Update of the Follow-Up of Mortality and Cancer Incidence among European Workers Employed in the Vinyl Chloride Industry

Abstract

Although vinyl chloride is an established cause of liver angiosarcoma, the evidence is inconclusive on whether it also causes other neoplastic and nonneoplastic chronic liver diseases as well as neoplasms in other organs. Furthermore, the shape of the dose-response relation for angiosarcoma is uncertain. We have extended for approximately 8 years the mortality and cancer incidence follow-up of 12,700 male workers in the vinyl chloride industry in four European countries. All-cause mortality was lower than expected, whereas cancer mortality was close to expected. A total of 53 deaths from primary liver cancer (standardized mortality ratio 2.40, 95% confidence interval = 1.80-3.14) and 18 incident cases of liver cancer were identified, including 37 angiosarcomas, 10 hepatocellular carcinomas, and 24 liver cancers of other and unknown histology. In Poisson regression analyses we observed a marked exposure response for all liver cancers, angiosarcoma, and hepatocellular carcinoma. The exposure-response trend estimated for liver cancer in analyses restricted to cohort members with cumulative exposures of <1,500 parts per million-years was close to that estimated for the full cohort (relative risk of 2.0 per logarithmic unit of cumulative dose). No strong relation was observed between cumulative vinyl chloride exposure and other cancers. Although cirrhosis mortality was decreased overall, there was a trend with cumulative exposure.

Hepatocellular carcinoma and the risk of occupational exposure

“…Various European and Italian studies have reported the apparent association between the amount and timing of exposure to VCM and development of HCC in those exposed [118][119][120] .…”

Meta-analysis of studies of occupational exposure to vinyl chloride in relation to cancer mortality

“…Their results are also available as detailed reports (6)(7). These studies combine populations of exposed workers included in previous investigations and extend the follow-up.…”

“…Two large, multicenter epidemiologic studies of workers exposed to vinyl chloride have been reported recently (4)(5). Their results are also available as detailed reports (6)(7).…”

Improving the Healthiness of Sustainable Construction: Example of Polyvinyl Chloride (PVC)

“…However, the actual incidence of angiosarcoma of the liver and hepatocellular carcinoma for workers employed after 1975 is lower than those employed before this time, with an increased latency period for the development of cancer in those employed after 1975 [45,53]. The link between liver cancer and VCM is now well established, with these results being witnessed in other studies, and further confirmed by the follow-up studies of these original cohorts [53][54][55][56].…”