Silicosis and lung cancer among workers in North Carolina dusty trades.
ABSTRACT In 1940-1983, 760 cases of silicosis were identified among male North Carolina (NC) workers in dusty trades. Vital status was ascertained through 1983 for 714 silicotics, and death certificates were obtained for 546 of the 550 decedents. The standardized mortality ratio (SMR) for lung cancer based on United States rates was 2.6 [95% confidence interval (95% CI) 1.8-3.6] for whites, 2.3 (95% CI 1.5-3.4) for whites unexposed to other known occupational carcinogens, and 2.4 (95% CI 1.5-3.6) for whites with no other exposure and diagnosed with silicosis while still employed in dusty trades. In addition, the age- and smoking-adjusted rate for silicotics was 3.9 times higher (95% CI 2.4-6.4) than that of nonsilicotic metal miners. This analysis effectively controlled for confounding by age, cigarette smoking, exposure to other occupational carcinogens, and detection bias. The results congrue with the hypothesis of an association between silicosis and lung cancer.
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ABSTRACT: Background To investigate exposure–response relationships for silica, silicosis, and lung cancer.Methods Quantitative review of the literature identified in a computerized literature search.ResultsThe risk of silicosis (ILO category 1/1 or more) following a lifetime of exposure at the current OSHA standard of 0.1 mg/m3 is likely to be at least 5–10% and lung cancer risk is likely to be increased by 30% or more. The exposure–response relation for silicosis is nonlinear and reduction of dust exposures would have a greater than linear benefit in terms of risk reduction. Available data suggests that 30 years exposure at 0.1 mg/m3 might lead to a lifetime silicosis risk of about 25%, whereas reduction of the exposure to 0.05 mg/m3 might reduce the risk to under 5%.Conclusions The lifetime risk of silicosis and lung cancer at an exposure level of 0.1 mg/m3 is high. Lowering exposures to the NIOSH recommended limit if 0.05 mg/m3 may have substantial benefit. Am. J. Ind. Med. 38:8–18, 2000. © 2000 Wiley-Liss, Inc.American Journal of Industrial Medicine 07/2000; 38(1):8 - 18. DOI:10.1002/1097-0274(200007)38:1<8::AID-AJIM2>3.0.CO;2-# · 1.59 Impact Factor
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ABSTRACT: ABSTRACTA questionnaire survey on the lifetime exposure to asbestos, quartz, and welding fumes among males aged38-48 years (n=9,186) and females aged 40-43 years (n=3,495) in the county of Telemark, Norway wascarried out in 1989-90. The overall response rate was 72%. A total of 42.9% of the males and 39.8% of thefemales were current smokers. Among the male responders, 32.5%, 16.4%, 21.1%, and 10.5% had beenexposed at any time to asbestos, quartz, welding fumes, and stainless steel welding fumes respectively. Thefigures for exposure among female responders were negligible, i.e. 0.7%, 0.5%, 0.5%, and 0.1% respectively.The mean reported duration of exposure for the exposed subjects was 9.8 years for asbestos, 8.8 years forquartz, and 11.3 years for welding fumes. Subjects reporting any one of the exposure factors were more likelyto be smokers. Exposure at the time of the survey was reported by 13.8% among the asbestos-exposedsubjects, and by 22.7% and 34.4% among those exposed to quartz and welding fumes respectively. The needfor primary intervention is emphasized. Smoking intervention in those already exposed to any of thesedeterminants for lung cancer is also needed, as tobacco smoke may increase the lung cancer risk further.Key words: smoking, gender, combined exposures, population survey, prevalent exposure