Rita Beamish from the Associated Press has written three articles that are running in papers around the world today:

Camp Lejeune Water Under Scrutiny
The former residents, who together seek nearly $4 billion, believe their families were afflicted by water containing industrial solvents before the Marines shut off the bad wells in the mid-1980s.

Dates Important in Water Contamination
Key events in the contamination of drinking water at Camp Lejeune in North Carolina.

Solvents in Water Present Perils
Industrial solvents known as TCE and PCE are known health hazards, but the amount of exposure that can cause harm is subject to debate.

Update (June 13):

Congress investigates tainted water at Marine base by Kimberly Hefling
The government Tuesday disclosed results from a new study the same day lawmakers listened to emotional testimony from families about cancers and other illnesses they blame on tainted tap water at the sprawling base.

When this blog first launched, we created a topic category called "Health Effects". This was one of many topic categories we included to enable readers to find pertinent information more easily (see the list of "Topics" to the left).

Over time, we have realized that many of our readers have a particular interest in the way TCE (or related solvents) impacts specific organs in the body — and what is known about its relationship to particular diseases. As such, we've decided to begin categorizing health effects information (articles, studies, resources, etc) by target site/organ in the body. In doing so, we've created a number of new Health Effects categories. In a few cases, we've created specific disease categories, such as Lymphomas or Leukemia.

Want to know how TCE effects the brain? Click on Health Effects - Brain. The heart? Click on Health Effects - Heart. Want to to see all posts related to all health effects? Choose Health Effects - All.

At the moment, you'll notice these categories are relatively empty. It may take us a few days or more to re-categorize all of our old health effects-related posts. In addition, as we publish new items related to specific health effects in the future, you will be able to find them in these new categories. Over time, we hope to add as many resources as possible in each category so that the TCE Blog continues to be a useful online resource.

Note: If there are resources (or categories) you would like to see added to our library of health effects information, please don't hesitate to contact us. Also, please don't hesitate to shout if you think there is a better/easier way to organize this information.

A recently published article from CancerConsultants.com reports:

Occupational Solvents May Increase Risk of Lymphoma

Researchers from Italy have reported that occupational exposure to solvents such as benzene, xylene, and toluene may increase the risk of developing non-Hodgkin’s lymphoma (NHL) and Hodgkin’s lymphoma (HL). The details of this case-control study were published in Epidemiology .

[...]

Many, but not all, studies show a consistent link between woodworking and Hodgkin’s disease . Trichloroethylene is an organic chemical used in dry cleaning, metal degreasing and as a solvent for oils and resins and has been identified to cause liver and kidney cancer in animals. Exposure to trichloroethylene has been associated with an increased chance of developing Hodgkin's disease and other cancers. Machinists in the metal working industry have also been reported to have a higher than average incidence of Hodgkin's disease. Exposure to pesticides has been associated with an increased incidence of Hodgkin's disease in some, but not all, clinical studies. It has also been known for some time that young adults with infectious mononucleosis are at increased risk for the development of Hodgkin’s lymphoma.

Read the full article here. Or check out the abstract of the study, entitled "Occupational Exposure to Solvents and the Risk of Lymphomas." (the full study is available here for download with registration)

This article was made available online yesterday by Environmental Health Perspectives. From the abstract [PDF]:

Trichloroethylene Monograph
Trichloroethylene Cancer Epidemiology: A Consideration of Select Issues
Cheryl Siegel Scott and Weihsueh A. Chiu

A large body of epidemiologic evidence exists for exploring causal associations between cancer and trichloroethylene (TCE) exposure. The U.S. Environmental Protection Agency’s 2001 draft TCE health risk assessment concluded that epidemiologic studies, on the whole, support associations between TCE exposure and excess risk of kidney cancer, liver cancer, and lymphomas, and, to a lesser extent, cervical cancer and prostate cancer. As part of a minimonograph on key issues in the health risk assessment of TCE, this article reviews recently published scientific literature examining cancer and TCE exposure and identifies four issues that are key to interpreting the larger body of epidemiologic evidence: (1) relative sensitivity of cancer incidence and mortality data; (2) different classifications of lymphomas, including non-Hodgkin’s lymphoma; (3) differences in data and methods for assigning TCE exposure status; and (4) different methods employed for causal inferences, including statistical or meta-analysis approaches. The recent epidemiologic studies substantially expand the epidemiologic database, with seven new studies available on kidney cancer and somewhat fewer studies available that examine possible associations at other sites. Overall, recently published studies appear to provide further support for the kidney, liver, and lymphatic systems as targets of TCE toxicity, suggesting, as do previous studies, modestly elevated (typically 1.5 to 2.0) site-specific relative risks, given exposure conditions in these studies. However, there are a number of challenging issues that need to be considered before drawing causal conclusions about TCE exposure and cancer from these data.

Download the full version here [PDF]

The International Agency for Research on Cancer classifies Trichloroethylene (TCE) as probably carcinogenic to humans (Group 2A). Here's a direct link to IARC's summary and evaluation (Updated 1997).



Update: The direct link above is no longer active. Try here.

Direct link here. Also added as permanent link in the right column under Science/Agency sites (------>)

Update:

ATSDR's full Toxicological profile of TCE (1997) is here.

In the spirit of sharing and for research purposes, we'd like to make available any Public Health Assessments (PHA's) that have been drafted or completed and involve TCE (or related issues).

First up is the 2005 Final Public Health Assessment for Cheshire, CT (the self-proclaimed Bedding Plant Capital of CT) conducted by the ATSDR and the CT Department of Public Health. History of this PHA can be found at the Cancer in Cheshire website* (also a permanent member of our Community site links over to the right (---->). Findings include:

- The town's public water supply (serving just over 20,000 pople) suffered from 16-30 years of ongoing TCE contamination;
- TCE contamination found in the town's private water supply over past 20 yrs. No add'l sampling ordered. Past and current health risk unknown;
- Known contamination sites, discovered over 20 yrs ago, may still be contaminated;
- Cancer rates (multiple types) elevated with statistical significance and some with rising trends;
- Official conclusion: Past exposure to TCE in the public water supply presented No Apparent Public Health Hazard;
- No follow-up recommended.

You can download the full PHA here (FYI: This is an 8 MB pdf document).

If you have any PHA's that you would like to share, please contact us directly.

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*Disclosure: I am a co-founder of the cancer in cheshire website and was petitioner of the ATSDR (which prompted the assessment above).

Since approximately 1993, the ATSDR has been tracking the health effects reported by discreet communities exposed to Trichloroethylene. Their National Exposure Registry (NER) basically tracks this kind of data for well-identified communities who have been exposed to it (there are myriad qualification requirements, I'm simplifying here).

The NER for TCE has some interesting data and discussion. It raises questions about elevated cancer findings among the TCE-exposed population. Unfortunately, the detailed comparison of cancer types by age/sex for the exposed population vs. the general population never actually appears in the reports (despite references to appendices with this data in 3 separate reporting years: 1994, 1996, and 1999). Maybe I just can't find it. To be sure, in May of 2004, I wrote the ATSDR to request the missing data/appendices. I received this response:

Mr. Fischbein:

The TCE Subregistry cancer outcomes analyses are slated to be released under a separate study. The results are not publically available at this time. Please do keep tabs on our publications for future releases.

I confess, I'm not sure what to make of this. If anybody has any thoughts, please let me know or feel free to use the comments feature below.

The Jacksonville Daily News reports that a panel of seven scientists met yesterday (Thurs) and will meet again today to discuss the potential for further study of Camp Lejeune contamination and its link to adverse health effects.

According to the report:

Some of the areas considered as focuses for further study include adult cancers and mortality, heart defects, frequency of hospital visits, neurological affects and autoimmune diseases [...and...] a variety of conditions in children who were in the womb during the contaminated years, including neural tube defects, oral clefs, childhood leukemia and non-Hodgkin's lymphoma, and a variety of heart defects. The independent panel was formed to further investigate the contamination of Camp Lejeune's water systems between 1968 and 1985 by the chemicals trichloroethylene (TCE) and tetrachloroethlyene (PCE), cleaning chemicals that leaked from a dry cleaning business on Lejeune Boulevard and into the drinking water for the Tarawa Terrace residential area and other areas of the base.

Panel members included Richard Maas, from the University of North Carolina at Asheville, and Dr. David Ozonoff, from the Boston University School of Public Health. Ozonoff, who has expressed concern over the EPA's handling of the TCE issue, shared this advice:

Ozonoff said he was especially worried about the [ATSDR's] inability to resolve the complaints of many people who were never notified of the contamination or who felt neglected by not being included in the [previous] study. "Let's face it, underlying this is an issue of trust," Ozonoff said. "While ATSDR has a long record of saying they help the community, there is a rocky history. You're going to have to figure out the trust issue."

Full article here. You can also find more information from the community group that has organized at Camp Lejeuene, THE STAND (Toxic Homefront Empowered Survivors Take All Necessary Defense).

Update: Not surprisingly, the Solvents Industry doesn't think further study is warranted. So much so, they issued this press release (warning: links directly to PDF doc)

In the U.S. National Toxicology Program's 11th Report on Carcinogens, TCE is reasonably anticipated to be a human carcinogen.

Here's a pdf of the TCE review only. Thanks to VJ for link.

In 2002, the EPA's Science Advisory Board (SAB) reviewed the EPA's 2001 draft health assessment of TCE. The SAB "commends the [EPA] for its groundbreaking work [...] in several important new areas of risk assessment" while also providing suggestions "to strengthen and provide confidence in the assessment."

Here is the full SAB review. Thanks to reader VJ for the link.

Here's a direct link to the EPA's 2001 Document: Trichloroethylene Health Risk Assessment: Synthesis and Characterization (external review draft)

From the EPA's abstract:

This assessment presents EPA's most current evaluation of the potential health risks from exposure to trichloroethylene (TCE). TCE exposure is associated with several adverse health effects, including neurotoxicity, immunotoxicity, developmental toxicity, liver toxicity, kidney toxicity, endocrine effects, and several forms of cancer. Mechanistic research indicates that TCE-induced carcinogenesis is complex, involving multiple carcinogenic metabolites acting through multiple modes of action. Under EPA's proposed (1996, 1999) cancer guidelines, TCE can be characterized as "highly likely to produce cancer in humans."

Update:

I'm trying to find the published responses to this document. I know the Halogenated Solvents Industry (along with several others, if I recall correctly) filed a rather lengthy response. If anyone knows where I can find these, please email me.