This increase was not related to the length of employment. Most of these were ulcer deaths. The number of deaths from ischemic heart disease IHD in the overall group was about what we expected. Last, for diseases of the urinary system, we saw an increase of urinary stones. We observed 2 deaths, both in white males who had been exposed to perc for more than 5 years. Both deaths were found in workers from dry cleaning shops which used perc only.
The workers in this study worked in and around four major U. Mortality among workers in the four sub-groups representing these locations was analyzed using local county mortality rates as well as U.
In general, the results for the four geographical sub-groups were consistent with the results for the overall group of workers.
These results generally suggest that geographical variation in mortality does not account for the observed increases in any disease outcome. In addition, the increases we observed in the NIOSH study have remained elevated throughout the s. Smoking increases the risk of all of the cancers we found in this study.
We did not have information on the smoking habits on the workers in our study. However the risk of lung cancer was not highly increased among the workers in this study. This suggests that the workers may not have smoked excessively. The use of other tobacco products such as chewing tobacco and snuff also is bad for your health. They can cause cancer of the inside the mouth, as well as other illnesses. ACS has programs and information on ways to stop smoking. They also have free information on the treatment and diagnosis of various cancers.
You may visit the ACS web site at www. The American Lung Association also has programs to help you stop smoking. Alcohol consumption also can contribute to the risk of some of the health effects observed in the NIOSH study. As with smoking habits, we did not have information on alcohol use among the workers in the study. If you drink alcohol, you should do so in moderation. There were four basic limitations in this study:. Studies by the National Cancer Institute and by other researchers also have found excess bladder, esophageal, and cervical cancer deaths among groups of dry-cleaning workers.
Some of the studies used union records which included laundry workers, because they belonged to the same unions as the dry cleaners. Therefore the findings in these studies also included workers who had jobs in other occupations, as well as dry-cleaning. If you still work in dry-cleaning, you probably are exposed to perc.
NIOSH believes that perc is a potential cancer-causing agent. Therefore, exposures to perc should be reduced to the lowest possible level. NIOSH exposure studies have shown that levels of less than 5 parts per million ppm over an 8-hour day are possible with well-maintained 4th generation machines.
A peak exposure should not exceed ppm. In California and a few other states, the PEL is 25 ppm. Some plants still use Stoddard solvent. Nealis showed Smith a designer jacket that wet cleaning caused to shrink, and left without what Nealis calls "that nice, finished, like-new look that you went to the cleaners for.
Some dry cleaners call their methods "organic. All it means for sure is that the cleaning methods include the use of carbon, which could apply to virtually all methods of cleaning. Another option? Stop buying clothes that require dry cleaning. That's what Mickelson did. She told Smith she now owns only one item, pair of pants, that is dry clean-only.
Though the dry cleaner beneath Mickelson's apartment no longer uses a PERC machine, she still worries about her family's exposure, telling Smith she worries "all the time" about its long-term effects, adding, "When one of us gets sick, I think, could this be something related to PERC? My greatest fear is that one of us is going to get cancer from it. Experts say, if you live or work in a building that has a PERC dry cleaner, you may want to have your local health department check the level of PERC in the air.
And if your clothes come back from the cleaners smelling like chemicals, it could be a sign they have too much PERC on them, and you should take them back and have them redone. Experts say unwrapping your dry cleaned clothes when you get home and airing them out could help, but if you take the plastic bag off inside your house, the PERC just goes into the air, where it can last up to a week.
It's better to air dry cleaning out in an open garage or outside. Mickelson says she airs out her dry cleaned pants by taking them for a walk around the block before bringing them home! Moreover, it is unlikely that the associations were dependent, totally or in part, on factors other than PERC exposures, such as common lifestyle factors as smoking or drinking alcohol. Data from more limited studies suggest that other types of cancer esophageal, kidney, lung, liver, cervical, and breast cancer are associated with PERC exposure.
In laboratory studies, PERC caused cancer in rats and mice when they ingested or inhaled high doses almost daily for a lifetime. Various studies provide data on background levels of PERC in outdoor and indoor air. The monitoring sites were selected to provide air quality data from the state's urban, industrial, residential, and rural areas. Based on samples collected across the state during to , the 50th percentile median and 95th percentile 3 PERC levels were 0.
Two outdoor samples were collected just outside each home for a total of samples. The 50th percentile and 95 th percentile PERC levels were less than 0. The table contains the results from air samples collected inside of buildings that were not near known sources of PERC and other chemicals for example, a home not known to be near a chemical spill, a hazardous waste site, a dry-cleaner, or a factory. This determination considered continuous, lifetime exposure and sensitive people.
Three other ways of expressing the new guideline are 0. Decisions about whether to take actions to further reduce exposure are generally made on a case-by-case basis at this level of risk. The purpose of the guideline is to help guide decisions about the urgency of the actions to reduce PERC exposure.
The urgency to initiate these actions and to determine, in a timely manner, whether they have reduced exposure, increases with indoor air levels, particularly when air levels are above the guideline.
Indoor air levels substantially above the guideline indicate a significant PERC source and may require more immediate remedial action.
In all cases, the specific corrective actions to be taken depend on a case-by-case evaluation of the situation. The goal of the recommended actions is to reduce PERC levels in indoor air to as close to background as practical.
The guideline is not a bright line between PERC levels that cause health effects and those that do not. The differences between exposure at the guideline and exposure levels known to cause effects in humans and animals are large. Thus, exposure to levels above but near the guideline will not cause health effects in most, if not all, people. In addition, the guideline is based on the assumption that people are continuously exposed to PERC in air all day, every day for as long as a lifetime.
Continuous exposure is rarely true for most people, who, if exposed, are more likely to be exposed for a part of the day and part of their lifetime. PERC levels can be measured in the breath for weeks following a high exposure to PERC because it is stored in body fat and is slowly released into the bloodstream and then exhaled in the breath.
PERC can be measured in blood. Because exposure to other chemicals can produce the same breakdown products in the urine and blood as PERC, the tests for breakdown products cannot determine if you have been exposed only to PERC. Although the tests can show if PERC levels in the body are elevated compared to background levels, they cannot conclusively determine when and for how long a person was exposed, what the source of that exposure was, or whether or not the person will develop adverse health effects.
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