tion (Hotz et al. 1992). In all cases, exposure was current, and no study could evaluate whether any adverse effects persisted beyond the period of exposure. IOM concluded that there was inadequate/insufficient evidence to determine whether an association exists between exposure to TCE, PCE, or other solvents and long-term reduction in olfactory function.

No additional studies of solvent exposure and long-term reduction in olfactory function were identified.

• There continues to be inadequate/insufficient evidence to determine whether an association exists between exposure to TCE, PCE, or other solvents and long-term reduction in olfactory function.

The committee undertook a general review of the epidemiologic evidence on TCE, PCE, and solvent mixtures. On the basis of the reviews referred to in this chapter, the committee concludes that the strongest evidence of an association between TCE or PCE and health outcomes is in the category of limited/suggestive evidence of an association related to the following end points:

• Esophageal cancer (PCE)

• Lung cancer (PCE)

• Breast cancer (PCE)

• Bladder cancer (PCE)

• Kidney cancer (TCE, PCE)

• Miscarriage (PCE)

The strongest evidence of an association between solvent mixtures and health outcomes is in the category of limited/suggestive evidence of an association related to the following end points:

• Adult leukemia

• Multiple myeloma

• Kidney toxicity

• Liver toxicity (hepatic steatosis)

• Female infertility

• Scleroderma

• Neurobehavioral effects

For all other outcomes considered, the committee categorized the evidence as inadequate/insufficient for determining whether associations exit.

Chapter 6 presents a more detailed review of the epidemiologic studies that involved community exposure to drinking water contaminated with TCE or PCE, and Chapter 8 reviews studies of former Camp Lejeune residents. Chapter 7 provides an integrated discussion of the epidemiologic evidence in context with the toxicologic evidence on TCE and PCE.