Counseling and Prevention

After completing this section, you will be able to describe how to prevent exposure to elevated levels of TCE.

All patients exposed to TCE need basic guidance on

• self-care, so they can minimize further risks and avoid complications to the extent possible, and
• clinical follow-up, so they understand when and why to return for further medical attention.

Advise patients to avoid exposures and conditions that might further increase their risk for disease or worsen their existing condition(s).

High levels of exposure can occur during cleanup of contaminated equipment and spills and might require use of an approved full-facepiece, self-contained breathing apparatus or other personal protective equipment. Industries and businesses should establish procedures for spill cleanup in advance, including capping all containers of liquid TCE and storing rags soaked with TCE in sealed containers.

In occupational exposures, the law requires employers or manufacturers to provide pertinent safety data sheets (SDS). The SDS for chemical products list their ingredients, describes their potential toxicity, and suggests precautions for safe use.

Advice on self-care for the patient might include the following:

At home

• Use safer alternatives to products with TCE.
• When using products containing TCE, ensure plenty of airflow/ventilation (e.g., opening all windows and using fans).
• Use appropriate PPE that protects against TCE (e.g., wear a proper respirator or protective gloves, or both) when using products that contain TCE.

At work

• OSHA’s Hazard Communication Standard [OSHA 2012] requires employers to provide labeling, SDS, and safety training on use of chemicals in the workplace.
• Read employer-provided SDS on products that you use.
• Be sure all containers of chemicals used at work are properly labeled.
• Attend employer-provided training on how to use chemicals safely at work.
• Be sure to use the employer-supplied PPE: gloves, goggles, mask, and respirator, as recommended.

TCE has been shown to be strongly associated with kidney cancer and to have a moderate association with non-Hodgkin lymphoma. Periodic clinical evaluation might help detect abnormalities at an early stage, if they occur. This would also be true for other TCE-related health effects. Consultation with a specialist in occupational and environmental medicine or others with expertise and experience treating patients exposed to TCE might help you develop a periodic monitoring plan, as appropriate.

Patient counseling on the importance of exposure mitigation and ways to reduce exposure risk would be prudent, along with instructions to consult you or another physician if concerns about exposure arise.

Advise patients to consult you or another physician if they develop signs or symptoms of

• CNS disorders or
• other health changes (especially those possibly related to liver and kidney problems).

TCE Poisoning Patient Education and Care Instruction Sheet

Refer to the following online resources for more information on the adverse effects of TCE, the treatment of TCE poisoning, and management of persons exposed to TCE. You may also contact ATSDR (see URLs provided below), your state and local health departments, and university medical centers.

NOTE: ATSDR cannot respond to questions about individual medical cases, provide second opinions, or make specific recommendations regarding therapy. Patients should address those issues directly with a health care provider.

CDC-INFO: 1-800-CDC-INFO (1-800-232-4636); TTY 888-232-6348 24 hours/day email: cdcinfo@cdc.gov.

ATSDR Toxicological Profile for Trichloroethylene

ToxFAQs™ for Trichloroethylene

Other Sources of Information

American Association of Poison Control Centers Poison Control Hotline: 1-800-222-1222

Association of Occupational and Environmental Clinics

Pediatric Environmental Health Specialty Units -PEHSUs

American College of Occupational and Environmental Medicine

American College of Medical Toxicologists

American College of Preventive Medicine

ATSDR Information Center

The National Institute for Occupational Safety and Health (NIOSH)

Other CSEMs

“Case Studies in Environmental Medicine: Trichloroethylene Toxicity” is one monograph in a series. To view the “Taking an Exposure History” or “Taking a Pediatric Exposure History” CSEMs and other publications in this series, go to http://www.atsdr.cdc.gov/csem/csem.html.

• Physicians should advise patients to avoid TCE exposures and factors that might further increase their risk for disease or worsen their existing condition(s).

• Physicians should advise patients to contact them or another physician if they develop neurological problems or other health changes.

To review relevant content, see “Self-care” and “Clinical follow up” in this section (3.4).

Refer to the following online resources for more information on the adverse effects of TCE, the treatment of TCE poisoning, and management of persons exposed to TCE. You may also contact ATSDR (see URLs provided below), your state and local health departments, and university medical centers.

NOTE: ATSDR cannot respond to questions about individual medical cases, provide second opinions, or make specific recommendations regarding therapy. Patients should address those issues directly with a health care provider.

CDC-INFO: 1-800-CDC-INFO (1-800-232-4636); TTY 888-232-6348 24 hours/day email: cdcinfo@cdc.gov.

ATSDR Toxicological Profile for Trichloroethylene

ToxFAQs™ for Trichloroethylene

Other Sources of Information

American Association of Poison Control Centers Poison Control Hotline: 1-800-222-1222

Association of Occupational and Environmental Clinics

Pediatric Environmental Health Specialty Units -PEHSUs

American College of Occupational and Environmental Medicine

American College of Medical Toxicologists

American College of Preventive Medicine

ATSDR Information Center

The National Institute for Occupational Safety and Health (NIOSH)