{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T20:25:51Z","timestamp":1768163151457,"version":"3.49.0"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["K23AA029752"],"award-info":[{"award-number":["K23AA029752"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background &amp; Aims<\/jats:title>\n                    <jats:p>Tetrachloroethylene (PCE) is a volatile organic compound (VOC) used in industrial settings. Pre\u2010clinical studies have linked PCE to hepatotoxicity, but clinical data beyond selected occupational cohorts represent a critical knowledge gap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We utilised data from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020, a nationally representative survey of the US population. Significant liver fibrosis was defined as liver stiffness measurement &gt;\u20098.2\u2009kPa by vibration\u2010controlled transient elastography. We used multivariate logistic regression to assess the association of PCE with significant liver fibrosis, controlling for potential demographic and clinical confounders. A negative control analysis was performed using N\u2010Acetyl\u2010S\u2010(2\u2010hydroxyethyl)\u2010l\u2010cysteine, a biomarker representing exposure to a mixture of VOCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1614 adults, 116 had detectable PCE, representing a weighted percentage of 7.4% (95% CI 5.1%\u201310.7%). Values ranged from 0.034 to 57.5\u2009ng\/mL, with a median concentration of 0.09\u2009ng\/mL (IQR 0.07\u20130.22\u2009ng\/mL). Detectable PCE (aOR 3.17 [95% CI 1.23\u20138.20]) was associated with significant liver fibrosis, an independent association supported by the negative control analysis. Additionally, the association between PCE and significant liver fibrosis was dose\u2010dependent (aOR per 1\u2009ng\/mL increase 5.13 [1.09\u201324.26]). The absolute risk difference between the predicted probability of significant liver fibrosis for detectable vs. undetectable PCE was 27.7% (95% CI 4.3%\u201351.0%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this nationally representative US study, PCE was associated with significant liver fibrosis with a dose\u2010dependent effect, and a negative control analysis suggesting that this association is distinct to PCE. Our results should encourage prospective studies to confirm PCE as a contributor to liver disease to inform environmental policies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70398","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T08:05:37Z","timestamp":1760601937000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tetrachloroethylene Is Associated With Presence of Significant Liver Fibrosis: A National Cross\u2010Sectional Study in\n                    <scp>US<\/scp>\n                    Adults"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7339-9189","authenticated-orcid":false,"given":"Yinan","family":"Su","sequence":"first","affiliation":[{"name":"Keck School of Medicine, University of Southern California  California Los Angeles USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer L.","family":"Dodge","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Liver Diseases University of Southern California Keck School of Medicine  California Los Angeles USA"},{"name":"Department of Population and Public Health Sciences University of Southern California Keck School of Medicine  California Los Angeles USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian P.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Liver Diseases University of Southern California Keck School of Medicine  California Los Angeles USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.03.017"},{"key":"e_1_2_9_3_1","first-page":"35","volume-title":"IARC Monographs on the Evaluation of Carcinogenic Risks to Humans Volume 106","author":"IARC Working 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https:\/\/www.atsdr.cdc.gov\/toxprofiles\/tp18.pdf."},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aca.2012.04.009"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.01.042"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28394"},{"key":"e_1_2_9_17_1","unstructured":"Centers for Disease Control \u201c2017\u2010March 2020 Data Documentation Codebook and Frequencies \u201d(2025) https:\/\/wwwn.cdc.gov\/Nchs\/Data\/Nhanes\/Public\/2017\/DataFiles\/P_LUX.htm."},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atmosenv.2009.01.032"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(22)00124-8"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01320-X"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/1541-4337.12731"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/19338244.2021.1900045"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1437519"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/1354750X.2021.1904000"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/toxsci\/kfl129"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1289\/EHP12006"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecoenv.2025.118854"},{"key":"e_1_2_9_28_1","unstructured":"Centers for Disease Control \u201cNational Report on Human Exposure to Environmental Chemicals \u201d(2025) https:\/\/www.cdc.gov\/exposurereport\/report\/pdf\/Volatile%20Organic%20Compounds%20(VOCs)%20NHANES\u2010p.pdf."}],"container-title":["Liver 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