Vinyl chloride exposure and cirrhosis: A systematic review and meta-analysis

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. (C) 2012 Editrice Gastroenterologica Italians S.r.l. Published by Elsevier Ltd. All rights reserved.