{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T05:17:26Z","timestamp":1777871846115,"version":"3.51.4"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Addis Ababa University and Norwegian Program for Capacity Development in Higher Education and Research for Development"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Perchloroethylene, a chemical commonly used in the dry-cleaning sector, presents a potential risk to kidney health. This study measured urinary and blood nephrotoxic biomarkers among dry cleaners compared to hotel laundry workers to assess PCE\u2019s impact. A multi-center comparative cross-sectional study was conducted with 164 randomly selected participants from 21 dry-cleaning shops and 26 hotel laundries. Data were collected through biological samples and structured questionnaires and with tests for statistical significance. The result showed that majority of the employees were females in both groups and the risk of nephrotoxicity was higher in dry cleaners as compared to hotel laundry workers. We found a significant mean difference in three biomarkers namely, Total Protein (TPU) with a Median &amp; IQR value of (102\u2009mg\/dl &amp;70.75\u2009mg\/dl) and (54.5\u2009mg\/dl &amp;27.25\u2009mg\/dl), Urinary creatinine with a Median &amp; IQR value of (193\u2009mg\/dl &amp; 111.06\u2009mg\/dl) and (142.93\u2009mg\/dl &amp; 78.17\u2009mg\/dl) and Urinary Calcium with a Median &amp; IQR value of (2.60 mmol\/l &amp; 2.94 mmol\/l) and (0.835 mmol\/l &amp; 0.79 mmol\/l) for the exposed and the control groups respectively. However, a significant difference was not found in urinary protein to creatinine ratio, urinary sodium, Blood urea nitrogen and S. creatinine between the two groups, but higher value of sodium above range and higher BUN within range was observed in dry cleaners and factors like employment duration, PCE spillage, handling frequency, sex, and poor ventilation correlated with immediate symptoms. In conclusion, dry cleaners are at greater risk of kidney damage linked to PCE exposure, warranting implementation of safety measures and regular health monitoring to protect workers.<\/jats:p>","DOI":"10.1371\/journal.pone.0348427","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T17:31:53Z","timestamp":1777570313000},"page":"e0348427","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of nephrotoxicity among dry cleaning workers exposed to perchloroethylene: A comparative cross-sectional study in Addis Ababa, Ethiopia"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8319-7373","authenticated-orcid":true,"given":"Philemon Mohammed","family":"Seid","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wossen","family":"Habtu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meaza Gezu","family":"Shentema","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teferi","family":"Abegaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"pone.0348427.ref001","year":"2014"},{"key":"pone.0348427.ref002","year":"2015"},{"key":"pone.0348427.ref003","unstructured":"Agency for Toxic Substances Disease Registry ATSDR. Toxicological Profile for Tetrachloroethylene. 2019. http:\/\/www.atsdr.cdc.gov\/toxprofiles\/tp18.pdf"},{"key":"pone.0348427.ref004","year":"2012"},{"issue":"5","key":"pone.0348427.ref005","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1093\/ndt\/13.5.1122","article-title":"Perchloroethylene-induced nephrotoxicity in dry-cleaning workers: Is there a role for free radicals?","volume":"13","author":"AK Salahudeen","year":"1998","journal-title":"Nephrology, Dialysis, Transplantation: Official Publication of the European Dialysis and Transplant Association-European Renal Association"},{"key":"pone.0348427.ref006","unstructured":"International Agency for Research on Cancer IARC. IARC monographs on the evaluation of carcinogenic risks to humans. 2014. https:\/\/monographs.iarc.fr\/wp-content\/uploads\/2018\/06\/mono106-002.pdf"},{"issue":"11","key":"pone.0348427.ref007","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1097\/01.jom.0000094990.52172.ea","article-title":"Perchloroethylene in alveolar air, blood, and urine as biologic indices of low-level exposure","volume":"45","author":"F Gobba","year":"2003","journal-title":"J Occup Environ Med"},{"issue":"1","key":"pone.0348427.ref008","first-page":"1","article-title":"Occupational exposure of trichloroethylene: Toxicity, current standards and suggested new biomarkers for kidney cancer","volume":"5","author":"W Nakpan","year":"2020","journal-title":"PSRU Journal of Science and Technology"},{"key":"pone.0348427.ref009","year":"2016"},{"key":"pone.0348427.ref010","unstructured":"Crews D, et al. Burden, access, and disparities in kidney disease. 2019. https:\/\/www.worldkidneyday.org\/wp-content\/uploads\/2019\/02\/2019-KI-Final-Article.pdf"},{"issue":"16","key":"pone.0348427.ref011","doi-asserted-by":"crossref","first-page":"2832","DOI":"10.3390\/ijerph16162832","article-title":"Evaluation of occupational exposure to perchlorethylene in a group of italian dry cleaners using noninvasive exposure indices","volume":"16","author":"A Modenese","year":"2019","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"pone.0348427.ref012","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1289\/ehp.1307359","article-title":"Human health effects of tetrachloroethylene: Key findings and scientific issues","volume":"122","author":"KZ Guyton","year":"2014","journal-title":"Environ Health Perspect"},{"issue":"1","key":"pone.0348427.ref013","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1124\/jpet.116.232629","article-title":"Target organ metabolism, toxicity, and mechanisms of trichloroethylene and perchloroethylene: Key similarities, differences, and data gaps","volume":"359","author":"JA Cichocki","year":"2016","journal-title":"J Pharmacol Exp Ther"},{"issue":"2","key":"pone.0348427.ref014","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1093\/toxsci\/kfy099","article-title":"Metabolism and toxicity of trichloroethylene and tetrachloroethylene in cytochrome P450 2E1 knockout and humanized transgenic mice","volume":"164","author":"Y-S Luo","year":"2018","journal-title":"Toxicol Sci"},{"issue":"3","key":"pone.0348427.ref015","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1080\/10408440091159202","article-title":"Renal toxicity and carcinogenicity of trichloroethylene: Key results, mechanisms, and controversies","volume":"30","author":"T Br\u00fcning","year":"2000","journal-title":"Crit Rev Toxicol"},{"issue":"6","key":"pone.0348427.ref016","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1177\/096032719000900603","article-title":"Study on kidney function in female workers exposed to perchlorethylene","volume":"9","author":"A Vyskocil","year":"1990","journal-title":"Hum Exp Toxicol"},{"issue":"5","key":"pone.0348427.ref017","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1002\/ajim.4700200504","article-title":"Renal function in dry cleaning workers exposed to perchloroethylene","volume":"20","author":"D Solet","year":"1991","journal-title":"Am J Ind Med"},{"issue":"3","key":"pone.0348427.ref018","article-title":"ARF requiring hemodialysis after accidental perchloroethylene ingestion","volume":"41","author":"YH Choi","year":"2003","journal-title":"Am J Kidney Dis"},{"key":"pone.0348427.ref019","doi-asserted-by":"crossref","first-page":"929743","DOI":"10.3389\/fneph.2022.929743","article-title":"Urinary sodium excretion is low prior to acute kidney injury in patients in the intensive care unit","volume":"2","author":"DG de Morais","year":"2022","journal-title":"Front Nephrol"},{"key":"pone.0348427.ref020","unstructured":"Blood urea nitrogen (BUN) test. 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Accessed 2025 March 18."},{"issue":"4","key":"pone.0348427.ref021","doi-asserted-by":"crossref","DOI":"10.1002\/jbt.23000","article-title":"The perchloroethylene-induced toxicity in dry cleaning workers lymphocytes through induction of oxidative stress","volume":"36","author":"A Ghahri","year":"2022","journal-title":"J Biochem Mol Toxicol"},{"key":"pone.0348427.ref022","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.tox.2007.03.001","article-title":"Modulation of hepatic and renal metabolism and toxicity of trichloroethylene and perchloroethylene by alterations in status of cytochrome P450 and glutathione","volume":"235","author":"LH Lash","year":"2007","journal-title":"Toxicology"},{"issue":"3","key":"pone.0348427.ref023","doi-asserted-by":"crossref","first-page":"95","DOI":"10.4103\/japtr.JAPTR_336_18","article-title":"Nephrotoxicity: Role and significance of renal biomarkers in the early detection of acute renal injury","volume":"10","author":"MS 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kidney health","volume":"7","author":"M Tang","year":"2014","journal-title":"Int J Nephrol Renovasc Dis"},{"key":"pone.0348427.ref028","doi-asserted-by":"crossref","first-page":"241","DOI":"10.3109\/08860229909085086","article-title":"Urinary biomarkers as indicators of renal disease","volume":"21","author":"RP Wedeen","year":"1999","journal-title":"Ren Fail"},{"key":"pone.0348427.ref029","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.taap.2018.05.033","article-title":"Incorporation of the glutathione conjugation pathway in an updated physiologically-based pharmacokinetic model for perchloroethylene in mice","volume":"352","author":"C Dalaijamts","year":"2018","journal-title":"Toxicol Appl Pharmacol"},{"issue":"11","key":"pone.0348427.ref030","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0111949","article-title":"Decrease in urinary creatinine excretion in early stage chronic kidney disease","volume":"9","author":"E Tynkevich","year":"2014","journal-title":"PLoS One"},{"issue":"23","key":"pone.0348427.ref031","doi-asserted-by":"crossref","first-page":"2473","DOI":"10.1056\/NEJMra054415","article-title":"Assessing kidney function--measured and estimated glomerular filtration rate","volume":"354","author":"LA Stevens","year":"2006","journal-title":"N Engl J Med"},{"key":"pone.0348427.ref032","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1146\/annurev.pharmtox.48.113006.094615","article-title":"Biomarkers of acute kidney injury","volume":"48","author":"VS Vaidya","year":"2008","journal-title":"Annu Rev Pharmacol Toxicol"},{"issue":"3","key":"pone.0348427.ref033","doi-asserted-by":"crossref","first-page":"111","DOI":"10.2486\/indhealth.29.111","article-title":"Subjective symptom increase among dry-cleaning workers exposed to tetrachloroethylene vapor","volume":"29","author":"SX Cai","year":"1991","journal-title":"Ind Health"},{"issue":"6","key":"pone.0348427.ref034","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1080\/135475000750052411","article-title":"Kidney and liver biomarkers in female dry-cleaning workers exposed to perchloroethylene","volume":"5","author":"T Andrea","year":"2000","journal-title":"Biomarkers"},{"issue":"6","key":"pone.0348427.ref035","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1053\/j.ajkd.2020.09.017","article-title":"Tubular secretion of creatinine and risk of kidney failure: The Modification of Diet in Renal Disease (MDRD) Study","volume":"77","author":"PS Garimella","year":"2021","journal-title":"American Journal of Kidney Diseases"},{"issue":"1","key":"pone.0348427.ref036","first-page":"20","article-title":"Evaluation of spot urine protein-creatinine ratio as a screening test for proteinuria","volume":"46","author":"M Guy","year":"2009","journal-title":"Ann Clin 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