A new study has raised significant concerns about the health risks associated with exposure to tetrachloroethylene (PCE), a common chemical used in dry cleaning and various consumer products. According to research published in the journal Liver International, PCE exposure is linked to a threefold increase in the risk of liver fibrosis in U.S. adults. The study, conducted by the Keck School of Medicine at the University of Southern California, analyzed data from the National Health and Nutrition Examination Survey (NHANES) and found that 7% of adults had detectable levels of the chemical in their blood.
Liver fibrosis is a severe condition characterized by the buildup of scar tissue in the liver, which can lead to liver cancer, liver failure, and even death. The study authors emphasize that the link between PCE exposure and liver scarring is particularly strong, with those exposed being three times more likely to show signs of significant liver fibrosis. The researchers also noted a dose-response relationship, meaning higher levels of PCE exposure correlate with a greater risk of developing the condition.
The U.S. Environmental Protection Agency (EPA) has already taken steps to restrict PCE, citing the chemical’s health risks. In December 2024, the EPA issued a final rule limiting its use, and in January 2025, compliance guidance was released for dry-cleaning and electrical cleaning applications. However, the agency is now reconsidering its stance on PCE due to the recent study’s findings, which the researchers say offer valuable data for policymakers. Lead author Dr. Brian P. Lee, a hepatologist and liver transplant specialist at Keck Medicine of USC, expressed surprise at the extent of PCE exposure and the strong link to liver scarring, noting that it applies to people who may not directly work with the chemical.
The study also highlights that individuals from higher-income households are most at risk of PCE exposure, likely due to greater use of dry cleaning services. Dr. Lee explained that while people with higher incomes may be more exposed through consumer use, those working in dry, cleaning facilities face prolonged, direct exposure. The research further indicates that factors like alcohol consumption and obesity-related liver issues do not appear to contribute significantly to liver fibrosis when PCE is present in the blood.
Long-term exposure to PCE has been associated with various health complications, including neurological impairments, mood and behavior changes, kidney damage, immune system effects, and increased cancer risk. The EPA warns that pregnant women and children are particularly vulnerable to the developmental effects of PCE. Despite the findings, the study acknowledges several limitations, including the cross-sectional nature of the research and the potential for results to apply only to the U.S. population. The authors emphasize the need for further research into environmental toxins and their role in liver disease risk.
As the prevalence of liver disease continues to rise in the U.S., the study underscores the importance of understanding contributing factors beyond traditional risk factors like alcohol consumption and obesity. Dr. Lee stresses that early detection and intervention are crucial, as liver disease often lacks symptoms until it is advanced. The findings highlight the need for public awareness and policy action to mitigate the risks posed by PCE exposure and protect public health.