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Mortality from liver cancer and leukaemia among polyvinyl chloride workers in Taiwan: an updated study
  1. Hui-I Hsieh1,2,3,
  2. Pau-Chung Chen1,
  3. Ruey-Hong Wong4,
  4. Chung-Li Du1,5,
  5. Yu-Yin Chang1,
  6. Jung-Der Wang1,5,
  7. Tsun-Jen Cheng1
  1. 1Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
  2. 2Department of Family Medicine, Cathay General Hospital, Taipei, Taiwan
  3. 3School of Medicine, College of Medicine, Fu-Jen Catholic University, Sinjhuang, Taiwan
  4. 4Department of Public Health, College of Health Care and Management, Chung Shan Medical University, Taichung, Taiwan
  5. 5Department of Occupational and Environmental Medicine, National Taiwan University Hospital, Taipei, Taiwan
  1. Correspondence to Tsun-Jen Cheng, Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Zhongzheng District, Taipei 10055, Taiwan; tcheng{at}


Objectives To investigate types of cancer caused by occupational exposure to vinyl chloride monomer (VCM) and the temporal mortality trends of these cancers in workers from polyvinyl chloride (PVC) manufacturing factories in Taiwan, with follow-up of the cohort extended by 15 years, from 1980 to 2007.

Methods A retrospective cohort study of workers from six PVC factories in Taiwan was conducted. 3336 male PVC workers were enrolled and further linked with the National Mortality Registry and National Household Registry databases. Standardised mortality ratios (SMR) with 95% CIs were calculated and compared to the general Taiwanese male population. Cause-specific mortality between two study periods, 1980–1997 and 1998–2007, was compared. Six-year moving averages of the SMRs were calculated to examine mortality trends.

Results Liver cancer mortality increased during 1989–1994 (SMR 1.90, 95% CI 1.01 to 3.25), reached a peak during 1991–1996 (SMR 2.31, 95% CI 1.39 to 3.61) and became non-significant during 1994–1999 (SMR 1.42, 95% CI 0.80 to 2.34). Leukaemia mortality significantly increased during 1984–1989 (SMR 6.06, 95% CI 1.24 to 17.53), reached a peak during 1985–1990 (SMR 7.56, 95% CI 2.06 to 19.35) and became non-significant during 1991–1996 (SMR 3.24, 95% CI 0.39 to 11.69). The mortality trend for haemolymphopoietic cancer showed a similar pattern to that of leukaemia.

Conclusions VCM may increase the risk of liver cancer and leukaemia. When VCM exposure was controlled at worksites, mortality from these cancers returned to background levels.

  • Occupational exposure
  • vinyl chloride monomer
  • mortality
  • leukaemia
  • liver
  • mortality studies

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  • Funding This study was funded by grants (NSC 95-2314-B-281-004, NSC 91-2320-B-002-162 and NSC 92-2320-B-002-140) from the National Science Council, Taiwan.

  • Competing interests None.

  • Ethics approval The study was approved by the Institutional Review Board of the College of Public Health, National Taiwan University.

  • Provenance and peer review Not commissioned; externally peer reviewed.