title: Vinyl chloride exposure and cirrhosis: a systematic review and meta-analysis.
abstract: 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.
  
  
  CONCLUSIONS
  Overall, our findings indicate the absence of increased risk of death from cirrhosis in vinyl chloride-exposed workers.
authors.affiliation: Department of Predictive and Preventive Medicine, Fondazione IRCCS, Istituto Nazionale Tumori, Milan, Italy. elisa.frullanti@istitutotumori.mi.it
authors.forename: Elisa
authors.initials: E
authors.lastname: Frullanti
authors.forename: Carlo
authors.initials: C
authors.lastname: La Vecchia
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Carlo
authors.initials: C
authors.lastname: Zocchetti
mesh_terms: D006801:Humans; D008103:Liver Cirrhosis / Q000139:chemically induced / Q000401:mortality*; D009784:Occupational Diseases / Q000139:chemically induced / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D014752:Vinyl Chloride / Q000633:toxicity*
chemical_list: D014752:Vinyl Chloride