A case-control study of occupational exposure to trichloroethylene and non-hodgkin lymphoma

Mark P. Purdue, Berit Bakke, Patricia Stewart, Anneclaire J. de Roos, Maryjean Schenk, Charles F. Lynch, Leslie Bernstein, Lindsay M. Morton, James R. Cerhan, Richard K. Severson, Wendy Cozen, Scott Davis, Nathaniel Rothman, Patricia Hartge, Joanne S. Colt

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Background: Previous epidemiologic findings suggest an association between exposure to trichloroethylene (TCE), a chlorinated solvent primarily used for vapor degreasing of metal parts, and non-Hodgkin lymphoma (NHL). Objectives: We investigated the association between occupational TCE exposure and NHL within a population-based case-control study using detailed exposure assessment methods. Methods: Cases (n = 1,189; 76% participation rate) and controls (n = 982; 52% participation rate) provided information on their occupational histories and, for selected occupations, on possible workplace exposure to TCE using job-specific interview modules. An industrial hygienist assessed potential TCE exposure based on this information and a review of the TCE industrial hygiene literature. We computed odds ratios (ORs) and 95% confidence intervals (CIs) relating NHL and different metrics of estimated TCE exposure, categorized using tertiles among exposed controls, with unexposed subjects as the reference group. Results: We observed associations with NHL for the highest tertiles of estimated average weekly exposure (23 exposed cases; OR = 2.5; 95% CI, 1.1-6.1) and cumulative exposure (24 exposed cases; OR = 2.3; 95% CI, 1.0-5.0) to TCE. Tests for trend with these metrics surpassed or approached statistical significance (p-value for trend = 0.02 and 0.08, respectively); however, we did not observe dose-response relationships across the exposure levels. Overall, neither duration nor intensity of exposure was associated with NHL, although we observed an association with the lowest tertile of exposure duration (OR = 2.1; 95% CI, 1.0-4.7). Conclusions: Our findings offer additional support for an association between high levels of exposure to TCE and increased risk of NHL. However, we cannot rule out the possibility of confounding from other chlorinated solvents used for vapor degreasing and note that our exposure assessment methods have not been validated.

Original languageEnglish (US)
Pages (from-to)232-238
Number of pages7
JournalEnvironmental Health Perspectives
Issue number2
StatePublished - Feb 2011


  • Cancer
  • Non-Hodgkin lymphoma
  • Occupational
  • Solvents
  • Trichloroethylene

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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