Abstract
Occupational exposure to trichloroethylene (TCE) has been associated with rare but severe systemic hypersensitivity reactions frequently accompanied by hepatic dysfunction, yet these reactions are often discussed within exposure-centered toxicological paradigms. This review synthesizes clinical and epidemiologic evidence on occupational trichloroethylene-associated hypersensitivity to clarify its characteristic phenotype and interpret the condition within a framework of idiosyncratic solvent-induced liver injury (ISILI). Across published reports, a highly consistent phenotype was observed, characterized by a latency period of approximately 2-8 weeks, low and variable attack rates (<1% to 12.5%), absence of a clear exposure-response relationship, frequent hepatic involvement, and rapid clinical relapse following re-exposure. These recurrent features differ from classical dose-dependent solvent toxicity and delineate a susceptibility-driven pattern consistent with established models of idiosyncratic liver injury. These findings support interpreting trichloroethylene-associated hypersensitivity within an idiosyncratic solvent-induced liver injury (ISILI) framework and highlight the limitations of conventional exposure-based prevention strategies.