Mortality from liver angiosarcoma, hepatocellular carcinoma, and cirrhosis among vinyl chloride workers.
Adult
Carcinoma, Hepatocellular
/ chemically induced
Cause of Death
Cohort Studies
Female
Hemangiosarcoma
/ chemically induced
Humans
Italy
/ epidemiology
Liver Cirrhosis
/ chemically induced
Liver Neoplasms
/ chemically induced
Male
Occupational Diseases
/ chemically induced
Occupational Exposure
/ adverse effects
Poisson Distribution
Vinyl Chloride
/ adverse effects
Young Adult
cohort study
liver cancer
liver cirrhosis
occupational exposure
vinyl chloride
Journal
American journal of industrial medicine
ISSN: 1097-0274
Titre abrégé: Am J Ind Med
Pays: United States
ID NLM: 8101110
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
accepted:
31
10
2018
pubmed:
27
11
2018
medline:
17
4
2020
entrez:
27
11
2018
Statut:
ppublish
Résumé
Occupational exposure to vinyl chloride monomer (VCM) has been established as a cause of hepatocellular carcinoma (HCC) and liver angiosarcoma (ASL). However, some controversy remains due to conflicting results on liver cirrhosis, and to evidence on HCC based on few confirmed cases. The aim of the study is to clarify the association between VCM exposure and mortality from liver diseases. In a cohort of 1658 workers involved in VCM production and polymerization, Poisson regression was adopted to estimate rate ratios (RR) across categories of VCM exposure for mortality due to ASL (n = 9), HCC (n = 31) confirmed by histological/clinical records, and the combination of deaths from liver cirrhosis and from liver cancer with clinical/histological evidence of cirrhosis (n = 63). Cumulative VCM exposure was associated with study outcomes; RRs in the highest compared to the lowest exposure category were: ASL 91.1 (95%Confidence Interval 16.8-497), HCC 5.52 (2.03-15.0), liver cirrhosis 2.60 (1.19-5.67). The risk of death from liver cirrhosis, as well as from HCC in the largest available series of confirmed cases, increased with VCM exposure.
Sections du résumé
BACKGROUND
Occupational exposure to vinyl chloride monomer (VCM) has been established as a cause of hepatocellular carcinoma (HCC) and liver angiosarcoma (ASL). However, some controversy remains due to conflicting results on liver cirrhosis, and to evidence on HCC based on few confirmed cases. The aim of the study is to clarify the association between VCM exposure and mortality from liver diseases.
METHODS
In a cohort of 1658 workers involved in VCM production and polymerization, Poisson regression was adopted to estimate rate ratios (RR) across categories of VCM exposure for mortality due to ASL (n = 9), HCC (n = 31) confirmed by histological/clinical records, and the combination of deaths from liver cirrhosis and from liver cancer with clinical/histological evidence of cirrhosis (n = 63).
RESULTS
Cumulative VCM exposure was associated with study outcomes; RRs in the highest compared to the lowest exposure category were: ASL 91.1 (95%Confidence Interval 16.8-497), HCC 5.52 (2.03-15.0), liver cirrhosis 2.60 (1.19-5.67).
CONCLUSIONS
The risk of death from liver cirrhosis, as well as from HCC in the largest available series of confirmed cases, increased with VCM exposure.
Substances chimiques
Vinyl Chloride
WD06X94M2D
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
14-20Subventions
Organisme : None
Pays : International
Informations de copyright
© 2018 Wiley Periodicals, Inc.