. Ritz B. Cancer mortality among workers exposed to chemicals during uranium processing. J Occup Environ Med. 1999 Jul;41(7):556–566. doi: 10.1097/00043764-199907000-00004. [DOI] [PubMed] [Google Scholar]
  71. Schlehofer B., Heuer C., Blettner M., Niehoff D., Wahrendorf J. Occupation, smoking and demographic factors, and renal cell carcinoma in Germany. Int J Epidemiol. 1995 Feb;24(1):51–57. doi: 10.1093/ije/24.1.51. [DOI] [PubMed] [Google Scholar]
  72. Schoenberg J. B., Stemhagen A., Mogielnicki A. P., Altman R., Abe T., Mason T. J. Case-control study of bladder cancer in New Jersey. I. Occupational exposures in white males. J Natl Cancer Inst. 1984 May;72(5):973–981. [PubMed] [Google Scholar]
  73. Shannon H. S., Haines T., Bernholz C., Julian J. A., Verma D. K., Jamieson E., Walsh C. Cancer morbidity in lamp manufacturing workers. Am J Ind Med. 1988;14(3):281–290. doi: 10.1002/ajim.4700140306. [DOI] [PubMed] [Google Scholar]
  74. Sharpe C. R., Rochon J. E., Adam J. M., Suissa S. Case-control study of hydrocarbon exposures in patients with renal cell carcinoma. CMAJ. 1989 Jun 1;140(11):1309–1318. [PMC free article] [PubMed] [Google Scholar]
  75. Shindell S., Ulrich S. A cohort study of employees of a manufacturing plant using trichlorethylene. J Occup Med. 1985 Aug;27(8):577–579. doi: 10.1097/00043764-198508000-00015. [DOI] [PubMed] [Google Scholar]
  76. Silverman D. T., Hoover R. N., Albert S., Graff K. M. Occupation and cancer of the lower urinary tract in Detroit. J Natl Cancer Inst. 1983 Feb;70(2):237–245. [PubMed] [Google Scholar]
  77. Silverman D. T., Levin L. I., Hoover R. N. Occupational risks of bladder cancer in the United States: II Nonwhite men. J Natl Cancer Inst. 1989 Oct 4;81(19):1480–1483. doi: 10.1093/jnci/81.19.1480. [DOI] [PubMed] [Google Scholar]
  78. Sinks T., Lushniak B., Haussler B. J., Sniezek J., Deng J. F., Roper P., Dill P., Coates R. Renal cell cancer among paperboard printing workers. Epidemiology. 1992 Nov;3(6):483–489. doi: 10.1097/00001648-199211000-00004. [DOI] [PubMed] [Google Scholar]
  79. Smith E. M., Miller E. R., Woolson R. F., Brown C. K. Bladder cancer risk among laundry workers, dry cleaners, and others in chemically-related occupations. J Occup Med. 1985 Apr;27(4):295–297. [PubMed] [Google Scholar]
  80. Spirtas R., Stewart P. A., Lee J. S., Marano D. E., Forbes C. D., Grauman D. J., Pettigrew H. M., Blair A., Hoover R. N., Cohen J. L. Retrospective cohort mortality study of workers at an aircraft maintenance facility. I. Epidemiological results. Br J Ind Med. 1991 Aug;48(8):515–530. doi: 10.1136/oem.48.8.515. [DOI] [PMC free article] [PubMed] [Google Scholar]
  81. Stemhagen A., Slade J., Altman R., Bill J. Occupational risk factors and liver cancer. A retrospective case-control study of primary liver cancer in New Jersey. Am J Epidemiol. 1983 Apr;117(4):443–454. doi: 10.1093/oxfordjournals.aje.a113562. [DOI] [PubMed] [Google Scholar]
  82. Stopps G. J., McLaughlin M. Psychophysiological testing of human subjects exposed to solvent vapors. Am Ind Hyg Assoc J. 1967 Jan-Feb;28(1):43–50. doi: 10.1080/00028896709342484. [DOI] [PubMed] [Google Scholar]
  83. Suarez L., Weiss N. S., Martin J. Primary liver cancer death and occupation in Texas. Am J Ind Med. 1989;15(2):167–175. doi: 10.1002/ajim.4700150205. [DOI] [PubMed] [Google Scholar]
  84. Swaen G. M. Increased incidence of renal cell tumours in a cohort of cardboard workers exposed to trichloroethylene. Arch Toxicol. 1995;70(2):127-8, 131-3. doi: 10.1007/BF02733674. [DOI] [PubMed] [Google Scholar]
  85. Tola S., Vilhunen R., Järvinen E., Korkala M. L. A cohort study on workers exposed to trichloroethylene. J Occup Med. 1980 Nov;22(11):737–740. [PubMed] [Google Scholar]
  86. Vamvakas S., Brüning T., Thomasson B., Lammert M., Baumüller A., Bolt H. M., Dekant W., Birner G., Henschler D., Ulm K. Renal cell cancer correlated with occupational exposure to trichloroethene. J Cancer Res Clin Oncol. 1998;124(7):374–382. doi: 10.1007/s004320050186. [DOI] [PMC free article] [PubMed] [Google Scholar]
  87. Vaughan T. L., Stewart P. A., Davis S., Thomas D. B. Work in dry cleaning and the incidence of cancer of the oral cavity, larynx, and oesophagus. Occup Environ Med. 1997 Sep;54(9):692–695. doi: 10.1136/oem.54.9.692. [DOI] [PMC free article] [PubMed] [Google Scholar]
  88. Waller L. A., Turnbull B. W. The effects of scale on tests for disease clustering. Stat Med. 1993 Oct;12(19-20):1869–1884. doi: 10.1002/sim.4780121913. [DOI] [PubMed] [Google Scholar]

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