Vinyl chloride and the liver☆
Vinyl chloride monomer is a known cause of angiosarcoma of the liver. It also has other toxic effects on the liver, and it has recently been suggested that exposure to vinyl chloride also causes hepatocellular carcinoma. However, the data on which this conclusion is based is incomplete. There is inadequate ascertainment of unequivocal diagnoses. In the largest studies lack of data meant that confounding diseases such as viral hepatitis or alcoholic liver disease could not be assessed. At best, the increase in risk is minimal, based on more than 22,000 exposed workers and more than 640,000 person years of observation.
However, based on the available data the hypothesis that vinyl chloride causes or contributes to the development of hepatocellular carcinoma remains unproven.
Keywords: Vinyl chloride, Hepatocellular carcinoma, Angiosarcoma
Abbreviations: VCM, vinyl chloride monomer, PVC, polyvinyl chloride, ASL, angiosarcoma of the liver, HCC, hepatocellular carcinoma, IARC, International Agency for Research in Cancer, SMR, standardized mortality ratio, AFP, alpha-fetoprotein
☆ The author declared that he is a paid consultant to the European Council of Vinyl Manufacturer’s for the workshop on the relationship between VCM and HCC, a consultant to Bayer and a speaker for Bayer Inc.
PII: S0168-8278(09)00634-5
doi:10.1016/j.jhep.2009.09.012
© 2009 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.
