II. Background
- Trichloroethylene (TCE) is a synthetic solvent
- Volatile halocarbon used as an industrial solvent
- Used in refrigerant fluid (HFC-134a) and as a degreaser of metal parts
- Used in dry cleaning as a spotting agent
- Replaced with the less toxic tetrachloroethylene
- Originally used as inhalational Anesthetic and Analgesic in the 1800s
- Banned in U.S. for human use in 1977
- Exposures
- Contaminated soil
- Remains stable in original form for >25 years
- Contamined food
- Concentrates in processed foods (including meats)
- Contaminated water
- Groundwater levels normally<30 mcg/L
- Occupational inhalation exposure (esp. degreaser use)
- Levels normally <100 ppm
- Contaminated soil
- Toxicity
- Releases toxic gases on combustion
- Neurologic toxicity
- Carcinogenic with occupational exposure
- Releases toxic gases on combustion
III. Mechanism
- Trichloroethylene (TCE) decomposes into other cytotoxins and carcinogens (esp. when exposed to heat or alkali)
- Neurologic Effects and Toxicity
- Acute Exposure
- Metabolizes to Chloral Hydrate
- Chloral Hydrate (as well as TCE) modulate GABA activity
- Chronic Exposure
- Cranial Nerve V (Trigeminal Nerve) selective demyelination
- Substantia NigraNeuron degeneration
- Acute Exposure
IV. Pharmacokinetics
- Trichloroethylene (TCE) is rapidly absorbed
- Respiratory inhalation is greatest
- Gastrointestinal absorption
- Skin absorption
- Storage
- Adipose tissue
- Metabolism
- Hepatic metabolism via CYP2E1 to Trichloroacetate (TCA) or Trichloroethanol
- Renal excretion of some metabolites
V. Findings
- Neurologic
- Cardiovascular
- Gastrointestinal
- Dermatologic
- Skin rashes or rashes
- Exfoliative Dermatitis
- Scleroderma
- Miscellaneous
- Rhabdomyolysis
- Hepatotoxicity
- Kidney Injury
- Eye irritation
- Disulfiram-like reaction with Alcohol ("degreaser's flush")
VI. Labs
- See Unknown Ingestion for full toxicologic testing
- Serum transaminases (AST, ALT)
- Drug Levels
- Urine Trichloroethylene and TCEth
- Blood TCEth
VII. Imaging
-
Chest XRay
- Indicated with repiratory symptoms or suspected aspiration
- Trichloroethylene (TCE) is radiopaque
VIII. Management
- See Decontamination After Toxin Exposure
- Supportive Care
- Persistent Dysrhythmias may be treated with Beta Blockers or Lidocaine
- Disposition
- Accidental Inhalation exposures may be discharged when improved after symptomatic management
- Admit large ingestions (>20 ml)
IX. References
- Carroll and Yakey (2025) Crit Dec Emerg Med 39(3): 35
- Chiu (2013) Environ Health Perspect 121(3):303-11 +PMID: 23249866 [PubMed]
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| Definition (NCI) | A synthetic, light sensitive, volatile, colorless, liquid that is miscible with many non-polar organic solvents. Trichloroethylene is used mainly as a degreaser for metal parts. Upon combustion, it produces irritants and toxic gases. Occupational exposure to trichloroethylene is associated with excess incidences of liver cancer, kidney cancer and non-Hodgkin's lymphoma. It is reasonably anticipated to be a human carcinogen. (NCI05) |
| Definition (CSP) | toxic liquid widely used as an industrial solvent, formerly used as an inhalation anesthetic. |
| Definition (MSH) | A highly volatile inhalation anesthetic used mainly in short surgical procedures where light anesthesia with good analgesia is required. It is also used as an industrial solvent. Prolonged exposure to high concentrations of the vapor can lead to cardiotoxicity and neurological impairment. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D014241 |
| SnomedCT | 255700004, 16808006, 333887003 |
| LNC | LP18006-4, MTHU010018 |
| English | Ethinyl Trichloride, Trichloride, Ethinyl, Trichloroethene, Trichloroethylene, Ethene, trichloro-, 1,1-Dichloro-2-chloroethylene, Ethylene Trichloride, ethinyl trichloride, Trichloroethylene [Chemical/Ingredient], trichloroethene, trichloroethylene, TRICHLOROETHYLENE, Trichloroethylene product, Trichloroethylene (substance), Trichloroethylene product (product), Trichloroethylene product (substance) |
| Swedish | Trikloretylen |
| Czech | trichlorethylen |
| Finnish | Trikloorietyleeni |
| Italian | Tricloruro di etinile, Tricloroetilene |
| Russian | ETINILTRIKHLORID, TRIKHLORETILEN, ТРИХЛОРЭТИЛЕН, ЭТИНИЛТРИХЛОРИД |
| Spanish | producto con tricloroetileno (producto), tricloroetileno (producto), producto con tricloroetileno, tricloroetileno (sustancia), tricloroetileno, producto (producto), tricloroetileno, producto, tricloroetileno, Tricloroetileno, Tricloruro de Etinil |
| Polish | Trichloren, Trichloroetylen, Trójchlorek etylenu, Trójchloroetylen |
| Japanese | エチニールトリクロライド, エチニルトリクロライド, トリクレン, トリクロロエチレン, 三塩化エチレン |
| French | Trichloro-éthylène, Trichloroéthylène |
| German | Ethylentrichlorid, Trichlorethylen |
| Portuguese | Tricloreto de Etinil, Tricloroetileno |
Ontology: Toxic effect of trichloroethylene (C0274845)
| Concepts | Injury or Poisoning (T037) |
| ICD10 | T53.2 , T53.2X, T53.2X1 |
| SnomedCT | 21781008, 290520009 |
| English | Trichloroethylene, Toxic effect of trichloroethylene, Trichlorethyln caus tox effect, Trichloroethylene causing toxic effect, poisoning by trichloroethylene, poisoning by trichloroethylene (diagnosis), Toxic effects of trichloroethylene, Toxic effects of trichloroethylene NOS, Toxic effect of trichloroethylene (disorder), Trichloroethylene poisoning, Trichloroethylene poisoning (disorder) |
| German | Toxische Wirkung: Trichloraethylen |
| Korean | 삼염화에틸렌의 중독작용 |
| Spanish | efecto tóxico del tricloretileno, efecto tóxico del tricloretileno (trastorno), intoxicación por tricloroetileno (trastorno), intoxicación por tricloroetileno |
| Dutch | Trichloorethyleen |
