Abstract
BackgroundThe production of vinyl chloride (VC) and polyvinyl chloride (PVC) involves the use of various chemicals, some known to be toxic and potentially or definitely carcinogenic. The related potential risk often has not been properly investigated. Updated cancer mortality among different subgroups of workers employed in a VC-PVC production plant located in Porto Marghera (Italy) was re-analyzed using an internal reference group of workers with low (or null) exposure to VC.MethodsMortality of 1658 male workers was analyzed by Poisson regression. Relative risks (RRs) and 95% confidence intervals (CIs) for blue collar workers and their specific subgroups of PVC baggers, PVC compound, autoclave and other blue collar workers were calculated using technicians and clerks as an internal reference group. The follow-up covered the period 1972–1999.ResultsSignificantly increased mortality rates were observed for all causes of death among the whole blue collar workforce (RR = 1.55; 95% CI = 1.03–2.35; 229 deaths), PVC baggers (1.72; 95% CI = 1.04–2.83; 49 deaths) and PVC compound workers (1.71; 95% CI = 1.09–2.67; 72 deaths). Liver cancer, including angiosarcoma, was increased among autoclave workers (9.57; 95% CI = 3.71–24.68; 7 deaths) and cardiovascular diseases among PVC baggers (2.25; 95% CI = 1.08–4.70; 12 deaths). Hemolymphopoietic system tumors, leukemias and lymphomas prevalently, were found only among exposed workers, with 4, 4 and 6 deaths observed among PVC baggers, PVC compound and other blue collar workers, respectively. An excess of lung cancer was found among PVC baggers.ConclusionThis cohort analysis, based on internal comparison, confirmed previously reported specific risk excesses for liver tumors and liver cirrhosis among autoclave workers and for lung cancer among PVC baggers, and revealed PVC compound workers as a possible new at risk group for all causes, all tumors and for liver and lung tumors. In conclusion, RRs for all causes of death and all tumors were increased among all blue collar workers.
Highlights
The production of vinyl chloride (VC) and polyvinyl chloride (PVC) involves the use of various chemicals, some known to be toxic and potentially or definitely carcinogenic
Workers were classified according to their job categories in four large, but reasonably homogeneous, groups: autoclave workers (n = 210, 5446 person-years), PVC baggers (n = 198, 4978 person-years), PVC compound workers and technicians and clerks (n = 202, 5303 person-years)
Numbers of observed deaths (Obs), Relative risks (RRs) and 95% confidence intervals (CIs) by job category using technicians and clerks as a reference are shown in table 3
Summary
The production of vinyl chloride (VC) and polyvinyl chloride (PVC) involves the use of various chemicals, some known to be toxic and potentially or definitely carcinogenic. Other analyses on the same workers revealed a statistically significant reduced mortality from all deaths combined and a not statistically significant reduction of mortality from all tumors among the whole cohort [1,7,8] Since these latter studies investigated the entire cohort – including both exposed and nonexposed workers – and used the general population of the Region where the plant is located (Veneto) as a reference, related analyses may well have hidden some health risk excesses. For this reason, the updated mortality of the same cohort was reanalyzed using an internal comparison group of non-exposed workers in order to describe the pattern of diseases specific for each subgroup of exposed workers
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