Metabolic interactions

Simultaneous exposure to other solvents tends to increase the retention and decrease the metabolism of 1,1,1-TCE (Savolainen et al., 1981); hence occupational exposure to mixed solvents may put workers at greater risk of 1,1,1-TCE toxicity.

• Aliphatic organochlorines

Thiele et al. (1982) suggested that pre-exposure to other chlorinated hydrocarbons might increase the potential for hepatic damage from 1,1,1-TCE. They report a case of hepatic cirrhosis after several years of heavy exposure to trichloroethylene, followed by three months of work that involved using an aerosolised degreaser containing 1,1,1-TCE. They suggest that an individual suffering hepatic injury from a chlorinated hydrocarbon may be at risk of further progression of the disease upon subsequent exposure to even a relatively non-toxic member of this family of organic solvents (in this case 1,1,1-TCE).

In vivo and in vitro studies demonstrated that combinations of trichloroethylene with tetrachloroethylene or 1,1,1-trichloroethane or both, were more toxic than the individual chemicals alone. Measures of effects were parameters of cell integrity (leak of potassium, lactate dehydrogenase and alanine aminotransferase in hepatocytes) for the in vitro tests and measures of hepatic and renal function (liver weight, alanine aminotransferase, sorbital dehydrogenase and urea) in rats. The effect of the three solvents together was greater than mixtures of two. This study did not investigate the mechanism of interaction (Stacey, 1989).

• Halothane anaesthesia

McLeod et al. (1987) postulate that an interaction occurs between exposure to 1,1,1-TCE and subsequent administration of halothane for anaesthesia. An adolescent boy who intentionally sniffed 1,1,1-TCE presented with multiple ventricular arrhythmias during tonsillectomy, and follow-up showed mild chronic left ventricular impairment. In a second case, a 54-year old man with repeated industrial exposure to 1,1,1-TCE, received halothane anaesthesia and deteriorated from mild stable cardiac failure to end stage cardiac failure.

• Surface active agents

Woo et al. (1983) reported a case of hypoxaemia and chest pain following inhalation of a 1,1,1-TCE aerosol product. The solvent was combined with a surface active agent in the product. The combined formulation increased the water solubility of 1,1,1-TCE and enhanced deposition in the upper airway thus causing considerable respiratory distress. The authors concluded that the symptoms could not be attributed to the propellant, surface active agent or 1,1,1-TCE alone.

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