An Ecological Evaluation of Vinyl Chloride Exposure and Liver Cancer Incidence and Mortality in Texa

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The goal of this analysis was to evaluate the association be-tween county-level ambient vinyl chloride (VC) and coun-ty-level liver cancer incidence and mortality rates in Texas. Modeled county-level ambient VC data were obtained from the National Air Toxics Assessment. Age-adjusted county-level liver cancer incidence rates were abstracted from the Texas Cancer Registry and age-standardized county-level liver cancer mortality rates were obtained from the peer-reviewed literature. Multivariable imputation was utilized to impute incidence rates in counties with suppressed liver cancer incidence rates. Negative binomial and Poisson re-gression models were utilized to evaluate the association between county-level ambient VC and county-level liver cancer incidence and mortality rates, respectively, adjust-ed for county-level heavy drinking prevalence, hepatitis mortality rates, median income, and race (percent His-panic). County-level ambient VC was not associated with county-level liver cancer incidence or mortality rates. Spe-cifically, when compared to the lowest tertile of ambient VC, the middle (relative risk [RR]: 1.06, 95% confidence interval [CI]: 0.95-1.19) and highest (RR: 1.03, 95% CI: 0.90-1.17) tertiles of ambient VC were not associated with liver cancer incidence. Similarly, county-level ambient VC in the middle (RR: 0.95, 95% CI: 0.85-1.05) and highest (RR: 0.93, 95% CI: 0.82-1.05) tertiles were not associat-ed with liver cancer mortality. This analysis suggests that county-level ambient VC is not associated with liver cancer incidence or mortality in Texas. Our study provides novel results regarding liver cancer risk from low-level non-occu-pational exposure to ambient VC.
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