[Early effects of PCE exposure on visual function among dry cleaning workers]. / Effetti precoci della esposizione e percloroetilene nei lavoratori delle levanderie a secco sulla funzione visiva.

BACKGROUND: A number of studies have shown a possible correlation between exposure to perchlorethylene (PCE) in dry cleaning workers and impairment of colour perception. OBJECTIVES: to ascertain the possible presence of alterations in visual function in a group of workers exposed to current limit value levels of PCE. METHODS: The study was conducted on 38 workers exposed to PCE in 21 dry cleaning establishments in the district of Modena and 60 controls selected according to criteria of comparability. We measured exposure to PCE among the dry cleaning workers using environmental monitoring (mean exposure 16.9 mg/m3). Both groups then answered a medical history questionnaire and underwent the Ishihara test for evaluating exclusion criteria followed by Lanthony D15d and Visual Acuity in Contrast Reduced (VCS) tests to evaluate changes in visual function. The results of Lanthony's test were expressed using Index Confusion Chromatic (ICC). RESULTS: In the cases the average value of ICC was 1.28 (DS 0.21) and in the controls 1.15 (SD 0.21); the difference was statistically significant (p <0.01). The values of ICC tended to be worse in subjects engaged only in the washing phase, who also had higher levels of exposure to PCE (mean exposure 26.8 mg/m3). The values of VCS for each frequency did not show, however, significant differences between the two groups. CONCLUSIONS: On this basis, our data indicate that occupational exposure to PCE well below the current limit values may still be able to induce impairment of colour perception and that such levels are therefore not adequately protective, at least against these effects.

Evaluation of Occupational Exposure to Perchlorethylene in a Group of Italian Dry Cleaners Using Noninvasive Exposure Indices.

Recent data suggest a general trend in decreased occupational exposure to perchlorethylene (PCE) in the dry-cleaning sector. The aims of this study were to confirm this trend to lower exposure levels in a group of Italian dry cleaners and to evaluate the current occupational PCE exposure in these works using noninvasive biological indices. Environmental exposure was assessed by personal sampling in 60 operators working in 21 dry cleaning shops in North Italy. PCE in the exhaled alveolar air (PCEalv), urinary concentration of PCE and of trichloroacetic acid (TCA) (PCEu and TCAu respectively), were measured as biological exposure indices. Median PCE environmental concentration in the whole sample was 10.6 mg/m3 (i.e., less than the 25% of the levels measured in the same area in a previous study). All values were less than 10% of the occupational limits. PCEu measured in samples collected at the end of the work shift resulted the biological markers having the strongest correlation with environmental PCE (r = 0.81). PCEalv also resulted in a high correlation (r = 0.66), while a lower correlation was found for TCAu measured at the end shift (r = 0.32). According to our results, PCEu can be proposed as a valid, noninvasive, and easily reliable exposure index to evaluate PCE exposure at the low levels currently observed in dry cleaners, therefore representing a promising alternative to invasive blood sample collections needed to determine PCE blood concentration.

Anosmia after exposure to a pyrethrin-based insecticide: a case report.

We present the case of a subject developing anosmia, preceded by nasal transient irritation and short lasting phantosmia and torqosmia, upon re-entrance into a room treated with a pyrethrin-based insecticide. The concentration of the insecticide in the room is unknown, but relatively high levels are predicted basing upon the modality of exposure and by the irritation symptoms in the subject. Despite corticosteroids therapy, anosmia has persisted unmodified for more than three years; according to, and based on evidence in the literature on olfactory disturbance prognosis, anosmia in this patient is likely to be permanent. The significance of this case report is related to the current wide use of insecticides containing pyrethrin and pyrethroids and highlights the need for more adequate attention to lowering airborne concentrations of pyrethrins and pyrethroids prior to re-entering the treated rooms. In particular, in a closed space sprayed with pyrethrins and pyrethroids insecticide, any irritant symptoms and/or dysosmia should be immediately considered relevant warning signs, and must be avoided.