PT  - JOURNAL ARTICLE
AU  - Kenneth A Mundt
AU  - Linda D Dell
AU  - Lori Crawford
AU  - Alexa E Gallagher
TI  - Quantitative estimated exposure to vinyl chloride and risk of angiosarcoma of the liver and hepatocellular cancer in the US industry-wide vinyl chloride cohort: mortality update through 2013
AID  - 10.1136/oemed-2016-104051
DP  - 2017 Oct 01
TA  - Occupational and Environmental Medicine
PG  - 709--716
VI  - 74
IP  - 10
4099  - http://oem.bmj.com/content/74/10/709.short
4100  - http://oem.bmj.com/content/74/10/709.full
SO  - Occup Environ Med2017 Oct 01; 74
AB  - Objective To evaluate mortality risks of angiosarcoma of the liver (ASL), primary hepatocellular carcinoma (HCC) and other cancers among 9951 men employed between 1942 and 1972 at 35 US vinyl chloride (VC) or polyvinyl chloride plants followed for mortality through 31 December 2013.Methods SMR and time-dependent Cox proportional hazards analyses were used to evaluate mortality risks by cumulative VC exposure.Results Liver cancer mortality was elevated (SMR=2.87, 95% CI 2.40 to 3.40), and ASL and HCC were strongly associated with cumulative VC exposure ≥865 parts per million-years (ppm-years) (ASL: HR=36.3, 95% CI 13.1 to 100.5; and HCC: HR=5.3, 95% CI 1.6 to 17.7 for ≥2271 ppm-years). Excess deaths due to connective and soft tissue cancers (SMR=2.43, 95% CI 1.48 to 3.75), mesothelioma (SMR=2.29, 95% CI 1.18 to 4.00) and explosions (SMR=3.43, 95% CI 1.25 to 7.47) were seen. Mortalities due to melanoma, brain cancer, lung cancer and non-Hodgkin’s lymphoma were not increased or associated with VC exposure.Conclusion The association between VC and ASL first reported in this cohort 44 years ago persisted and was strongest among workers most highly exposed. VC exposure also was associated with HCC mortality, although it remains possible that misdiagnosis of early ASLs influenced findings.