Exposure to tetrachloroethylene, a chemical commonly known as PCE and widely used in dry cleaning, may triple a person’s risk of developing significant liver fibrosis, according to a study published in Liver International by researchers at Keck Medicine of USC. The findings suggest that environmental toxins could explain cases of liver disease that do not stem from traditional causes like heavy alcohol use or obesity.
Understanding PCE Exposure and Liver Fibrosis Risk
Researchers analyzed data from the National Health and Nutrition Examination Survey (NHANES) collected from 2017-2020. The analysis revealed that about 7% of the U.S. population had detectable levels of PCE in their blood. Individuals with measurable PCE exposure were three times more likely to have significant liver fibrosis compared to unexposed participants, according to the study led by Brian P. Lee, MD, MAS, a hepatologist and liver transplant specialist with Keck Medicine.
Fibrosis occurs when repeated injury causes scar tissue to build up in the organ. If left untreated, severe scarring can progress to cirrhosis, liver failure, liver cancer, or death. According to Lee F. Peng, MD, PhD, chief of gastroenterology and hepatology at Hackensack Meridian Jersey Shore University Medical Center, halogenated hydrocarbons like PCE are notorious for causing liver injury by initiating inflammation that leads to hepatic scarring.
The Dose-Response Relationship in PCE Blood Concentrations
The study uncovered a clear exposure pattern connecting the concentration of the chemical in the bloodstream to the severity of organ damage. For every one nanogram per milliliter increase in PCE concentration, the odds of having significant liver fibrosis increased five-fold. This dose-effect strengthens the link showing that the chemical may directly drive liver damage rather than just share a correlation, according to Lee.
Unlike metabolic dysfunction-associated steatotic liver disease (MASLD) or alcohol-related damage, the significant liver fibrosis identified in participants with PCE in their blood could not be explained by alcohol consumption, obesity, diabetes, or high cholesterol. This discovery offers a potential clue for patients who ask doctors how they developed liver damage despite lacking traditional risk factors.
Did you know?
PCE is a synthetic, colorless liquid effective at dissolving grease. In addition to dry cleaning, it appears in consumer and industrial items like spot removers, adhesives, metal degreasers, and stainless steel polish.
Common Routes of Exposure and Regulatory Phaseouts
People commonly encounter PCE by breathing it in, as dry-cleaned clothing can gradually release small amounts of the chemical into the surrounding air over time. Spills or improper disposal can also allow the chemical to move through soil and contaminate groundwater and drinking water supplies. Interestingly, the Keck Medicine analysis found an unexpected socioeconomic pattern: people from higher-income households were more likely to have detectable PCE levels, likely due to a higher frequency of using dry cleaning services.
Concerns regarding the compound are long-standing. The International Agency for Research on Cancer classifies PCE as a probable carcinogen, linking it to bladder cancer, multiple myeloma, and non-Hodgkin lymphoma. In response to these health risks, the United States Environmental Protection Agency initiated a 10-year phaseout of PCE use in dry cleaning while restricting other industrial applications and imposing workplace protections.
Frequently Asked Questions
What is PCE?
Tetrachloroethylene (PCE) is a colorless volatile organic compound used primarily as a solvent in dry cleaning, metal degreasing, and various manufacturing products.
How does PCE affect the liver?
When PCE metabolizes in the liver, its metabolites react with cells to degrade fat in cell membranes, initiating inflammation and scar tissue buildup known as liver fibrosis.
What are the main symptoms of liver fibrosis?
As scarring worsens, it can impair liver function and eventually lead to complications of cirrhosis.
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