The following are commonly asked questions and answers about the reported health problems linked with TCE and PCE exposure in children, adults, and animals.

Reported health effects linked with TCE and PCE exposure in people
Reported health effects linked with TCE and PCE exposure in animals
Reported health effects linked with TCE and PCE exposure in both people and animals

Reported health effects linked with TCE and PCE exposure in people

Q: What did the 1998 ATSDR health study "Volatile Organic Compounds in Drinking Water and Adverse Pregnancy Outcomes" at Camp Lejeune find?

A: Overall, the study found a link between PCE-contaminated drinking water and lower birth weights for infants of older mothers and mothers with histories of fetal loss. PCE-contaminated drinking water was also linked with small-for-gestational-age infants for older mothers and mothers with two or more prior fetal losses. This study could not look at fetal deaths because existing records were not complete.

Q: What have other studies found about the persistent health effects of TCE and PCE?

A: The effects of exposure to any chemical depend on—

• When you are exposed (during pregnancy, in infancy),
• How much you are exposed to,
• How long you are exposed,
• How you are exposed (breathing, drinking), and
• What your personal traits and habits are.

Therefore, not everyone who is exposed to TCE or PCE will develop a health problem.

A limited number of studies have been done that looked at the health problems in children and adults related to drinking water contaminated with TCE and PCE. A much larger number of studies have looked at health problems among workers exposed to TCE and PCE.

Health Outcomes Found to be Linked to TCE and/or PCE
Below is a list of the types of health outcomes that have been found to be linked to TCE and/or PCE. The numbers in parentheses indicate the reference for the study. All of the references are listed at the end.

Reported health problems in children who were exposed in the womb from their mother drinking water contaminated with TCE and/or PCE include—

• Leukemia (1-3)
• Small for gestational age (4-6)
• Low birth weight (6-8)
• Fetal death (4, 7, 9)
• Major heart defects (7, 10)
• Neural tube defects (4, 7, 9)
• Oral cleft defects (including cleft lip) (4, 7, 9)
• Chonal atresia (nasal passages blocked with bone or tissue) (4, 9)
• Eye defects (4, 9)

Reported health problems in children who were exposed in the womb from their mother working with TCE and/or PCE include—

• Low birth weight (11)
• Miscarriage (12, 13)
• Major malformations (11)

Reported health problems in people of all ages from drinking water contaminated with TCE and/or PCE include—

• Non-Hodgkins lymphoma (1, 12)
• Bladder cancer (17)
• Breast cancer (18)
• Lung cancer (14)

Reported health problems in people of all ages from working with TCE and/or PCE include—

• Hodgkins disease (15)
• Non-Hodgkins lymphoma (15)
• Cervical cancer (15)
• Kidney cancer (15)
• Liver/biliary cancer (15)
• Ovarian cancer (15)
• Prostate cancer (15)
• Neurological effects (delayed reaction times problems with short-term memory, visual perception, attention, and color vision) (13)

Workers are exposed to much higher levels of TCE and PCE than are people who drink contaminated water. Therefore, the health problems seen in people who worked with TCE and PCE may not be seen in people who drank contaminated water.

For health problems not listed in the tables—

• Studies, so far, do not support a link with the particular health outcome and TCE or PCE exposure, or
• There is not enough information to see if the outcome is linked to TCE or PCE exposure.

Q: How are studies in animals and people different?

A: In studies done in laboratory animals, such as mice, the animals are exposed to much higher levels of chemicals than are people. Animals are also exposed in different ways than are people. In animal studies, we know the exact types and levels of chemicals the animals are exposed to. We can't tell for certain the exact levels people are exposed to. Also, people are usually exposed to multiple chemicals. Medications, alcohol intake, and lifestyle factors also play a role in how these chemicals affect people.

Reported health effects linked with TCE and PCE exposure in animals

Q: What health effects are seen in animal studies of PCE exposure?

A: Results of animal studies showed that PCE can cause liver and kidney damage. The studies also showed that PCE can cause liver cancer in animals. Exposure to very high levels of PCE can be harmful to the unborn pups of pregnant rats and mice. Changes in behavior were seen in the offspring of rats that breathed high levels of the chemical while they were pregnant. Behavioral changes included being hyperactive. Various neurological problems were seen in both the mother and offspring. Neurological problems included being unable to coordinate muscles and decreased movement.

Q: What health effects are seen in animals from TCE exposure?

A: Results of animal studies showed that TCE may cause liver, kidney, or lung cancer. The studies also showed that TCE can cause neurological problems and liver and kidney damage in animals. Neurological problems included being unable to coordinate muscles and decreased movement.

Reported health effects linked with TCE and PCE exposure in both people and animals

Q: What health effects are seen in both people and animals from TCE and PCE exposure?

A: When there are studies in people, results of animal studies are used to help support any observed links. Results of animal studies are used when there are no studies in people. Reported health effects seen in both people and animals include—

• Lung cancer
• Kidney cancer
• Liver cancer
• Neurological effects

Some health effects seen in people cannot be tested for in animals.

References

1. Cohn P, Klotz J, Bove F, Fagliano J. 1994. Drinking water contamination and the incidence of leukemia and non-Hodgkin's lymphoma. Environ Health Perspect 102:556-61.

2. Costas K, Knorr RS, Condon SK. 2002. A case-control study of childhood leukemia in Woburn, Massachusetts: the relationship between leukemia incidence and exposure to public drinking water. Sci Total Environ 300:23-35.

3. New Jersey Department of Health and Senior Services. 2003. Case-control study of childhood cancers in Dover Township (Ocean Country), New Jersey. Trenton, New Jersey: New Jersey Department of Health and Senior Services.

4. Massachusetts Department of Public Health, Centers for Disease Control and Prevention, Massachusetts Health Research Institute. 1996. Final report of the Woburn environmental and birth study. Boston, Massachusetts: Massachusetts Department of Public Health.

5. Agency for Toxic Substances and Disease Registry. 1998. Volatile organic compounds in drinking water and adverse pregnancy outcomes: U.S. Marine Corps Camp Lejeune, North Carolina. Atlanta: US Department of Health and Human Services.

6. Sonnenfeld N, Hertz-Picciotto I, Kaye WE. 2001. Tetrachloroethylene in drinking water and birth outcomes at the US Marine Corps Base at Camp Lejeune, North Carolina. Am J Epidemiol 154(10):902-8.

7. Bove FJ, Fulcomer MC, Klotz JB, Esmart J, Dufficy EM, Savrin JE. 1995. Public drinking water contamination and birth outcomes. Am J Epidemiol 141:850-62.

8. Rodenbeck SE, Sanderson LM, Rene A. 2000. Maternal exposure to trichloroethylene in drinking water and birthweight outcomes. Arch Environ Health 55:188-194.

9. Bove F, Shim Y, Zeitz P. 2002. Drinking water contaminants and adverse pregnancy outcomes: a Review. Environ Health Perspect 110(S): 61-73.

10. Goldberg SJ, Lebowitz MD, Graver EJ, Hicks S. 1990. An association of human congenital cardiac malformations and drinking water contaminants. J Am Coll Cardiol 16:155-164.

11. Khattak S, K-Moghtader G, McMartin K, Barrera M, Kennedy D, Koren G. 1999. Pregnancy outcome following gestational exposure to organic solvents: a prospective controlled study. JAMA 281(12): 1106-09.

12. Pesticide and Environmental Toxicology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency. 1999. Public health goal for trichloroethylene in drinking water. Sacramento, California.

13. Pesticide and Environmental Toxicology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency. 2001. Public health goal for tetrachloroethylene in drinking water. Sacramento, California.

14. Paulu C, Aschengrau A, Ozonoff D. 1999. Tetrachloroethylene-contaminated drinking water in Massachusetts and the risk of colon-rectum, lung, and other cancers. Environ Health Perspect 107(4):265-71.

15. Wartenberg D, Reyner D, Scott CS. 2000. Trichloroethylene and cancer: epidemiologic evidence. Environ Health Perspect 108(S2):161-176.

16. Morgan RW, Kelsh MA, Zhao K, Heringer S. 1998. Mortality of aerospace workers exposed to trichloroethylene. Epidemiology 9(4):424-31.

17. Aschengrau A, Zierler S, Cohen A. 1993. Quality of community drinking water and the occurrence of late adverse pregnancy outcomes. Arch Environ Health 48:105-13.

18. Aschengrau A, Rogers S, Ozonoff D. 2003. Perchloroethylene-contaminated drinking water and the risk of breast cancer: additional results from Cape Cod, Massachusetts, USA. Environ Health Perspect 111(2):167-73.

• Adams C, Keil D, Meyers K, et al. 2003. Lifetime exposure to trichloroethylene (TCE) modulates immune function. Toxicologist 72(S-1):375.
• Altmann L, Welge P, Mensing T, et al. 2002. Chronic exposure to trichloroethylene affects neuronal plasticity in rat hippocampal slices. Environmental Toxicology and Pharmacology 12(3):157-67.
• Agency for Toxic Substances and Disease Registry (ATSDR). 1997. Toxicological profile for Trichloroethylene. U.S. Department of Health and Human Services, Public Health Service, ATSDR.
• Agency for Toxic Substances and Disease Registry (ATSDR). 1997. Toxicological profile for Tetrachloroethylene. U.S. Department of Health and Human Services, Public Health Service, ATSDR.
• Berger T, Horner CM. 2003. In vivo exposure of female rats to toxicants may affect oocyte quality. Reprod Toxicol 17(3):273-81.
• Bushnell PJ, Oshiro WM. 2000. Behavioral components of tolerance to repeated inhalation of trichloroethylene (TCE) in rats. Neurotoxicol Teratol 22(2):221-9.
• Crofton KM, Zhao X. 1997. The ototoxicity of trichloroethylene: extrapolation and relevance of high-concentration, short-duration animal exposure data. Fundam Appl Toxicol 38(1):101-6.
• Ebrahim AS, Babakrishnan K, Sakthisekaran D. 1996. Perchloroethylene-induced alterations in glucose metabolism and their prevention by 2-deoxy-D-glucose and vitamin E in mice. J Appl Toxicol 16(4):339-48.
• Fisher JW, Channel SR, Eggers JS, et al. 2001. Trichloroethylene, trichloroacetic acid, and dichloroacetic acid: do they affect fetal rat heart development? Int J Toxicol 20(5):257-67.
• Forkert P, Lash L, Nadeau V, et al. 2002. Metabolism and toxicity of trichloroethylene in epididymis and testis. Toxicol Appl Pharmacol 182(3):244.
• Griffin JM, Blossom SJ, Jackson SK, et al. 2000. Trichloroethylene accelerates an autoimmune response by Th1 T cell activation in MRL +/+ mice. Immunopharmacology 46:123-37.
• Griffin JM, Gilbert KM, Lamps LW, et al. 2000. CD4(+) T-cell activation and induction of autoimmune hepatitis following trichloroethylene treatment in MRL+/+ mice. Toxicol Sci 57(2):345-52.
• Johnson PD, Goldberg SJ, Mays MZ, et al. 2003. Threshold of trichloroethylene contamination in maternal drinking waters affecting fetal heart development in the rat. Environ Health Perspect 111:289-92.
• Kumar P, Prasad A, Saxena DK, et al. 2000. Fertility and general reproduction studies in trichloroethylene exposed rats. Indian Journal of Occupation Health 43(3):117-26.
• Kumar P, Prasad AK, Maji BK, et al. 2001. Hepatotoxic alterations induced by inhalation of trichloroethylene (TCE) in rats. Biomed Environ Sci 14(4): 325-32.
• Mattsson JL, Albee RR, Yano BL, et al. 1998. Neurotoxicologic examination of rats exposed to 1,1,2,2-tetrachloroethylene (perchloroethylene) vapor for 13 weeks. Neurotoxicol Teratol 20(1):83-98.
• Mensing T, Welge P, Voss B, et al. 2002. Renal toxicity after chronic inhalation exposure of rats to trichloroethylene. Toxicol Lett 128(1-3):243-7.
• Muijser H, Lammers JH, Kullig BM. 2000. Effects of exposure to trichloroethylene and noise on hearing in rats. Noise Health 2(6): 57-66.
• Potter CL, Chang LW, Deangelo AB, et al. 1996. Effects of four trihalomethanes on DNA strand breaks, renal hyaline droplet formation and serum testosterone in male F-344 rats. Cancer Letters 106:235-42.
• Warren DA, Graeter LJ, Channel SR, et al. 2002. Trichloroethylene, trichloroacetic acid and dichloroacetic acid: does in utero exposure to these chemicals affect eye development? Toxicologist 66(1-S):24.
• Waseem M, Ali M, Dogra S, et al. 2001. Toxicity of trichloroethylene following inhalation and drinking contaminated water. J Appl Toxicol 21(6):441-4.
• Xu H, Wade MG, Anupriwan A, et al. 2003. Inhalation exposure to trichloroethylene of male mice causes impaired sperm function but has minimal effects on testis function. Biol Reprod 2003;68(Suppl 1):181-2.
• Zablotny CL Carney EW Dugard PH. 2002. Evaluation of trichloroethylene in a rat inhalation developmental toxicity study. Toxicologist 66(1-S):237.