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Tetrachloroethylene

Perchlorethylene


Presentation

  • Hypersensitivity pneumonitis (HP) is a complex syndrome of varying intensity and clinical presentation, and has been described in association with numerous exposures. Early diagnosis is essential to limit irreversible lung damage.[ncbi.nlm.nih.gov]
  • TRI was present in measurable concentrations in 22 subjects (range: 0.026-0.090 micrograms/l) and PER in 31 subjects (range: 0.031-2.540 micrograms/l).[ncbi.nlm.nih.gov]
  • A patient with massive exposure to tetrachloroethylene fumes presented with coma and severe pulmonary edema.[ncbi.nlm.nih.gov]
  • The patient underwent supportive treatment along with 3 sessions of plasmapheresis, and consequently, he presented a favorable outcome.[ncbi.nlm.nih.gov]
  • The case presented is that of a 27-year-old female, found dead by her father at home with cotton swabs dipped in the nostrils. She was already known for this type of abuse and previously admitted twice to the hospital for nonfatal acute poisonings.[ncbi.nlm.nih.gov]
Fatigue
  • Odor is an adequate warning for high-dose acute exposures, but might not be adequate for prolonged exposures because olfactory fatigue can occur.[atsdr.cdc.gov]
Metal Worker
  • Some examples of workers at risk of being exposed to tetrachloroethylene include the following: Workers in dry cleaning industries Workers who use it to degrease metals Workers in industries who use it to make other chemicals NIOSH recommends that employers[cdc.gov]
Nasal Discharge
  • Negherbon [1959] also reported that a 20- to 30-minute exposure to 206 to 235 ppm causes dizziness in humans (along with eye irritation, sinus congestion, nasal discharge, and sleepiness) [Rowe et al. 1952].[cdc.gov]
Nausea
  • Inhaling its vapors (particularly in closed, poorly ventilated areas) can cause dizziness, headache, sleepiness, confusion, nausea, difficulty in speaking and walking, unconsciousness, and death.[stargate.wikia.com]
  • […] oxidizers; chemically-active metals such as lithium, beryllium & barium; caustic soda; sodium hydroxide; potash Exposure Routes inhalation, skin absorption, ingestion, skin and/or eye contact Symptoms irritation eyes, skin, nose, throat, respiratory system; nausea[cdc.gov]
  • J / mol · K Safety Ingestion May cause nausea, vomiting. May damage liver and kidneys. May cause symptoms like for inhalation. Inhalation May irritate mucous membranes. Can cause headache, dizziness, stupor, unconsciousness.[worldofmolecules.com]
  • […] throat, and nose irritation, dizziness, loss of inhibition, and some incoordination after 10 minutes; 500 ppm for 2 hours caused slight discomfort; 206-356 ppm for 2 hours caused headache, burning of the eyes, sinus congestion, impaired coordination, and nausea[cdc.gov]
  • Signs of tetrachloroethylene poisoning in the short term include dizziness, faintness, headaches and nausea. Longer-term exposure can cause the same effects at lower doses. At high concentrations, seizures, collapse, coma and death have occurred.[nicnas.gov.au]
Vomiting
  • Give large quantities of water and induce vomiting. Do not make an unconscious person vomit. Medical observation is recommended for 24-48 hours after breathing overexposure, as pulmonary edema may be delayed.[chemicalbook.com]
  • Gastrointestinal Ingestion or inhalation of tetrachloroethylene can cause nausea and vomiting.[atsdr.cdc.gov]
  • J / mol · K Safety Ingestion May cause nausea, vomiting. May damage liver and kidneys. May cause symptoms like for inhalation. Inhalation May irritate mucous membranes. Can cause headache, dizziness, stupor, unconsciousness.[worldofmolecules.com]
Loss of Appetite
  • Print instructions only. 11k [ ] Call your doctor or the Emergency Department if you develop any unusual signs or symptoms within the next 24 hours, especially: dizziness or clumsiness nausea or vomiting loss of appetite difficulty breathing [ ] No follow-up[atsdr.cdc.gov]
Flushing
  • […] chemically-active metals such as lithium, beryllium & barium; caustic soda; sodium hydroxide; potash Exposure Routes inhalation, skin absorption, ingestion, skin and/or eye contact Symptoms irritation eyes, skin, nose, throat, respiratory system; nausea; flush[cdc.gov]
  • Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed.[webmd.com]
  • While the water companies flushed the pipes to address this problem, people are still being exposed to PCE in the dry cleaning and textile industries, and from consumer products, and so the potential for an increased risk of illness remains real."[sciencedaily.com]
  • Flush exposed or irritated eyes with plain water or saline for at least 15 minutes. Remove contact lenses if easily removable without additional trauma to the eye.[atsdr.cdc.gov]
Headache
  • Inhaling its vapors (particularly in closed, poorly ventilated areas) can cause dizziness, headache, sleepiness, confusion, nausea, difficulty in speaking and walking, unconsciousness, and death.[stargate.wikia.com]
  • […] beryllium & barium; caustic soda; sodium hydroxide; potash Exposure Routes inhalation, skin absorption, ingestion, skin and/or eye contact Symptoms irritation eyes, skin, nose, throat, respiratory system; nausea; flush face, neck; dizziness, incoordination; headache[cdc.gov]
  • Can cause headache, dizziness, stupor, unconsciousness. Skin May cause skin irritation, severe burns. Eyes May cause severe irritation More info Hazardous Chemical Database ( ) SI units were used where possible.[worldofmolecules.com]
  • […] drunkenness, but no narcosis after 95 minutes; 513-690 ppm caused eye, throat, and nose irritation, dizziness, loss of inhibition, and some incoordination after 10 minutes; 500 ppm for 2 hours caused slight discomfort; 206-356 ppm for 2 hours caused headache[cdc.gov]
  • Signs of tetrachloroethylene poisoning in the short term include dizziness, faintness, headaches and nausea. Longer-term exposure can cause the same effects at lower doses. At high concentrations, seizures, collapse, coma and death have occurred.[nicnas.gov.au]
Confusion
  • The difference in mean color confusion indices (CCI) was statistically significant for the Farnsworth test but not Lanthony's D-15d test [Farnsworth CCI mean difference 0.05, 95% confidence interval (CI): 0.003, 0.10; Lanthony CCI mean difference 0.07[ncbi.nlm.nih.gov]
  • Inhaling its vapors (particularly in closed, poorly ventilated areas) can cause dizziness, headache, sleepiness, confusion, nausea, difficulty in speaking and walking, unconsciousness, and death.[stargate.wikia.com]
  • Australia's Tetrachloroethylene emission report Description In high concentrations, in air, with closed or poorly ventilated areas, single exposures to tetrachloroethylene may cause central nervous system effects leading to dizziness, headache, sleepiness, confusion[npi.gov.au]
  • When concentrations in air are high—particularly in closed, poorly ventilated areas—acute exposures can cause dizziness, headache, sleepiness, confusion, nausea, difficulty in speaking and walking, unconsciousness, and death.[vdh.virginia.gov]
  • Health effects Like many chlorinated hydrocarbons, tetrachloroethylene is a central nervous system depressant, and inhaling its vapors (particularly in closed, poorly ventilated areas) can cause dizziness, headache, sleepiness, confusion, nausea, difficulty[worldofmolecules.com]
Ataxia
  • Chronic Exposure Prolonged exposure to tetrachloroethylene can result in memory and concentration impairment, vision disturbances, dizziness, irritability, ataxia, sleep disturbances, and peripheral neuropathy.[atsdr.cdc.gov]
Slurred Speech
  • Symptoms can include irritability, impaired coordination, lightheadedness, headache, slurred speech, malaise, nausea, ataxia, sedation, coma, and death. Peripheral neuropathies and optic neuritis have been reported (POSINDEX, 2014).[atsdr.cdc.gov]

Workup

Pseudomonas
  • Pseudomonas stutzeri OX1 naphthalene-oxidation activity is induced 3.0-fold by tetrachloroethylene (PCE) and 3.1-fold by trichloroethylene (TCE) at 100 µM.[doi.org]
  • Induction of toluene oxidation activity in Pseudomonas mendocina KR1 and Pseudomonas sp. strain ENVPC5 by chlorinated Solvents and alkanes . Appl. Environ. Microbiol. 61 , 3479–3481 (1995). 23. Heald, S. & Jenkins, R.O.[nature.com]
  • It has been identified as a Pseudomonas spp. Degradation of PCE by this bacterium was quantified by gas chromatography.[doi.org]
  • Bioremediation has been successful under anaerobic conditions by reductive dechlorination by Dehalococcoides sp. and under aerobic conditions by cometabolism by Pseudomonas sp.[en.wikipedia.org]
Hepatic Necrosis
  • Histological examination of the liver revealed massive hepatic necrosis, prominently, in zone 3 of the hepatic lobules.[ncbi.nlm.nih.gov]
Liver Biopsy
  • Repeat liver biopsy performed 6 months after the patient's discharge showed architectural distortion with postnecrotic cirrhosis. Physicians should be aware of the possibility of acute liver failure induced by tetrachloroethylene.[ncbi.nlm.nih.gov]

Treatment

  • Treatment of cells with either TCE or PER resulted in a dose- and time-dependent inhibition of cell growth. A significantly increase in the frequency of micronuclei (MN) was also observed with either TCE or PER treatment.[ncbi.nlm.nih.gov]
  • Instead of excavation or extraction for above-ground treatment or disposal, tetrachloroethylene contamination has been successfully remediated by chemical treatment or bioremediation.[en.wikipedia.org]
  • The patient underwent supportive treatment along with 3 sessions of plasmapheresis, and consequently, he presented a favorable outcome.[ncbi.nlm.nih.gov]
  • Analysis of cord blood cells via flow cytometry showed that PCE treatment induced a statistically significant increase in necrosis after 24 h, while the clonogenicity of Human Colony-Forming Unit-Granulocyte/Macrophage (CFU-GM) and Burst-Forming Unit-Erythrocyte[ncbi.nlm.nih.gov]
  • Granular Activated Carbon Filter Cartridges From EPA.gov NSF/ANSI Standard 58: Reverse Osmosis Drinking Water Treatment Systems The following treatment method(s) have proven to be effective for removing tetrachloroethylene to below 0.005 mg/L or 5 ppb[h2odistributors.com]

Epidemiology

  • METHODS: The updated assessment of PCE synthesized and characterized a substantial database of epidemiological, experimental animal, and mechanistic studies.[ncbi.nlm.nih.gov]
  • The limited epidemiological and toxicological data available for exposure to perc during developmental lifestages, as well as the evidence for critical windows of exposure, highlight early life as a period of potential susceptibility.[ncbi.nlm.nih.gov]
  • The epidemiologic study is described in the accompanying paper by Aschengrau et al.[ncbi.nlm.nih.gov]
  • OBJECTIVES: We assessed the epidemiological evidence for the association between tetrachloroethylene exposure and bladder cancer from published studies estimating occupational exposure to tetrachloroethylene or in workers in the dry-cleaning industry.[ncbi.nlm.nih.gov]
  • The author also included recommendations for the conduct of further epidemiological and environmental studies.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Prevention

  • Prevent the release of vapours/mist into workplace air. Do not use near welding operations, flames or hot surfaces because of the risk of formation of toxic hydrogen chloride or phosgene.[web.archive.org]
  • […] skin redness); liver damage; [potential occupational carcinogen] Target Organs Eyes, skin, respiratory system, liver, kidneys, central nervous system Cancer Site [in animals: liver tumors] Personal Protection/Sanitation ( See protection codes ) Skin: Prevent[cdc.gov]
  • A second batch of preventive measures is in preparation including modifications of the machines to limit solvent exposure and a specific regulation concerning their inspection and maintenance.[ncbi.nlm.nih.gov]
  • […] being exposed to tetrachloroethylene include the following: Workers in dry cleaning industries Workers who use it to degrease metals Workers in industries who use it to make other chemicals NIOSH recommends that employers use Hierarchy of Controls to prevent[cdc.gov]
  • The drycleaning plant had been closed voluntarily before the standard was established, and the interim standard was used to prevent reopening of the plant through a health order issued by the Vermont Health Department.[ncbi.nlm.nih.gov]

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