Agency for Toxic Substances and Disease Registry
Case Studies in Environmental Medicine (CSEM) 

Tetrachloroethylene Toxicity
How to Use This Course

Introduction

The goal of Case Studies in Environmental Medicine (CSEM) is to increase the primary care provider’s knowledge of hazardous substances in the environment and to help in evaluation and treating of potentially exposed patients. This CSEM focuses on tetrachloroethylene (PCE) toxicity.

Available Versions

Two versions of the Tetrachloroethylene Toxicity CSEM are available.

• the HTML version http://www.atsdr.cdc.gov/csem/pce/ provides content through the Internet;
• the downloadable PDF version provides content in an electronic, printable format, especially for those who may lack adequate Internet service.

Instructions

To make the most effective use of this course, we recommend that you

• take the Initial Check to assess your current knowledge about tetrachloroethylene (PCE) toxicity
• read the title, learning objectives, text, and key points in each section
• complete the progress check exercises at the end of each section and check your answers
• complete and submit your assessment and posttest response online if you wish to obtain continuing education credit. Continuing education certificates can be printed immediately upon completion.

Instructional Format

This course is designed to help you learn efficiently. Topics are clearly labeled so that you can skip sections or quickly scan sections you are already familiar with. This labeling will also allow you to use this training material as a handy reference. To help you identify and absorb important content quickly, each section is structured as follows

Title

Serves as a “focus question” that you should be able to answer after completing the section

Learning Objectives

Describes specific content addressed in each section and focuses your attention on important points

Text

Provides the information you need to answer the focus question(s) and achieve the learning objectives

Key Points

Highlights important issues and helps you review

Progress Check

Enables you to test yourself to determine whether you have mastered the learning objectives

Answers

Provide feedback to ensure you understand the content and can locate information in the text

Learning Objectives

Upon completion of the Tetrachloroethylene Toxicity CSEM, you will be able to

Overview

• Describe the properties of tetrachloroethylene

Exposure Pathways

• Identify sources of tetrachloroethylene exposure
• Identify the primary routes of exposure to tetrachloroethylene

Who is at Risk

• Identify the occupations most heavily exposed to tetrachloroethylene
• Identify who is at risk of exposure to tetrachloroethylene

Standards and Regulations

• Identify the Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) for tetrachloroethylene
• Identify the U.S. Environmental Protection Agency’s (EPA) maximum contaminant level (MCL) for tetrachloroethylene in drinking water

Biological Fate

• Identify where tetrachloroethylene is most likely to be retained in the body
• Explain the two major pathways of tetrachloroethylene metabolism in the body

Physiological Effects

• Describe the physiological effects associated with tetrachloroethylene exposure

Clinical Evaluation

• Identify the primary focuses of the exposure history
• Describe characteristic clinical presentations of patients with acute tetrachloroethylene exposure
• Describe characteristic clinical presentations of patients with chronic tetrachloroethylene exposure
• Identify direct and measurements that can assist with diagnosis of tetrachloroethylene exposure.
• Identify indirect measurements that can assist with diagnosis of tetrachloroethylene exposure.

Treatment and Management

• Describe the principal treatment strategy for managing tetrachloroethylene poisoning
• Describe instructions for patient self care
• Describe instructions for clinical follow-up