Pirastu R, Belli S, Bruno C, Comba P, De Santis M, Foà V, Maltoni C, Masina A, Reggiani A
Università La Sapienza, Dipartimento di Biologia Animale e dell'Uomo, Roma.
Med Lav. 1991 Sep-Oct;82(5):388-423.
A mortality study was performed on 5,946 vinyl chloride (VC)-polyvinyl chloride (PVC) workers of the nine Italian plants. The aims of the study were to investigate the cause-specific mortality of workers exposed to VC in production and polymerization stages and to ascertain whether exposure is associated with a higher risk of cancers other than liver angiosarcoma. An incident cohort was enumerated in five plants, a mixed cohort in two and a cross sectional one in the remaining two facilities. Cause-specific Standardized Mortality Ratios (SMR) were calculated for the six incidence cohorts with a sufficiently long follow-up period. Both Italian and regional rates were used for the comparison. A pooled analysis of six cohorts was performed. For deceased persons, information from death certificates was used in the mortality analysis. Additional clinical and pathological data were sought for all decreased individuals (Best Evidence = BE). The results of the study confirm the carcinogenic action of vinyl chloride on the liver but not on the other suggested target organs (i.e., lung, lymphopoietic tissues, brain). A deficit for all causes of death and cardiovascular disease was evident in most cohorts and in the pooled cohort. Analysis of BE data showed a broad spectrum of carcinogenic action of VCM on the liver as demonstrated by the occurrence of both angiosarcomas and other histotypes of tumours.
对意大利9家工厂的5946名氯乙烯（VC）-聚氯乙烯（PVC）工人进行了一项死亡率研究。该研究的目的是调查在生产和聚合阶段接触VC的工人的死因特异性死亡率，并确定接触是否与除肝血管肉瘤以外的其他癌症的较高风险相关。在5家工厂中确定了一个发病队列，在2家工厂中确定了一个混合队列，在其余2家工厂中确定了一个横断面队列。对随访期足够长的6个发病队列计算了死因特异性标准化死亡率（SMR）。使用意大利和地区的比率进行比较。对6个队列进行了汇总分析。对于死亡人员，在死亡率分析中使用了死亡证明书中的信息。为所有死亡个体（最佳证据=BE）寻求了额外的临床和病理数据。研究结果证实了氯乙烯对肝脏的致癌作用，但对其他建议的靶器官（即肺、淋巴造血组织、脑）没有致癌作用。在大多数队列和汇总队列中，所有死因和心血管疾病的死亡率均明显不足。对BE数据的分析表明，氯乙烯单体对肝脏具有广泛的致癌作用，这可通过血管肉瘤和其他组织学类型肿瘤的发生得到证明。
