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Vinyl chloride exposure and cirrhosis: a systematic review and meta-analysis
Elisa Frullanti1, Carlo La Vecchia, Paolo Boffetta
1Department of Predictive and Preventive Medicine, Fondazione IRCCS, Istituto Nazionale Tumori, Milan, Italy. elisa.frullanti@istitutotumori.mi.it
Background:
It has been proposed that vinyl chloride exposure is associated with increased risk of death from cirrhosis, although epidemiologic evidence is limited.
Methods:
We analyzed the risk of death from cirrhosis by occupational vinyl chloride exposure by conducting a meta-analysis on seven available studies, including more than 40,000 workers exposed to vinyl chloride mostly in North America and Europe, with a total of 203 deaths from cirrhosis.
Results:
All epidemiological studies on vinyl chloride exposure and risk of death from cirrhosis resulted in an overall relative risk of 0.73 (95% confidence interval 0.61-0.87). Thus, the epidemiologic evidence does not suggest an excess mortality from cirrhosis in vinyl chloride-exposed workers; this is consistent with histopathological observations in livers of angiosarcoma patients and of vinyl chloride-exposed rodents revealing no signs of cirrhosis.
Conclusion:
Overall, our findings indicate the absence of increased risk of death from cirrhosis in vinyl chloride-exposed workers.
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