Mortality from liver disease among italian vinyl chloride monomer/polyvinyl chloride manufacturers

Abstract

The possible association in humans between nonangiosarcoma primary liver tumors (PLC-non-A), particularly hepatocellular carcinoma (HCC), and exposure to vinyl chloride monomer (VCM) is supported by both experimental and human data. This article presents a review of the information regarding 253 deaths that occurred in seven plants manufacturing VCM/PVC and one plant extruding PVC. The retrieval of clinical and pathological data, in addition to the information from death certificate, is referred to as "best evidence" (BE). BE has been carried out for 63 deaths. A total of 14 primary liver cancer (PLC) were detected: seven were angiosarcoma (PLC-A), and two of the remaining seven were hepatocellular carcinoma (HCC). In our series of 14 PLC cases, there was no significant difference between PLC-A and PLC-non-A as to length of exposure and latency. There was no noticeable difference in terms of job title between ASL and non-ASL cases. The list of longest held jobs shows the presence of various job titles, different from autoclave cleaner, for primary liver cancer, PLC-A and PLC-non-A. In conclusion, our observations show that VCM may have a broader carcinogenicity action on the liver and that exposure lower than that occurring in autoclave cleaning can cause primary liver cancer, both angiosarcoma and nonangiosarcoma.

A collaborative study of cancer incidence and mortality among vinyl chloride workers.

“…There was no excess according to process type or category of years since first exposure . A slight excess was suggested for < 15 years of employment, while the SIR values were close to 100 for [15][16][17][18][19] and~20 years of employment. For the ranked level of exposure, the risks in the high and low categories were virtually identical.…”

Cytomorphologic Features of Angiosarcoma on Fine Needle Aspiration Biopsy

“…Angiosarcoma is most commonly found in skin and soft tissue, breast and liver. 49 Associations between exposure to Thorotrast (Fellows-Trafalgar, Detroit, Michigan, U.S.A.), 5,26,28,45 vinyl/polyvinyl chloride, 5,43,45,57 arsenic 5,17,45 and androgenic anabolic steroids 18 and angiosarcoma have been documented. The development of angiosarcoma in patients who have received radiation therapy 6,7,13,38,59 and in patients who have developed chronic postmastectomy lymphedema 29,51,53,58 is also well documented.…”

Human hemangiosarcomas have a common polymorphism but no mutations in the connexin37 gene

“…Human hepatic angiosarcoma is a very rare neoplasm that is strongly associated with occupational exposure to vinyl chloride (Pirastu et al, 1990) and Thorotrast (Jennings and Priestley, 1978). Therefore, in this study, we have examined whether mutations of Cx37 could be an etiological event for this type of human tumor.…”