Parkinson's Trichloroethylene Exposure Questionnaire

Millions of New Yorkers have been exposed to highly toxic Trichloroethylene in drinking water, contaminated indoor air, occupational settings or consumer products. Multiple epidemiological and scientific reports document with statistically significant findings that Trichloroethylene is causally associated with up to a 500% increased Parkinson's risks.

What is Trichloroethylene? (Hover over to view)

For more than a century TCE was widely used as a degreasing agent, chemical intermediate, ingredient in hundreds of consumer and industrial products as well as a dry cleaning solvent and spot remover. TCE is nearly ubiquitous in developed communities as an air, land and water pollutant because it resists degradation. TCE has been detected in drinking water all over New York and from coast-to-coast.

According to the U. S. Environmental Protection Agency:
"TCE is widely used as a solvent in a variety of industrial, commercial and consumer applications including for hydrofluorocarbon (HFC) production, vapor and aerosol degreasing, and in lubricants, greases, adhesives, and sealants. TSCA [Toxics Substance Control Act, not in the original] requires that when EPA [Environmental Protection Agency, not in the original] determines a chemical substance presents unreasonable risk that EPA address by rule the unreasonable risk of injury to health or the environment and apply requirements to the extent necessary so the chemical no longer presents unreasonable risk. EPA determined that TCE presents an unreasonable risk of injury to health due to the significant adverse health effects associated with exposure to TCE, including non-cancer effects (liver toxicity, kidney toxicity, neurotoxicity, immunotoxicity, reproductive toxicity, and developmental toxicity) as well as cancer (liver, kidney, and non-Hodgkin lymphoma) from chronic inhalation and dermal exposures to TCE. TCE is a neurotoxicant and is carcinogenic to humans by all routes of exposure. The most sensitive adverse effects of TCE exposure are non-cancer effects (developmental toxicity and immunosuppression) for acute exposures and developmental toxicity and autoimmunity for chronic exposures. To address the identified unreasonable risk, EPA is proposing to: prohibit all manufacture (including import), processing, and distribution in commerce of TCE and industrial and commercial use of TCE for all uses..."

Millions of New Yorkers also were exposed to TCE in workplace settings before the use of the chemical was prohibited in our state in 2021: TCE Industry Classifications

As part of efforts to require comprehensive remediation of known Trichloroethylene threats across our state, Toxics Targeting seeks to identify New Yorkers with Parkinson's who can be documented to have been exposed to Trichloroethylene that might be associated with their neurodegenerative ailment.

Please contact me about the New York Parkinson's Prevention Campaign.

If you have questions, please call 800 2 TOXICS (800 286 9427).

Please fill out the Parkinson's Questionnaire below if you live, or once lived, in New York, have been diagnosed with Parkinson's and are concerned that you might have been, or continue to be, exposed to Trichloroethylene and other toxic chemicals associated with increased neurodegenerative risks.

The results of the questionnaire will not be publicly disclosed. There is no cost or compensation to participate in this voluntary survey. Selected individuals might be contacted to learn more about their Trichloroethylene exposures or to disclose information about known or possible exposures.

Thank you for your assistance. If you have questions, please call 800 286 9427.

First Name *

Last Name *

Street Address *

Street address which includes street number and street name. Example: 123 Main St

City *

State *

State (2-letter designation i.e. NY for New York)

E-mail *

Phone

Phone number (will not be shared or displayed)

Have you been diagnosed with Parkinson's? *

Yes

If so, when and by whom?

Previous Places of Residence

Address and Dates at that address

Address and Dates at that address 2

Address and Dates at that address 3

Address and Dates at that address 4

Where were you born? *

When were you born? *

Address where you lived when you were born?

Any family members or neighbors diagnosed with Parkinson's?

Special Concerns

Occupational History

Firm name, address, job description, period of occupation

Firm name, address, job description, period of occupation 2

Firm name, address, job description, period of occupation 3

Have you worked in a factory, commercial business, military facility or any occupational setting where you used, handled or were exposed to trichloroethylene, solvents or other toxic chemicals?

Yes

These could include manufacturing operations, dry cleaners, electronics production, metal fabrication, machine shops, auto repair businesses, printing operations, gas and electric utility systems, chemical production plants, electroplating businesses and these industrial classifications.

Have you ever lived in the immediate vicinity of any of the below-referenced government-documented sources of trichloroethylene? *

Yes

See: Selected Trichloroethylene (TCE) Public Health and Environmental Threats That Reportedly Do Not Meet Cleanup Requirements

Explain

Have you ever lived in a home/apartment or worked in a building with a sub-slab depressurization system that might have been installed to mitigate soil gas vapor intrusion of trichloroethylene or other volatile chemical solvents? *

Yes

See: Examples of Sub-Slab Depressurization Systems

Explain

Has your drinking water ever been contaminated with trichloroethylene or other volatile chemical solvents? *

Yes

Explain

Were you ever were exposed to environmental contamination associated with trichloroethylene or other volatile chemical solvents? *

Yes

Explain

Have you been getting slower in your usual daily activities? *

Yes

Explain

Is your handwriting smaller? *

Yes

Explain

Is your speech slurred or softer? *

Yes

Explain

Do you have trouble rising from a chair? *

Yes

Explain

Do your lips, hands, arms and/or legs, etc. shake? *

Yes

Explain

Have you noticed more stiffness? *

Yes

Do you have trouble fastening buttons or dressing? *

Yes

Do you shuffle your feet and/or take smaller steps when you walk? *

Yes

Do your feet seem to get stuck to the floor when walking or turning? *

Yes

Have you or others noticed that you don't swing one arm when walking? *

Yes

Do you have more trouble with your balance? *

Yes

Have you or others noticed that you stoop or have abnormal posture? *

Yes

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Parkinson's Trichloroethylene Exposure Questionnaire