Mortality from liver angiosarcoma, hepatocellular carcinoma, and cirrhosis among vinyl chloride workers

Ugo Fedeli, Paolo Girardi, Giulio Gardiman, Davide Zara, Luca Scoizzato, Maria N. Ballarin, Michela Baccini, Roberta Pirastu, Pietro Comba, Giuseppe Mastrangelo

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)14-20
Number of pages7
JournalAmerican Journal of Industrial Medicine
Issue number1
Publication statusPublished - Jan 2019


  • cohort study
  • liver cancer
  • liver cirrhosis
  • occupational exposure
  • vinyl chloride

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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