Association between Residential Proximity to PERC Dry Cleaning Establishments and Kidney Cancer in New York City

Jing Ma,David O Carpenter,Judith Schreiber,Lawrence Lessner

doi:10.1155/2009/183920

Abstract

Perchloroethylene (PERC) is commonly used as a dry cleaning solvent and is believed to be a human carcinogen, with occupational exposure resulting in elevated rates of kidney cancer. Living near a dry cleaning facility using PERC has been demonstrated to increase the risk of PERC exposure throughout the building where the dry cleaning is conducted, and in nearby buildings. We designed this study to test the hypothesis that living in an area where there are many PERC dry cleaners increases PERC exposure and the risk of kidney cancer. We matched the diagnosis of kidney cancer from hospitalization discharge data in New York City for the years 1994–2004 by zip code of patient residence to the zip code density of dry cleaners using PERC, as a surrogate for residential exposure. We controlled for age, race, gender, and median household income. We found a significant association between the density of PERC dry cleaning establishments and the rate of hospital discharges that include a diagnosis of kidney cancer among persons 45 years of age and older living in New York City. The rate ratio increased by 10 to 27% for the populations in zip codes with higher density of PERC dry cleaners. Because our exposure assessment is inexact, we are likely underestimating the real association between exposure to PERC and rates of kidney cancer. Our results support the hypothesis that living near a dry cleaning facility using PERC increases the risk of PERC exposure and of developing kidney cancer. To our knowledge, this study is the first to demonstrate an association between residential PERC exposure and cancer risk.

Highlights

Perchloroethylene (PERC), known as tetrachloroethylene or tetrachloroethene, is a volatile, nonflammable liquid with a sweet odor
Our analysis found no significant relationship between the density of PERC dry cleaners and “all cancer,” but, more importantly, did identify a significant association between the density of PERC dry cleaning establishments and the rate of hospital discharges that included a diagnosis of kidney cancer (ICD9 189.0 and 189.1)
Given the significant limitations in our study, in exposure assessment, the relationship between residential exposure to PERC and kidney cancer may be stronger than what we report in this study

Summary

Introduction

Perchloroethylene (PERC), known as tetrachloroethylene or tetrachloroethene, is a volatile, nonflammable liquid with a sweet odor. It has been used as the primary solvent in the dry cleaning industry since the 1930s. The United States Environmental Protection Agency (EPA) estimates that there are about 34,000 dry cleaner facilities nationwide and approximately 82% of them use PERC as their primary solvent [1]. The Agency for Toxic Substances and Disease Registry [2] estimates that more than 650,000 workers might be regularly exposed to PERC [2]. The absorption and distribution of PERC to body tissues and fluids is not disputed, adverse health effects of exposure are still being evaluated

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Conclusion