Chemicals commonly used in dry cleaning may triple the risk of liver damage, increasing the risk of cancer and ultimately liver failure, a new study has suggested.
In 2024, the US Environmental Protection Agency issued a final rule restricting the the use of tetrachloroethylene, also known as PCE, with a ten year phase out after the toxic chemical was linked to cancer and other serious health problems.
PCE is mainly used as a solvent for dry cleaning, but is also used as a metal degreaser in industrial cleaning and was previously classified as a ‘likely human carcinogen’.
The main health concern with PCE is not just through wearing dry-cleaned clothes, but rather exposure through air and water pollution, which has now been shown to triple the risk of potentially deadly liver damage.
Known medically as metabolic dysfunction-associated steatotic liver disease, MASLD (formerly known as non-alcoholic fatty liver disease) is a common form of liver disease caused by a build-up of fat inside the liver, which triggers inflammation.
Over time, this leads to scarring— known as fibrosis—which can eventually cause cirrhosis, liver failure or cancer.
There are a number of known risk factors for the disease, including smoking, drinking, being overweight or obese, and taking certain medications long-term, like paracetamol or ibuprofen.
Now, a new study published in the journal Liver International has found that exposure to PCE may tripe a person’s risk of fibrosis.
Scientists have found a link between a common chemical used in dry cleaning and liver damage
It’s a common and dangerous misconception that only alcohol can cause liver scarring
‘Liver fibrosis is the main predictor of liver-related morbidity and mortality, meaning that the more liver fibrosis you have, the more likely you are to die from liver disease,’ Dr Brian Lee, a transplant hepatologist who treats patients before and after liver transplant, and study lead author, explained.
In the study, researchers from the University of Southern California analysed health data from 1,614 adults from the National Health and Nutrition Examination Survey, between 2017 and 2020.
They traced the level of PCE in participants’ blood and then looked at how many went on to develop liver damage.
At the end of the study, the researchers found that 81 participants had detectable amounts of the toxic chemical in their blood, and individuals expose to the PCE were three times more likely to have significant liver damage compared to those were not exposed to PCE.
Dr Lee told Medical News Today: ‘Liver disease is on the rise, and it’s important to understand what is contributing to these trends beyond traditional risk factors like alcohol and diabetes to inform interventions.
It is thought that when PCE is processed by the liver, the byproducts, known as metabolites, react with liver cells that degrade the fat in the cell membrane, triggering a chain reaction causing inflammation and scarring.
The researchers also found that for every one nanogram per milliliter increase in PCE concentration in the blood the chance of significant liver scarring increased fivefold.
‘This finding shows a dose-effect of PCE and liver fibrosis, which strengthens the potential link that PCE causes liver fibrosis, rather than just a correlation,’ Dr Lee explained.
He added: ‘Doctors should ask patients about potential environmental exposures, and policy makers should enact policies that protect the public from environmental poisons.’
The researches now hope their findings will inform screening strategies to identify those at risk of liver disease earlier.
Where liver disease was once largely confined to the elderly and heavy drinkers, it’s now rising rapidly among younger adults. Cases in children have also doubled over the past two decades.
The British Liver Trust estimates the condition may now affect one in five people in the UK—though experts have warned the true figure could be as high as 40 per cent.
Worryingly, around 80 per cent of those affected remain undiagnosed, as the disease often has no obvious symptoms—or it has symptoms that are mistaken for less serious problems.
In most cases, it is only spotted during routine blood tests or liver function tests carried out for unrelated issues. However, some sufferers will experience fatigue, malaise and liver pain or discomfort felt in the abdomen under the ribs.
Figures from The Liver Trust revealed there were 11,000 deaths from liver disease last year—many of which could have been prevented with early intervention and lifestyle changes.
According to the British Liver Trust, liver disease is the only major disease to see death rates continually rising, with figures having quadrupled in the past 50 years.
