{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:46:56Z","timestamp":1791913616953,"version":"4.3.4"},"reference-count":40,"publisher":"American Chemical Society (ACS)","issue":"7","license":[{"start":{"date-parts":[[2017,12,29]],"date-time":"2017-12-29T00:00:00Z","timestamp":1514505600000},"content-version":"vor","delay-in-days":1379,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background: In 2012, the International Agency for Research on Cancer classified tetrachloroethylene, used in the production of chemicals and the primary solvent used in dry cleaning, as \u201cprobably carcinogenic to humans\u201d based on limited evidence of an increased risk of bladder cancer in dry cleaners.<\/jats:p>\n                  <jats:p>Objectives: We assessed the epidemiological evidence for the association between tetrachloroethylene exposure and bladder cancer from published studies estimating occupational exposure to tetrachloroethylene or in workers in the dry-cleaning industry.<\/jats:p>\n                  <jats:p>Methods: Random-effects meta-analyses were carried out separately for occupational exposure to tetrachloroethylene and employment as a dry cleaner. We qualitatively summarized exposure\u2013response data because of the limited number of studies available.<\/jats:p>\n                  <jats:p>Results: The meta-relative risk (mRR) among tetrachloroethylene-exposed workers was 1.08 (95% CI: 0.82, 1.42; three studies; 463 exposed cases). For employment as a dry cleaner, the overall mRR was 1.47 (95% CI: 1.16, 1.85; seven studies; 139 exposed cases), and for smoking-adjusted studies, the mRR was 1.50 (95% CI: 0.80, 2.84; 4 case\u2013control studies).<\/jats:p>\n                  <jats:p>Conclusions: Our meta-analysis demonstrates an increased risk of bladder cancer in dry cleaners, reported in both cohort and case\u2013control studies, and some evidence for an exposure\u2013response relationship. Although dry cleaners incur mixed exposures, tetrachloroethylene could be responsible for the excess risk of bladder cancer because it is the primary solvent used and it is the only chemical commonly used by dry cleaners that is currently identified as a potential bladder carcinogen. Relatively crude approaches in exposure assessment in the studies of \u201ctetrachloroethylene-exposed workers\u201d may have attenuated the relative risks.<\/jats:p>\n                  <jats:p>Citation: Vlaanderen J, Straif K, Ruder A, Blair A, Hansen J, Lynge E, Charbotel B, Loomis D, Kauppinen T, Kyyronen P, Pukkala E, Weiderpass E, Guha N. 2014. Tetrachloroethylene exposure and bladder cancer risk: a meta-analysis of dry-cleaning-worker studies. Environ Health Perspect 122:661\u2013666;\u2002http:\/\/dx.doi.org\/10.1289\/ehp.1307055<\/jats:p>","DOI":"10.1289\/ehp.1307055","type":"journal-article","created":{"date-parts":[[2014,3,21]],"date-time":"2014-03-21T12:19:35Z","timestamp":1395404375000},"page":"661-666","source":"Crossref","is-referenced-by-count":45,"title":["Tetrachloroethylene Exposure and Bladder Cancer Risk: A Meta-Analysis of Dry-Cleaning-Worker Studies"],"prefix":"10.1021","volume":"122","author":[{"given":"Jelle","family":"Vlaanderen","sequence":"first","affiliation":[{"name":"Section of Environment and Radiation, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Straif","sequence":"additional","affiliation":[{"name":"Section of IARC Monographs, International Agency for Research on Cancer, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avima","family":"Ruder","sequence":"additional","affiliation":[{"name":"National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Blair","sequence":"additional","affiliation":[{"name":"Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnni","family":"Hansen","sequence":"additional","affiliation":[{"name":"Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsebeth","family":"Lynge","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Charbotel","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lyon\/Unit\u00e9 Mixte de Recherche Epid\u00e9miologique et de Surveillance Transport Travail Environnement (IFSTTAR\/UCBL), Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Loomis","sequence":"additional","affiliation":[{"name":"Section of IARC Monographs, International Agency for Research on Cancer, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Kauppinen","sequence":"additional","affiliation":[{"name":"Finnish Institute of Occupational Health, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pentti","family":"Kyyronen","sequence":"additional","affiliation":[{"name":"Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eero","family":"Pukkala","sequence":"additional","affiliation":[{"name":"Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland"},{"name":"School of Health Sciences, University of Tampere, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabete","family":"Weiderpass","sequence":"additional","affiliation":[{"name":"Cancer Registry of Norway, Oslo, Norway"},{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Community Medicine, Faculty of Health Sciences, University of Troms\u00f8, The Arctic University of Norway, Troms\u00f8, Norway"},{"name":"Folkh\u00e4lsan Research Center, Samfundet Folkh\u00e4lsan, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neela","family":"Guha","sequence":"additional","affiliation":[{"name":"Section of IARC Monographs, International Agency for Research on Cancer, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"316","published-online":{"date-parts":[[2014,3,21]]},"reference":[{"key":"2026080603024486800_micit1","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1136\/bmj.326.7382.219","article-title":"Interaction revisited: the difference between two estimates.","volume":"326","author":"Altman","year":"2003","journal-title":"BMJ"},{"key":"2026080603024486800_micit2","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/S1047-2797(02)00250-8","article-title":"Extended mortality follow-up of a cohort of dry cleaners.","volume":"13","author":"Blair","year":"2003","journal-title":"Ann 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