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Cohort and case-control analyses of workers exposed to vinyl chloride: an update.

Wu-W; Steenland-K; Brown-D; Wells-V; Jones-J; Schulte-P; Halperin-W
J Occup Med 1989 Jun; 31(6):518-523
Cancer mortality rates among 4835 men from a large polymerization complex and a 3635 member subcohort with possible vinyl-chloride (75014) monomer (VCM) exposure were examined. Originally studied in 1974, subjects were followed up through 1986 to investigate dose response using nested case/control studies. Exposures were mostly to VCM and polyvinyl-chloride (9002862) (PVC) dust with some butadiene (106990). VCM exposures were presumed minimal since 1974. Cumulative doses were calculated from exposure levels to each chemical from job held and worker job duration data information. The NIOSH control selection computer program was used to match five comparisons for age to each case subject. Most workers had been employed less than 5 years. Results for whole cohort indicated the following standardized mortality ratios (SMRs) and 90 percent confidence intervals, respectively: 300 (196 to 449) for liver cancer, 122 (104 to 142) for lung cancer, and 166 (100 to 250) for brain cancer. VCM subcohort SMRs were similar to whole cohort's with only liver cancer excess significant. Increased risk for liver cancer only was consistently associated with more than 5 years employment duration in VCM exposed jobs. Case/control results for association between cumulative doses of individual chemicals and cancer types indicated only VCM exposure and liver cancer were significantly associated. Estimated odds ratio for liver cancer was 7.96 for 5 years VCM exposure at the highest exposure level. Analysis of liver cancer cases after separation into angiosarcomas (12 of 19 cases) and others indicated a positive dose response only for angiosarcomas. The authors conclude that the data did not associate observed excess risk of lung and brain cancers with VCM or PVC dust exposure. At least 19 other potentially carcinogenic or toxic chemicals were used or produced at this complex.
JOCMA7; NIOSH-Author; Long-term-exposure; Risk-analysis; Humans; Cancer-rates; Carcinogens; Mortality-surveys; Occupational-exposure; Chemical-manufacturing-industry; Chemical-factory-workers; Airborne-dusts; Disease-incidence; Lung-cancer; Liver-cancer
75-01-4; 9002-86-2; 106-99-0
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Journal of Occupational Medicine