Incidence of cancer among workers exposed to vinyl chloride in polyvinyl chloride manufacture

Based on results from two previous studies where an excess of melanomas was found in a cohort of workers exposed to vinyl chloride (VCM), a follow up of the incidence of cancer in the same cohort of 428 workers was carried out to scrutinise whether or not the excess could be confirmed by new cases. The total number of deaths in the study group from 1953 to the end of 1993 was 132 v 141 expected, and the total number of incident cancer cases was 56 v 57 expected. There were 11 cases of lung cancer v eight expected, seven cases of melanomas v 2.07 expected, and two cases of thyroid cancer v 0.34 expected. Five of the seven melanoma cases had occurred in the group that had been most heavily exposed to VCM v 0.7 expected. In the present follow up we also found five cases of the spinocellular cancer of the skin v 1.7 expected. Out of these five cases four were diagnosed after 1984. Two of the five cases v 0.7 expected had occurred in the most heavily exposed group. The total number of skin cancers (melanomas and spinocellular cancers) were 12 v 3.7 expected. There was one new case of melanoma between 1985 and 1993 v 0.7 expected. Hence, the strength of the relation between the observed and expected number of cases was reduced compared with the last follow up, and does not strengthen the previously indicated causal relation between exposure to VCM and development of malignant melanoma. There was no excess of testicular cancers in this study. The present results may indicate that occurrence of spinocellular skin cancer could bear some relation to work in the manufacture of polyvinyl chloride (PVC). Confirmation is needed from studies on other cohorts exposed to VCM.