review or solvent mixtures and cirrhosis or persistent alterations in liver function tests after cessation of exposure.

There is limited/suggestive evidence of an association between chronic exposure to solvents and hepatic steatosis that could persist after cessation of exposure.

TABLE 9.3 Selected Epidemiologic Studies: Hepatic Steatosis and Exposure to Organic Solvents



Exposed Cases

Estimated Relative Risk (95% CI)

Brodkin et al., 1995

Dry-cleaning workers in Seattle



Hepatic parenchymal changes and tetrachloroethylene exposure



Crude exposure


2.5 (0.6–10.1)a


Old dry- or wet-transfer operation


4.2 (1.1–15.3)a





<10 process-adjusted years


5.1 (0.8–33.1)a


≥10 process-adjusted years


1.2 (0.2–7.2)a

Lundqvist et al., 1999

Male steatosis patients in Sweden



Intense exposure to solvents at anytime


6.7 (1.4–30)


in 1 year of preceding 15 years


7.7 (1.7–48)


in >5 years of preceding 15 years


29.7 (3.2–218)

NOTE: NA=not available.

aAdjusted for age, alcohol consumption, body-mass index, sex, and serologic evidence of hepatitis.

bData are for the highest exposure group as determined from type of job, title, and questionnaire exposure information.


Several gastrointestinal effects have been examined with regard to a potential relationship to solvent exposure. Pancreatitis occurs when inflammation in and around the pancreas disrupts its exocrine and endocrine functions. Autodigestion (during which digestive enzymes that are normally secreted in an inactive form become activated in the pancreas and begin to digest the pancreatic tissue) is one theory of the pathogenesis of pancreatitis (Greenberger et al., 1998). Chronic pancreatitis is a persistent inflammation that can result in extensive damage. Most of the estimated 50,000–80,000 cases of acute pancreatitis annually in the United States are caused by alcohol abuse or gallstones (NIDDK, 2001). Because chronic alcohol consumption is a known risk factor in the development of pancreatitis, researchers have theorized that occupational-solvent exposure, particularly to alcohol-based solvents, could cause chronic pancreatitis.

Epidemiologic Studies of Gastrointestinal Effects and Exposure to Organic Solvents

There are few epidemiologic data on the potential gastrointestinal effects of exposure to solvents.

Yamaguchi and colleagues (1985; Sato et al., 1987) examined the association between trichloroethylene exposure and pneumatosis cystoides coli, a benign condition of the large intestine involving formation of multiple gas-filled cysts. The cases (n=13) and

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