Vinyl chloride exposure and cirrhosis: a systematic review and meta-analysis.

It has been proposed that vinyl chloride exposure is associated with increased risk of death from cirrhosis, although epidemiologic evidence is limited. 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. 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. Overall, our findings indicate the absence of increased risk of death from cirrhosis in vinyl chloride-exposed workers.