Heavy exposure to
solvent linked to cancer
By N. Seppa
The chemical solvent trichloroethylene has a bad reputation these days.
The popular nonfiction book A Civil Action (1995, Jonathan Harr,
Random House) and its movie version relate how residents of a Massachusetts
town came to blame a set of leukemia cases on trichloroethylene and
other chemicals in the town's water supply.
In Europe, scientists know trichloroethylene well. During studies of
various cancers, they have analyzed patients' exposure to the solvent.
While the work hasn't yet produced hard proof that the chemical causes
malignancies, German researchers now report strong evidence linking
excessive trichloroethy-lene exposure to cancer via a specific gene
mutation.
For decades, metal-processing workers in Germany used trichloroethylene
as a degreaserbreathing its fumes in poorly ventilated rooms,
washing floors with it, even scrubbing their hands and arms with the
chemical. To gauge the cancer risk these practices imparted, scientists
scrutinized a gene called von Hippel-Lindau (VHL), which normally suppresses
the disease.
Mutations in this gene cropped up in 33 of 44 kidney cancer patients
who had been exposed to trichloroethylene in the workplace, researchers
report in the May 19 Journal of the National Cancer Institute.
In general, about half of kidney cancer patients have a mutated VHL,
says coauthor Hiltrud Brauch of the Margarete Fischer-Bosch Institute
of Clinical Pharmacology in Stuttgart.
The intensity of exposure to trichloroethylene varied among the former
factory workers, and those getting heavier doses of the solvent over
many years were more likely to have multiple VHL mutations. Of the 17
cancer patients with the greatest solvent exposures, 11 had two or more
mutations in VHL.
The VHL gene is a string of hundreds of nucleotides, the components
of DNA. At nucleotide 454, the scientists identified a potential weak
link in the molecular chain. In 13 of the trichloroethylene-exposed
cancer patients, a defect showed up at this precise location. In contrast,
none of 107 people with kidney cancer who had not been exposed to trichloroethylene
and none of 97 healthy volunteers had a mutation at nucleotide 454.
Of 14 patients with multiple VHL mutations, 9 had a defect at the 454
spot.
"I think this is a very important, exciting study," says W. Marston
Linehan, a urologist at the National Cancer Institute in Bethesda, Md.
While researchers suspected a link between trichloroethylene and kidney
cancer, "there was no molecular basis for it until this study," he says.
However, the study data don't establish whether such a mutation is
merely a marker of trichloroethylene overexposure or instead a risk
factor for kidney cancer, says toxicologist Laura C. Green of Cambridge
Environmental, a consulting firm in Massachusetts. Further tests on
animals may clarify this point, she says.
Also, the study concentrates on gross overexposure to the chemical
and so contributes little to the debate behind A Civil Action.
The German workers encountered trichloroethylene doses that "are thousands
of times greater" than the amounts people typically come across in contaminated
air or drinking water, Green says.
The researchers have produced "a good paper," says toxicologist Steven
R. Tannenbaum of the Massachusetts Institute of Technology. However,
he cautions that the work on VHL mutations, and particularly the 454
nucleotide site, is far from conclusive. He notes that the majority
of the heavily exposed workers with kidney cancer had an intact 454
site.
The cancer tracked in this study, clear-cell renal carcinoma, accounts
for roughly 85 percent of kidney cancer cases, Linehan says. Kidney
cancer itself ranks 13th in frequency among malignancies in the United
States. It is diagnosed in roughly 27,000 people annually and accounts
for about 12,000 deaths every year.