Human Health Effects of Trichloroethylene: Key Findings and Scientific Issues



Background: In support of the Integrated Risk Information System (IRIS), the U.S. Environmental Protection Agency (EPA) completed a toxicological review of trichloroethylene (TCE) in September 2011, which was the result of an effort spanning > 20 years.


We summarized the key findings and scientific issues regarding the human health effects of TCE in the U.S. EPA’s toxicological review.


In this assessment we synthesized and characterized thousands of epidemiologic, experimental animal, and mechanistic studies, and addressed several key scientific issues through modelling of TCE toxicokinetics, meta-analyses of epidemiologic studies, and analyses of mechanistic data.


Toxicokinetic modelling aided in characterizing the toxicological role of the complex metabolism and multiple metabolites of TCE. Meta-analyses of the epidemiologic data strongly supported the conclusions that TCE causes kidney cancer in humans and that TCE may also cause liver cancer and non-Hodgkin lymphoma. Mechanistic analyses support a key role for mutagenicity in TCE-induced kidney carcinogenicity.

Recent evidence from studies in both humans and experimental animals point to the involvement of TCE exposure in autoimmune disease and hypersensitivity.

Recent avian and in vitro mechanistic studies provided biological plausibility that TCE plays a role in developmental cardiac toxicity, the subject of substantial debate due to mixed results from epidemiologic and rodent studies.


TCE is carcinogenic to humans by all routes of exposure and poses a potential human health hazard for noncancer toxicity to the central nervous system, kidney, liver, immune system, male reproductive system, and the developing embryo/fetus.

Read full study below


Persons working with or working in areas using trichloroethylene in Baldonnel have suffered the following illnesses. 

Untimely deaths are marked thus *

      • Brain Tumour*
      • Colorectal Cancer*
      • Crohn’s Disease*
      • Lung Cancer*
      • Multiple Sclerosis
      • Non-Hodgkin’s Lymphoma*
      • Oesophageal Cancer*
      • Pancreatic Cancer*
      • Parkinson’s Disease
      • Renal Cancer*

1991 – DFSS 1 – Defence Forces Safety Standards on the Control of Substances (Chemicals) Hazardous to Health (COSHH)









Information on substances used at work can be obtained from a wide variety of sources. It is not merely a matter of asking the supplier – some materials have no. external supplier in the sense that they are produced within the workplace itself; by-products, intermediates, even the final product of the process. Whatever the source of the material, nothing effective can be done by way of control unless the chemical components are known. This is necessary in order to select the least toxic of a number of alternative materials which may be available and to be able to render appropriate medical treatment in cases of exposure, as well as to achieve safe and legal disposal of waste, and to introduce the right control measures.


Section 10 of the Safety, Health and Welfare at Work Act 1989 places duties onsuppliers of substances. It shall be the duty of any person who designs, manufactures, imports or supplies any articles for use at work to:-

(a) ensure, so far as is reasonably practicable, that the articles is. designed, constructed, tested and examined so as to be safe and without risk to health when used by a person at a place of work;

(b) take such steps as are necessary to secure that persons supplied by that person with the articles are provided with adequate information etc.

Additionally, necessary steps must be taken to ensure, so far as is reasonably practicable, that persons so supplied are provided with revisions of such information as are necessary by reason of its becoming known that rise to anything gives a serious risk to health or safety.

The supplier’s information should be sufficient to enable the constituents of the material to be identified, describing the specific hazards of the product, dangerous conditions which may arise, and the necessary safety precautions. It is common ground amongst recipients that the standard of suppliers’ information varies enormously. In a 1974 US Government survey it was found that firms questioned used 95,000 different trade-named products, and that the composition of 90% of these products was not known to the companies using them. Disclosure of composition of products is not a requirement under SAHAWA, and suppliers sometime claim that the formulation is a trade secret. A useful review of manufacturers’ attitudes and the user’s need to know is contained in “Chemical Risk” by Maurice Frankel of Social Audit (Pluto Press, 1982). The book suggests that employers should adopt a policy of not using trade-named substances unless their composition is fully known. This means the provision of a data sheet (see below). The simplest test of the adequacy of suppliers’ information is whether there is sufficient information to allow the user to carry out a COSHH assessment.

Chemical Components of Hazardous Substances

Once the type of chemical composition is known, information can be sought from a variety of sources. The supplier’s data sheet should not be used sources should alone; other be used to check that what is supplied is fact, or else that the basis for the opinion can be justified. Specialist information is available from Eolas which is accessible to the public.


Data becomes less reliable and less available for mixtures, for which there is often little toxicological information. Some compounds exhibit the so-called “synergistic effect” in association with others, and a knowledge of this possibility is necessary for those evaluating hazards. for example, the combined effect of asbestos dust and the products of tobacco smoke in the lungs produces a greatly increased risk of lung cancer. Medical evidence suggests that for an estimate of lung cancer risk in people who smoke and are exposed to asbestos, you must multiply (as opposed to add) the separate individual risks from these agents. This obviously results in a much greater level of overall risk.


This section discusses the desirable contents of a data sheet received by the end user, in this case the person carrying out the COSHH assessment. One of the main recommendations of this is that the Defence Forces performing assessments, should produce its own internal data sheets compiling them from the suppliers’ information into a standard format which can’ then be assembled into a COSHH information pack for the organisation.

It is therefore necessary to devise a set of headings of information which constitutes the minimum information needed to identify and control the hazard (if any) adequately.

Appropriate Contents of Safety Data Sheets

Data FieldTypical Contents
1. Product and Company IdentificationTrade Name Company Name, Division, Address Issue Date of Data Sheet Emergency Advice Telephone Number
2. Information On IngredientsChemical Name(s) Mixture Ingredients Rough Proportions
3. Physico-Chemical DataAppearance Odour Boiling Point Melting/Freezing Point Flash Point Auto-F lammability Explosive Properties PH Value (As Supplied) Vapour Pressure Relative Density Viscosity Solubility Partition Co-Efficient Other Selected Data
4. Stability/ReactivityCondition To Avoid (Temperature,Pressure, Light, Shock) Materials To Avoid Hazardous Decomposition Products
5. Handling/StorageConditions Of Storage Specifying Limits Handling Precautions
6. Personal ProtectionRPE Hand Protection Eye Protection Skin Protection
7. Fire-FightingSuitable Extinguishing Media Unsuitable Extinguishing Media Specialist Protective Equipment for Firefighters
8. Measures In Case Of Accidental ReleasePersonal Precautions Environmental Precautions Clean-Up Methods
9. Health Hazard Toxicity DataConcise,. understandable descriptions of toxicological effects, including exposure routes, symptoms of both gross short-termover exposure and of longer-term lesser exposure, delayed effects and information about any relevant occupationa] exposure limit
10. First Aid MeasuresBrief, understandable, subdivided by exposure route, include delayed effects and whether immediate medical attention is required. Notes To Physicians
11. Ecological InformationMobility Persistence Degradability Aquatic Toxicology
12. Waste DisposalEnvironmental Impact Assessment Methods Of Disposal Handling Of Contaminated Packaging
13. TransportTransport Regulation Requirements
14. Hazard LabellingCPL Hazard Classification Description

For Defence Forces data sheets it will be neither appropriate nor necessary to include all the above fields of information. of comprehension, and selection will be required of what is needed and the necessary contents of each field which will be appropriate and relevant for the end users.


All substances potentially hazardous to health, can be that managed safely provided a suitable strategy has been devised and is in place. Such a Strategy will contain four parts:-





The term assessment encompasses not only the assessment of the hazards and risks involved, but also the subsequent development of control techniques applicable to the substance in question. An assessment therefore, should be regarded as a total strategy, and is best set down in writing.

This Standard uses the words hazard and risk. The words have specific and different meanings. A hazard is a situation with a potential to cause .injury or damage. A hazardous substance is one which, by virtue of its chemical properties, constitutes.a hazard. A risk is the probability or likelihood of the hazard actually causing a degree of injury or damage. Thus assessment of a hazardous substance is based solely on the properties of the substance, whereas assessment of the risk needs a review of these properties in the light of the specific way substances are handled, used or encountered at work and judgement of whether the risk to people, (and property and the environment) is tolerable.

How Hazardous Substances Are Encountered At Work

Every workshop and most offices, shops and other workplaces, handle chemicals. Hazardous substances may be encountered at work in five main ways:-

    • as raw materials for manufacturing or service processes. Examples are solvents for degreasing paints used to coat the product or for respraying cars, fertilisers in agriculture, and toners for dry copiers;
    • as engineering and cleaning materials, such as lubricants, cutting oils, water treatment chemicals, decorative paints, toilet cleaner and bleaches:
    • for service functions, such as adhesives, correcting fluids;
    • as products of the process, whether as intended products, by-products, waste products or intermediates; or
    • as incidental products such as the Legionella micro-organism, vehicle exhaust fumes or ozone from copiers.

The Hazards Of Chemicals

The principle groups of chemicals are those classified as very toxic, toxic, harmful, corrosive or irritant, under the EEC Regulations governing classification, packaging and labelling of dangerous substances. There are three other groups: micro-organisms, unclassified substances and dust. Dust is defined as hazardous if it is present in substantial quantity, even if it has no apparently harmful properties covered in DFSS 1 1991.

Some substances have hazards which could endanger many people immediately in a Single incident. Others may be the cause of disease which could take many years to develop. Substances can be categorised according to the type of harm they can cause; many substances fall into more than one category.

Corrosive chemicals, such as strong acids or strong bases, will attack other materials or people. Chemical burns are usually painful, deep-seated and slow to heal.

Irritants such as acrylates may affect the skin, causing problems like. dermatitis, or they can affect the respiratory tract. Some people may also be allergic to certain sensitisers such as isocyanates and epoxy resins.

Agents of anoxia are those vapours or gases which dilute the oxygen available in the air or prevent the body using it effectively. Examples are carbon dioxide, carbon monoxide and hydrogen cyanide.

Toxic substances are those which can harm the body, in a number of ways. Often, these work by damaging an organ such as the liver or kidneys. Examples are chlorinated solvents and the heavy metals.

A few substances can prevent the correct development and growth of the cells of the body. Carcinogens can cause or promote the growth of unwanted cells, as a cancer. Teratogens may cause an embryo to develop abnormally, and to be born with defects or be stillborn. Mutagens can cause cell changes with an attendant risk of cancer.

Effects Of Hazardous Substances

Apart from their innate hazardous properties, the ease with which substances can enter the body and the body entry route are further crucial factors in determining the total harmful effect. Substances may penetrate the skin, either through cuts, or if they are fat solvents, through intact skin. They may be ingested through the mouth, often as a result of poor standards of hygiene. Normally the most important route of entry though is through the respiratory system. This is because the respiratory system can be a very efficient and sensitive method of transferring materials from the outside environment into the body.

Substances may cause harmful health effects from a single dose, or from an accumulation of smaller doses, or from continuous exposure over long periods. The effect may be acute illness, or a chronic, long term disease.

Single doses do not necessarily cause only acute disease, neither are cumulative doses the only causes of chronic disease.

The Assessment

Who will be judged competent to carry out an assessment? The simple answer is – anyone, provided that the result provides adequate control of all the potential hazards deriving from substances used, produced, stored and handled at work. Persons must have expertise commensurate with the risk, process complexity and variability. For most Units using substances, there will be people in place with special or certainly adequate, knowledge of those substances.

The aim of this Section is to provide such an approach, which can be logged in the format suggested by the accompanying charts. The approach has the benefit of “showing the working” and also minimises the chances of missing a substance or failing to complete the assessment. The charts include an assessment sheet to record the results of air sampling exercises, and provides a File Record.

Assessment – A Structured Approach

Phase 1

Obtaining And Passing On Knowledge
      1. Prepare lists of chemicals, substances, mixtures which are used, bought in, produced in the location/activity, or to which employees are otherwise exposed at work.
      2. Consolidate the lists, and prepare a suitable Data Sheet.
      3. Marshall information from suppliers, external data sources, industry associations, etc., on the properties and hazards.
      4. Summarise the basic hazards (if any) of each substance in the list.
      5. Prepare summary data sheets on substances judged to be hazardous to a common pattern, and distribute to interested parties.

Phase 2

Assessment Of Risks In Practice
      1. Assess each process using the substances listed.
      2. Identify substances defined “hazardous to health”.
      3. Review all substances and associated hazards to identify further hazards or rule against unacceptable processes or practices.
      4. Assess likely exposure to the substances listed, including any exposure of non-employees.
      5. Compare this with a standard. (Provided through Eolas).
      6. Decide on need for air sampling and for biological monitoring and who should perform this, to assist in (4) and (5).
      7. If air sampling is required, record the results.
      8. Ensure medica1 records are kept in respect of any personal biological monitoring carried out.

Phase 3

Control Of Hazards And Risks
      1. For each chemical, decide and record how it is to be controlled.
      2. Produce, or review, safe operating procedures in written form for each substance deemed to be hazardous, to cover processes and controL measures.
      3. Ensure that specific reference is made to appropriate personal protective equipment necessary, by type and/or irish/British Standard.

Phase 4

Monitoring Effectiveness
      1.  Establish a procedure for reviewing control] measures.
      2. Establish the frequency of any required air sampling as an on-going check, recording the results.
      3. Set up necessary arrangements for maintenance, examination and testing of local exhaust ventilation and other appropriate control measures.
      4. Establish procedures for supplying and maintaining personal protective equipment.
      5. Establish a procedure for incorporating newly-acquired substances, new hazard information or changed work practices into the assessment.
      6. Establish the training process as appropriate.
      7. Agree with Supervisors the frequency at which the assessment will be repeated in full or in part.
      8. Sign and date the finished assessment, and decide on distribution of

The next part of the Section takes the four stages identified above in more detail, and should be read in conjunction with the Assessment Pro Formae.

1. Obtaining Knowledge

The necessary information on substances must be acquired and collated. Substances may be brought into an organisation for a number of purposes. They may be:-

(a) Bought In As Raw MaterialsRaw Materials Solvents Products Which Generate Oust. During Processing Finishing chemicals
(b) Produced As Part Of The ProcessIntended Products By-Products Waste Products Intermediate Products
(c) Bought For Engineering And CleaningCleaning Solvents Bleaches Oils Water Treatment Chemicals General Cleaning Fluids
(d) Bought For Service FunctionsChemicals For Copiers Adhesives Correcting Fluids Sodium Hypochlorite For Swimming Pools
(e) Produced By Other Means
"Legionella" and Other Micro-Organisms Engine Fumes Welding Fumes Ozone From Copiers

It will be seen that “substances” includes not only simple materials but mixtures, intermediates, waste and final products.

The first stage in the obtaining of necessary knowledge is to prepare a complete of all substances that are bought, used or made on the premises. The list could be produced by a number of individuals, some of whom may approach the subject by listing the work activities and deriving the list from an analysis. Others may carry out physical audits of the workplace, stores areas and the like to forma list of substances known to be physically present. A combination of these different lists will be more thorough than the list produced by any single individual.

The second stage is the production (and re-ordering) of the list in tabular form, so that progress reached can be easily noted and compared. It will be found simpler to begin with raw materials and follow with processes and the remainder.

The third stage is the marshalling of all necessary information about each substance, compound, mixture or “pure” chemical. A primary source for this information, but never the only source or the complete source, should be the: supplier. As. discussed in the previous section, data sheets provided by suppliers will rarely contain all the necessary information, and may only highlight hazards thought by the supplier to be of particular relevance. Also, the layout of data sheets may vary and some suppliers may limit the information provided deliberately or by default.

The completion of the data sheets forces the fourth stage or preparation. (Other sources of information are listed in the bibliography. (The assessor should be in possession of a current copy of at least one of the principal standard works on chemical hazards.)

Although some suppliers are reluctant to reveal the chemical] composition of their products on grounds of alleged commercial confidentiality, there can be few, if any, occasions on which commercial confidentiality can be justified as grounds for not supplying health and safety information. It is not possible to assess the control of a chemical adequately unless its nature is known. All chemical components of mixtures and proprietary products should be established and listed in the data sheet.

Once the data sheet is produced, it should be made readily available to any employee who may need the information, especially safety representatives. Training needs, which will be assessed regularly, will include the use of data sheets as well as the hazards associated with the specific substances encountered by trainees. A copy of the compiled data sheets should also be held by the person or persons responsible for first-aid.

The fifth stage of preparation consists of summarising the basic hazards of the substances. This information should already be present in the individual data sheets, and can usefully be tabulated alongside the name of the substances.

2. The Assessment Of Risk

The risk associated with a substance depends not only on its inherent properties (which have just been listed), but also upon the way it is to be used and the way in which it can be misused or mishandled. Before any control measures can be decided upon, every process using substances must be assessed. The depth of the assessment need not be the same in all cases, for instance if the substance concerned has a low hazard rating, or if the type of process means that exposure to the substance is likely to be low regardless of any control measures which may be applied. However, if the substance is already identified as hazardous, or the process is such that people will be exposed at high levels unless specific control measures are adopted, then an assessment with a satisfactory outcome will become a (written) justification for continuing to use the process or the substance. Sometimes the result of the assessment will be that the process should stop or be replaced by a safer one.

At this point, identify the substances which are defined as “substances hazardous to health”. These substances should be listed. The listing should contain three categories of substances:-

(a) Substances definitely classified as “hazardous to health”.

(b) Substances definitely not so classified.

(c) Substances needing further consideration or investigation.

Even for category (b), further evaluation should still be continued, of course, Since it is possible that the ways in which these substances are used in practice may make them hazardous by virtue of their quantity, temperature, etc. (Even though a substance may not be classed as “hazardous” under this scheme, it should be remembered that the assessment is a useful tool to identify all potentially hazardous substances, and it will be of value to pursue the assessment to ensure that even the lower-order hazards are adequately managed.)

Next, all the substances in the list should be reviewed to see where they are used on the premises. Each process should then be examined to see how the substances are used, what possibility there is for people to come into contact with them, the type of effect they can cause and the likely levels of exposure. The assessment must also look at chemical products, intermediates and possible products of an unwanted reaction, as well as the substances listed. (Fire and explosion risks should be investigated as well as the risks to health of substances and processes.) All the information necessary for doing this part of the assessment should already be contained on the hazard data sheets.

The assessment must also examine the possibility of substances becoming airborne as gas, vapour, dust or aerosol. Handling methods, spills or leaks and the possibility of ingestion must be considered, as airborne contaminants are not the only danger in the workplace. Ingestion and skin contact must also be evaluated. There may be a situation such as during work in tanks, sewers or other confined spaces, where vapours or gases may suddenly enter the workplace. Assessments need to consider all such possibilities.

Access the likely exposure of all those likely to become exposed. Special attention should be paid to recognising the possible presence of other people where the process is being carried out.

These assessments of exposure must then be compared with a known standard. These standards are generically referred to as “occupational exposure limits” (OELs). Most exposure limits are presented as concentrations in air of the substance concerned, as parts per million by volume in air (ppm) or weight per volume of air (mg/m3). Exposure limits are not to be regarded as dividing lines between safe and dangerous concentrations; rather they represent estimates based on more or less sound information of what people might reasonably be exposed to, day after day at work, without suffering obvious ill-effects. The exposure limits cannot safeguard everyone, some people already suffering from another disease may be at risk even if the exposure limit is met, others may be extra-sensitive. None of the lists offers standards on more than a few hundred of the many thousands of substances in regular use. These substances are given an OEL in EH40 produced by the Health and Safety Executive (UK) and available through Eolas.

If a substance is not in the list, it would be wise to set a local exposure limit, based on knowledge of the hazards of the substance and comparisons made with similar materials. Advice might valuably be sought from a toxicologist or other specialist adviser through EOLAS.

If the possibility of substances becoming airborne is low, and the concentration in air is thought unlikely ever to exceed a quarter of the OEL, then air sampling will not normally be needed. (Arranged through the Defence Advisory Group).

Whenever there is doubt as to the concentrations of hazardous substances in people’s breathing zones, or in the atmospheres of workplaces, then a carefully planned and suitable air sampling exercise should if possible be performed.

Similarly, if is suspected, as with some substances, that accumulation in the body is occurring, and there is an available biological monitoring technique for measuring this, then such a technique should be considered (i.e. blood/urine tests). Such tests are the province of the Director of Medical Services who will of course retain personal records:in accordance with regulations.

As regards both “operator breathing zone” and “static” air sampling, a wide variation in airborne concentrations across working shifts is likely to occur. The factors influencing this include: –

      1. the number of contaminant sources;
      2. the rates of release from each source:
      3. the nature and position of each source;
      4. the dispersion situation as influenced by ventilation, temperatures, etc;

The following further factors are also likely to influence the degree of personal exposure: –

      1. The work shift pattern;
      2. Reduced or nil exposure between shifts;
      3. Variation in process operation;
      4. Failure to follow precautions.

The main principles of planning and performing a responsible air sampling programme therefore include: –

      1. Always carefully monitor individual operator breathing zone concentrations (and not just background concentrations at static points).
      2. Do as much air sampling as reasonably practicable – the more results (if correctly interpreted) the greater likelihood of a correct overall conclusion.
      3. Carefully consider the suitability and stated accuracy of the air sampling and analytical technique(s) involved. (Such details are given in the HSE Methods for Detection of Hazardous Substances Series – “MDHS” Series). Further useful guidance is also given in HSE Guidance Note EH42 – (Monitoring Strategies for Toxic Substances). Sampling materials available from Eolas.
      4. Carefully record the results, conclusions and recommendations of each sampling exercise.

These steps, taken in sequence, will provide all necessary information on substance designated as “hazardous”. Decisions can then be made on the most appropriate controls.


At this stage in the assessment, information on the hazards of the materials and the likely exposure has been collected and tabulated. The final stage consists of making decisions on the best ways of controlling the hazards. This logical sequence of conducting the assessment permits review of existing control measures, which may well prove upon examination to be adequate. This can be stated, but it would be useful to note down what these measures are so that it can be demonstrated that a full assessment has indeed taken place on the date specified.

The techniques of control, in order of effectiveness, are:-

      • elimination (including process change);
      • substitution;
      • enclosure;
      • isolation;
      • local exhaust ventilation and reduced time exposure;
      • dilution ventilation;
      • use of personal protective equipment;
      • personal hygiene and washing facilities;
      • training.

Reviews of needs often reveal substances and processes which are no longer necessary. Otherwise, substitution is always the most desirable control followed by design and engineering techniques. Control systems which rely upon appropriate behaviour are always less effective than these and are more liable to failure. They each have a place in the effective management of chemical risks.

(a) Elimination/ Substitution

Can safer materials be used? There are some substances which should never be used. Others may be banned as a matter of policy. Rational justification should always be insisted upon from those who wish to use a more hazardous substance in preference to a less hazardous one.

(b) Enclosure

Can the material be handled so that individuals need never come into contact with it?

(c) Isolation

Can we put it somewhere else? The system of isolation is required to prevent access effectively, or certainly restrict access to those who need to be there.

(d) Reduced Time Exposure

As already indicated OEL’s are time-related and it may well be possible to keep below them by reducing the period(s) of exposure.

(e) Ventilation

When the hazard cannot be completely contained, ventilation systems can offer a possible solution. However, their design and installation is a specialised skill which must be done by competent ventilation engineers.

The two main methods of ventilation are general (dilution) ventilation and local exhaust ventilation (LEV). General ventilation allows the contaminant to be diluted by the introduction of fresh air into the workroom, This can be done by a general extractor fan, by blowing air into the room, or installation of air conditioning. Dilution ventilation of this kind can ensure that humidity and carbon dioxide levels are maintained within known limits, and is important generally for the control of the working environment.

It is also the preferred technique for controlling the atmosphere within a confined space. However, it is a very inefficient way of controlling specific air contaminant problems. For this, local exhaust ventilation is preferable since it captures emissions at source.

Ventilation systems only work well if they are used as intended and designed and when they are maintained in good condition. They require training of operators to use them effectively, and their performance must be monitored.

The best results are achieved by extracting contaminated air as close to the source as possible, or using an enclosure with extract ventilation such as a fume cupboard or paint spray booth.

(f) Personal Protective Equipment

The issuing of personal protective equipment against a hazard constitutes  an explicit statement that nothing further can be done to control exposure other than by requiring operators to wear and maintain a personal piece of equipment. It should be recognised by all concerned that personal protective equipment is the last line of defence, and should never be selected as the first or only option where other control measures such as those discussed above are available. Personal protective equipment will be needed, though, then the other control measures will not be feasible, or will offer only partial control. Systems for the selection, use and maintenance of personal protective equipment must be thorough. Training and information are required in the selection process, as well as in the correct use and maintenance of it.

(g) Personal Hygiene and Washing Facilities

Where hazardous substances present a risk, particularly of skin contact and/or ingestion, the value of good personal hygiene and provision of adequate washing facilities is self-evident.

(h) Training

To be effective, all the foregoing control measures need the backup of training for all concerned.

Monitoring Effectiveness

Assessment is only the first step in complying with Safety Regulations in the use of chemicals. It will be necessary to make sure that the control strategies set out in the assessment are followed and are effective. This is why they should be reviewed. Assessment requires not only a review of risks, but also a review of the measures used to control the risks. Purchasing procedures, quality control, permit-to-work systems and access to plant if isolation is the chosen strategy all offer examples of such measures.

After the assessment has been completed, consideration should be given to methods of publicising the results where appropriate. The information produced by the assessment is the kind which is intended to be given to employees and to safety representatives, who are entitled to receive it and be consulted by Commanding Officers. (Section 13 of Safety Health and Welfare at Work Act.)




General Texts

Chemicals – A Bibliography: List of Health and Safety Executive/Health and Safety Commission References. HSE, UK. ;

Guidance Notes in the Environmental Hygiene (EH) Series. HSE, HMSO, UK.

Occupational Health Guidelines for Chemical Hazards. NIQOSH/OSHA, USA.

Encyclopedia of Occupational Health and Safety. International Labour Office, Geneva.

Cashman J. R. Hazardous Materials Emergencies. Technomic Publishing Co., USA.

Fundamentals of Industrial Hygiene. National Safety Council, USA.

Handbook of Occupational Hygiene. Kluwer Publishing Ltd., Brentford, Middlesex, UK.

Hazards Of Chemicals

Patty, F. A., Industrial Hygiene and Toxicology. Interscience Publishers, New York, USA

Encyclopedia of Chemical Toxicology. (2nd Edition). Kirk-Othmer, Wiley-Interscience, New York, USA.

Registry of Toxic Effects of Chemical Substances (RTECS). NIOSH, USA.

Gleason M. N. et al. Clinical Toxicology of Commercial Products. The Williams Wilkins Co., USA.

Sax N. I., Dangerous Properties of Industrial Materials. Nan Nostrand Rheinhold Co., USA

Deichmann W. B. & Gervarde H. W. Toxicology of Drugs and Chemicals. Academic Press, USA

Stecher P. G. The Merck Index. Merck & Co. Inc., USA.

Pocket Guide to Chemical Hazards. NIOSH/OSHA, USA

Standards For Control And For labelling Of Chemicals

Occupation Exposure Limits for Airborne Toxic Substances. (Gives limits  other information on standards applied by a number of countries). International Labour Office, Geneva.

Occupational Exposure Limits – Guidance Note EH40. (Revised Annually). HSE, HMSO , UK.

Threshold Limit Values (TLVs} and Biological Exposure Indices. (Revised Annually) American Conference of Governmental Industrial Hygienists (ACHIH)  Cincinnati, Ohio, USA.

Information Approved for the Classification, Packaging and Labelling of Dangerous Substances  (Authorised and Approved List) 1988. HMSO, UK.

Control Techniques

An Introduction to Local Exhaust Ventilation HS(G)37. Health and Safety Executive , HMSO, UK

The Industrial Environment – Its Evaluation & Control. (1973) NIOSH , USA.

Industrial Ventilation: A Manual of Recommended Practice. (17th Edition). American Conference of Governmental Industrial Hygienists (ACGIH) , USA.

Fundamentals Governing the Design and Operation of Local Exhaust Systems. (ANSI Standard Z9. 2). New York, USA.

CIBSE Guide. (Published in .sections). Chartered Institution of Building Services Engineers London, UK.

Monitoring Techniques

Monitoring Strategies for Toxic Substances: Guidance Note EH42.

Methods for the Determination of Hazardous Substances (IIDHS Series). HSE, UK.

Occupational Exposure Sampling Strategy Manual.
(Publication Number 77 – 173). NIOSH, USA



References acquired and produced by HSE Library and Information Services (UK ). Available through IRS-DIALTECH, Pergamon Infoline  and Prestel.


Produced by International Occupational Safety and Health Information Centre, International Labour Office, Geneva (Switzerland). Available on-line through IRS-D IALTECH


Produced by Royal Society of Chemistry (UK). Available on-line through IRS-DIALTEC, Pergamon Infoline .


Produced by National Institute for Occupational Safety and Health (USA). Available on-line through Pergamon Infoline.


Registry of Toxic Effects of Chemical Substances. Produced by NIOSH (USA).


EOLAS, Glasnevin, Dublin 9.

IRS DIALTECH, Department of Trade and Industry, Room 392, Ashdown House, 123 Victoria Street, London, SWlE 6RB. (Telephone 071 – 215 6578).

PERGAMON ORBIT INFOLINE, 12 Vandy Street, London, EC2A 2DE. (Telephone 071 – 377 4650) .

SILVER PLATTER, 10 Barley Mow Passage, London , W4 4PW . (Telephone 081 – 995 8242).

NIFAST, Nore Road, Glasnevin, Dublin 9.

Protection of Defence personnel against health risks of chromium-6 was inadequate


From 1984-2006, employees of the Dutch Ministry of Defence were exposed to chromium-6 during maintenance work. This occurred at five so-called POMS sites (POMS: Prepositioned Organizational Materiel Storage), where principally American NATO equipment was stored and maintained by Defence personnel.

The Ministry of Defence had the responsibility to inform both employees and occupational physicians about the health risks of exposure to chromium-6-based paint and to ensure the use of the appropriate protective equipment. This did not happen adequately.


Netherlands Armed ForcesThe extent to which Defence personnel were exposed to chromium-6 at the five POMS sites differed according to their positions. Employees in the technical maintenance positions had the highest exposure to chromium-6. The chromium-6 to which Ministry of Defence personnel were exposed in the period 1984-2006 can no longer be detected in their bodies. The fact is that chromium-6 is readily converted to chromium-3 in the body and is subsequently excreted.

Health effects of chromium-6

Defence personnel working in technical maintenance positions were exposed to chromium-6, which may have caused the following diseases: lung cancer, nasal and nasal cavity cancer, gastric cancer, chromium-6-related allergic contact dermatitis, allergic asthma and allergic rhinitis, chronic lung diseases and perforation of the nasal septum due to chromium ulcers. Because most of these diseases can also be induced by other causes, in many cases it cannot be determined with certainty that these diseases are the result of exposure to chromium-6 at the POMS sites. For other health problems, such as dental problems, no or insufficient scientific evidence has been found for a possible relationship with exposure to chromium-6.

Responsibilities, working conditions and duty of care

In its capacity as employer, the Ministry of Defence had the responsibility of notifying both employees and occupational physicians of the risks of exposure to chromium-6 containing paint. Most POMS employees indicated that they were not aware of the health hazards related to chromium-6. Furthermore, hardly any of the occupational physicians at the Ministry of Defence that participated in this study knew that there was a possibility that employees were exposed to chromium-6 in the period that the POMS sites were operational. The Ministry of Defence’s prevention and care policy did not comply with the applicable rules, particularly in the early years.

RIVM has conducted research into chromium-6 on behalf of the Minister of Defence. We have published a serie of ten reports on chromium-6 at the POMS sites of the Dutch Ministry of Defence . A combined English summary of the ten reports is available in the report ‘Chromium-6 at the Ministry of Defence’s POMS sites: health effects and responsibilities’.

Read full article journal at the National Institute for Public Health and the Environment of the Netherlands


Chromium 6 aka hexavalent chromium was extensively used in Baldonnel for example in paint strippers like Ardrox 666, paint primers like Metaflex FCR as well as corrosion inhibitors like Mastinox 6856k

Specific hexavalent chromium ingredients used in the Irish Air Corps included

      • Barium chromate
      • Calcium dichromate
      • Magnesium chromate
      • Potassium chromate
      • Sodium chromate
      • Strontium chromate
      • Zinc chromate.

Zinc chromate would have been in the air in the Spray Paint Shop & Engineering Wing hangar any time primer was being sprayed and in many instances personnel carrying out the spraying would have inadequate or no  PPE and personnel in close proximity in the hangar carrying out other tasks  would have had zero PPE and zero awareness of exposure.

Barium chromate & strontium chromate are used in all hangars and some workshops as a component of Mastinox 6856k. This was used with bare hands and likely ingested by some personnel due to inadequate wash facilities. There have been instances where personnel have had parts of their stomach removed from such exposure and have lost all their teeth. 

Sodium chromate is a component of Ardrox 666 which can be seen here dribbling out of the extractor fan in ERF.

Some Safety Data Sheets showing hexavalent chromium ingredients.

it is highly likely that military & civilian personnel in other workshops in the Defence Forces were exposed to chromium 6 / hexavalent chromium.


Impact of Firefighting Aqueous Film-Forming Foams on Human Cell Proliferation and Cellular Mortality



Evaluate the toxic effects of Aqueous Film-Forming Foams used by firefighters for Class B fire suppression in human-derived kidney cells (HEK-293).


Three widely used AFFFs were collected from fire departments and were added to HEK-293 cells in various concentrations. Seventy-two hours post-treatment, cellular proliferation and toxicity were examined using commercially available kits.


All AFFFs evaluated induced cellular toxicity and significantly decreased cell proliferation, even when cells were treated with concentrations 10-fold lower than the working concentration used for fire suppression.


Despite the reduced usage of PFAS-containing AFFFs in the firefighter work environment, the evaluated AFFFs demonstrated significantly altered cellular proliferation, while also inducing toxicity, indicating the presence of toxic compounds. Both stronger implementation of PFAS-containing AFFFs restrictions and robust evaluation of fluorine-free and next-generation AFFFs are warranted.

In Brief

Firefighters are routinely exposed to per- and polyfluoroalkyl substances (PFAS) through the use of Aqueous Film-Forming Foams (AFFFs) for the suppression of Class B fire, which derive from flammable and combustible liquids, such as gasoline and alcohol. The addition of surfactants and PFAS in the AFFFs allows them to form an aqueous film that can extinguish the fire, while also coating the fuel. As such, AFFFs are often used for fire extinction in airports and military bases.

Exposure to PFAS in the general population may arise from ingestion of contaminated food or water, usage of consumer products containing PFAS, such as non-stick cookware or stain resistant carpets and textiles, and inhalation of PFAS-containing particulate matter. Detection of increased serum PFAS concentrations has been linked to an elevated risk for kidney cancer in humans, and firefighters are known to have increased serum concentrations of certain PFAS after attending training exercises. In the same study it was also observed that the average urinary excretions of 2-butoxyacetic acid (2-BAA) a surfactant often added in AFFFs exceeded the reference limit of the occupationally unexposed population, ranging from 0.5 to 1.4 mmol/mol creatinine.

Furthermore, an increased risk of mortality from kidney cancer has been observed in firefighters compared to the U.S. population. The detrimental health effects of PFAS are exacerbated by their increased half-lives in humans. A recently published study examined the half-lives of short- and long- chained PFAS in the serum of 26 airport employees and observed a wide range of half-lives which was dependent on the length and chemical structure of each substance that was examined. Indicatively, the shortest half-life was described for perfluorobutanesulfonic acid (PFBS), while the linear isomer of perfluorooctanesulfonic acid (PFOS) had the longest half-life (average of 44 days and 2.93 years, respectively), findings which are in agreement with other sources in the literature.

One aspect of this phenomenon could be attributed to renal reabsorption, as humans actively transport PFAS in the proximal tubules. A recently published scoping review of 74 epidemiologic, pharmacokinetic, and toxicological studies examined the relationship between PFAS exposure and kidney-related health outcomes. It was observed that exposure to PFAS was associated with lower kidney function, including chronic kidney disease (CKD), and histological abnormalities in the kidneys, as well as alterations in key mechanistic pathways, that can induce oxidative stress, and metabolic changes leading to kidney disease.

The alarming number of studies showcasing the harmful health effects pertaining to PFAS exposure has led to the banning of the production of AFFFs containing highly toxic, long chain PFAS, such as perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) since 2015. However, this regulation is gradually being implemented across states and little is known about the toxicity of the next generation AFFFs. Based on the above, in the present study we evaluate cellular proliferation and toxicity in kidney-derived cells (HEK-293) that were exposed to three widely used AFFFs.

Read full study below


Organic solvents and Multiple Sclerosis susceptibility


Photo of dichloromethane (DCM) as stored by Irish Air Corps in 2015. DCM was banned in the EU in 2012.

We hypothesize that different sources of lung irritation may contribute to elicit an immune reaction in the lungs and subsequently lead to multiple sclerosis (MS) in people with a genetic susceptibility to the disease. We aimed to investigate the influence of exposure to organic solvents on MS risk, and a potential interaction between organic solvents and MS risk human leukocyte antigen (HLA) genes.


Using a Swedish population-based case-control study (2,042 incident cases of MS and 2,947 controls), participants with different genotypes, smoking habits, and exposures to organic solvents were compared regarding occurrence of MS, by calculating odds ratios with 95% confidence intervals using logistic regression. A potential interaction between exposure to organic solvents and MS risk HLA genes was evaluated by calculating the attributable proportion due to interaction.


Overall, exposure to organic solvents increased the risk of MS (odds ratio 1.5, 95% confidence interval 1.2–1.8, p = 0.0004). Among both ever and never smokers, an interaction between organic solvents, carriage of HLA-DRB1*15, and absence of HLA-A*02 was observed with regard to MS risk, similar to the previously reported gene-environment interaction involving the same MS risk HLA genes and smoke exposure.


The mechanism linking both smoking and exposure to organic solvents to MS risk may involve lung inflammation with a proinflammatory profile. Their interaction with MS risk HLA genes argues for an action of these environmental factors on adaptive immunity, perhaps through activation of autoaggressive cells resident in the lungs subsequently attacking the CNS.

Read full study below


Anecdotal evidence has been emerging for some time of potential illness clusters at Casement Aerodrome to which Multiple Sclerosis has now been added. We are calling for these potential clusters to be investigated by competent authorities.

Suspected illness clusters currently include.

What did the British ever do for us? A fit for purpose solvent extraction system at Irish Air Corps!

The British Royal Flying Corps built a solvent exhaust stack at the now Irish Air Corps airbase at Baldonnel over 100 years ago. This exhaust stack stack featured a powerful fan for safely removing solvent fumes from a degreasing bath.
In the mid 1980s the Air Corps Machine Shop was moved to this location at the front of the ERF (Engine Repair Flight) building. To facilitate this move the “Trike Bath”, a heated trichloroethylene solvent vapour degreaser, was located to a new Non Destructive Testing (NDT) Shop to the rear of Engine Repair Flight (ERF). The 25 foot extractor chimney was replaced with an inadequate 6 inch fan which was ducted through a nearby window. 
Around 2006 an NDT technician in ERF turned yellow from jaundice due to a chemical induced liver injury. After the NDT technician turned yellow the officer in charge of Health & Safety ordered that the Safety Data Register and adverse air quality tests be destroyed.
The ERF building was condemned in September 2007, a fact that was denied in the Dáil by the former Junior Minister for Defence Paul Kehoe TD.
After some serving & former ERF personnel sought their medical files throught their solicitors in early 2008 the building vanished.
#97dead #DelayDenyDie #TCE #Trike

Trichloroethylene used to clean the floors in Irish Air Corps cookhouse!

Every now and again when investigating poor health & untimely deaths of colleagues in the Irish Air Corps at Casement Aerodrome we come across a cluster of unexplained deaths or illness in particular work locations.

Exposures are briefly explained by location below those in RED were unexplained until personnel came forward to highlight misuse of chemicals in these locations.

Apprentice Hostel

Exposure to asbestos was the main problem in the apprentice hostel and it does not appear to have been fully removed until the mid 1990s although some efforts were made to remove the bulk of it in the late 1980s. The 1990s effort used a professional removal service while the late 1980s effort used apprentices without any PPE whatsoever. Persistent black marks on lino or floor tiles would be dealt with by calling to the nearest hangar or workshop to borrow some MEK or Trike

Avionics, ERF & Parachute Shop

Illness & untimely deaths in Avionics Squadron and Engine Repair Flight (Engine Shop) can be explained by unprotected exposure to the chemicals used in both locations and by their exposure to exhaust fumes from the Spray Paint Facility. The Parachute Shop which was part of ERF establishment also used toxic glues and exposed personnel to fumes from PU coated drysuits.

Basic Flight Training School

Illness & untimely deaths in BFTS can be explained by the IRAN inspections where DCM/Phenol paint strippers were used without PPE and the extensive use (like in heli) of corrosion inhibitors like Mastinox. Of course the fuel for the Marchettis was leaded gasoline with its own issues.

Battery Shop

Illness in the battery shop can be explained by exposure to battery electrolytes & charging fumes. The personnel walking around here with holes in their jumper, trousers and shirts from sulphuric acid was almost comical if it wasn’t such a serious risk to their health.

Cookhouse / NCOs Mess

Until now we had not been able to satisfactorily explain the unusual body count & illnesses of personnel who served in the old cookhouse kitchen, new cookhouse kitchen and NCOs Mess kitchen.

Recently we were made aware of a practice in the old cookhouse as far back as the mid 1970s whereby personnel who worked there procured solvent degreaser from up camp. We believe this degreaser again to be trichloroethylene.

This solvent was provided sometimes in 25 litre drums and sometimes in gallon containers where it was usually decanted into smaller vessels like milk bottles or coke bottles to be spread on the floor and then mopped and squeegeed until the floor was spotless.

And it turns out that this practice continued in the new cookhouse and technicians from ERF who dropped down 25 litre drums of Trike were rewarded with a wrap up of some food like steaks.

We believe this floor degreasing practice occurred in the NCOS Mess kitchen but we have no evidence yet that it occurred in the Officers Mess Kitchen but given the fluidity of personnel movements between the various catering locations it is a distinct possibility.

For some information on Illnesses caused by trichloroethylene click here.

Engineering Wing Hangar & Workshops

Illness & untimely deaths in Engineering Wing Hanagar can be explained by unprotected exposure to Paint Shop chemicals including isocyanates & thinners, Hydraulic Shop chemicals, Sheet Metal Shop chemicals, wood dust from the Carpentry Shop, welding fumes from the Welding Shop as well as paint stripper fumes and mastinox fumes from Marchetti IRANs or Alouette equivalent teardowns.

Fire Crew

Members of the fire crew would have had exposure to exhaust gasses of idling aircraft engines and would have also had exposure to fuel fumes  and burning fumes from training exercises. The Fire Crew also used PFAS based fire fighting foams.

Heli Wing

Illness & untimely deaths in Heli Wing are easily explained by unprotected exposure to the chemicals used maintaining helicopters, by exposure to fuel vapours from gravity refueling, exposure to exhaust gasses from gas turbine engines and the immune sensitisation capabilities of polyurethane coated immersion suits.  Toxic tubbing in Heli was also a thing.

Light Strike Squadron

Similarly illness & untimely deaths in Light Strike Squadron can be explained by unprotected exposure to refueling fumes, exhaust gasses and other lubricants, greases, hydraulic fluids and sealants used to maintain the Fougas. Toxic tubbing in LSS was also a thing.

Main Block

Illness & untimely deaths in the Main block can be explained by unprotected exposure to photographic film & printing chemicals. These photographic chemicals used in photo section drove death, illness & harm to offspring in personnel throughout the main block

Chemicals in use by workshops in Air Sp Coy Signals further exposed personnel in the mainblock to chemicals they would not have expected to be exposed to like trichloroethane etc.

Units exposed in the main block would include 

  • Admin Wing HQ
  • AE Section
  • Drawing Office
  • Air Corps INT
  • Medical Aid Post
  • Sgt Majors Office
  • Signals Bottom Workshop
  • Signals Top Workshop
  • Signals COMCEN
  • Signals Orderly Room & CO’s Office
  • Signals PC Maintenance Workshop
  • Signals Stores
  • Station Commanders Office

Main Tech Stores

Illness & untimely deaths in Main Technical stores can be explained by the fact that the building is sited on the old Camp Stables where hundreds if not thousands of litres of toxic chemicals such as Ardrox 666 were dumped into the ground. Complaints were made by civilian & military personnel about poor air quality  in MTS and studies were carried out but the reports have disappeared. There is also evidence that used chemical drums containing isocyanates were stored in MTS in an open state.

Photo Section

When photo section moved out of the Main Block to the old cookhouse in the early 1990s they brought their dangerous chemicals to this new locations. This new location was better equipped than the expellair in the main block. But faulty equipment and lack of chemical health & safety training meant illness & death continued.

Photographers who flew regularly exposure to refueling fumes, exhaust gasses from gas turbine engines and the immune sensitisation capabilities of polyurethane coated immersion suits.


Obviously refuelers were exposed on an ongoing basis to high amounts of refueling fumes and aircraft exhaust gasses but also to other dangerous additives like FSII.

Training Depot

On at least two occasions that we are aware of there was catastrophic damage caused to floors and walls by misuse of chemicals in ACTD.

On the first occasion in the late 1980s we are aware of a recruit using what we suspect to be a large quantity of MEK on twine backed traditional lino the last room on the left of the depot. The use of the chemical on this occasion melted the lino through to the twine backing.

On the second occasion in the mid 1990s at least 25 litres of trichloroethylene was used to clean the floor of some of the demonstration rooms that had been recently redecorated. The Trike was spread on the floor using mops and squeegees making the apprentices carrying out the job high. The next morning it was discovered that all the floor tiles had shriveled up and that all the paint on the walls up to about 1m had dissolved and flowed down the walls to the floor.

For some information on Illnesses caused by MEK click here.


The physical layout of Baldonne means that the prevailing wind blows the exhaust gasses from idling aircraft over the whole camp.

There does not appear to have been any initiative whatsoever to reduce camp personnel exposure to exhaust gasses and in many cases aircraft exhaust into hangars due to the prevailing wind.

We have little information on chemical exposures at Gormanston except for tubbing and the use of JetA1 powered heaters inside hangars. We would welcome any information in this regards. 

Fourth study of mortality and cancer incidence in aircraft maintenance personnel: a continuing study of F1-11 Deseal/Reseal personnel 2016


From 1974 to 2000, the Royal Australian Air Force (RAAF) put in place formal Deseal/Reseal (DSRS) programs, in addition to informal repair methods, to correct fuel leaks in Australia’s F-111 fleet of aircraft. These programs were undertaken at RAAF Base Amberley in Queensland, and were suspended in early 2000 due to health concerns among DSRS personnel. A series of inquiries, investigations and scientific studies were commenced to determine the extent and impact of those health concerns.

As part of those investigations, the Mortality and Cancer Incidence Study (MCIS) was started to answer the following research question: did RAAF personnel involved either directly or indirectly in the F-111 DSRS maintenance programs (the DSRS-exposed Study Population) experience higher levels of mortality or cancer incidence compared with two groups of non-exposed RAAF personnel (the Comparison populations)—the RAAF Base Amberley (non-technical) Comparison Population and the RAAF Base Richmond (technical) Comparison Population?

Key findings

The results of the 4th MCIS show that involvement in the DSRS programs at RAAF Base Amberley was associated with a statistically significant 20–30% increase in the rate of cancer diagnosis, compared with both Comparison populations.

Involvement in the DSRS programs was also associated with a statistically significant 27% decrease in mortality compared with the Amberley Comparison Population.

Download the full study below.


The key takeaway here is that a statistically significant 20-30% increase in cancer was turned into 27% lower mortality by awareness, vigilance and a coordinated medical response. 

  • Medical treatment for a range of conditions
  • Counselling through Open Arms – Veterans & Families Counselling;
  • Participation in Open Arms – Veterans & Families Counselling coordinated programs, including the Lifestyle Management Course and Heart Health;
  • Eligibility to participate in the Better Health Program – a cancer screening and disease prevention program; and
  • approved travel to attend medical consultations and counselling sessions and healthy lifestyle programs through Open Arms – Veterans & Families Counselling.

The policy of successive Taoisigh, Tánaistí, Ministers for Defence, Chiefs of Staff and Director Generals of the Department of Defence was, and appears still to be, to let personnel suffer and die unnecessarily without any targeted intervention whatsoever by the state. 




Illnesses linked to dichloromethane aka DCM aka methylene chloride

CAS number: 75-09-2

Diseases linked to this toxicant grouped by strength of evidence.

Photo of DCM-based paint stripper as used by the Irish Air Corps in 2015. An EU ban on the use of DCM-based paint strippers came into force three years earlier on the 6th of June 2012.

Strong Evidence

  • Arrhythmias*
  • Myocardial infarction (heart attack)*

Good Evidence

  • Brain cancer – adult*
  • Fetotoxicity (miscarriage / spontaneous abortion, stillbirth)*
  • Reduced fertility – male (infertility and subfertility)*

Limited Evidence

  • Breast cancer*
  • Hepatocellular cancer (liver cancer)
  • Lung cancer*
  • Pancreatic cancer*
  • Peripheral neuropathy*
  • Prostate cancer*

Illnesses marked thus * have been suffered by Irish Air Corps personnel or their offspring.

Illnesses linked to #Trichloroethylene aka TCE aka TRIKE

Illnesses linked to trichloroethylene aka TCE aka TRIKE

CAS number: 79-01-6

Diseases linked to this toxicant grouped by strength of evidence.

Strong Evidence

  • Acute hepatocellular injury (hepatitis)*

Good Evidence

  • Acute tubular necrosis
  • Arrhythmias
  • Autoimmune antibodies (positive ANA, anti-DNA, RF, etc.)*
  • Cardiac congenital malformations*
  • Childhood leukemias
  • Cirrhosis*
  • Cognitive impairment (includes impaired learning, impaired memory, and decreased attention span) / mental retardation / developmental delay*
  • Decreased coordination / dysequilibrium
  • Fetotoxicity (miscarriage / spontaneous abortion, stillbirth)*
  • Hearing loss*
  • Hepatocellular cancer (liver cancer)*
  • Lymphoma (non-Hodgkin’s)*
  • Psychiatric disturbances (disorientation, hallucinations, psychosis, delirium, paranoias, anxiety/depression, emotional lability, mood changes, euphoria)*
  • Renal (kidney) cancer*
  • Scleroderma
  • Trigeminal neuropathy

Limited Evidence

  • ADD/ADHD, hyperactivity*
  • Adult-onset leukemias*
  • Brain cancer – adult*
  • Breast cancer*
  • Cervical cancer
  • Choanal atresia
  • Genito-urinary malformations (includes male and female)
  • Hodgkin’s disease (lymphoma)*
  • Immune suppression
  • Low birth weight / small for gestational age / intra-uterine growth retardation
  • Lung cancer*
  • Multiple myeloma*
  • Nephrotic syndrome
  • Neural tube defects / CNS malformations
  • Oral clefts (cleft lip and palate)
  • Pancreatic cancer*
  • Pancreatitis
  • Peripheral neuropathy*
  • Prostate cancer*
  • Raynaud’s phenomenon
  • Systemic lupus erythematosus*
  • Testicular cancer*

Illnesses marked thus * have been suffered by Irish Air Corps personnel or their offspring.