![]() ![]() Walk along most sandy beaches and you will be walking on millions of grains of crystalline silica, one of the commonest minerals on earth and a major ingredient in glass and in ceramic glazes. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist.ġ0th International Classification of Diseases JEM, The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of the National Institute for Occupational Safety and Health. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.įunding: This research was supported by grants from the National Natural Scientific Foundation of China (30571553), National Basic Research Program of China (2011CB503800), Innovative Research Groups of the Natural Science Foundation of Hubei Province (2008CDA005), the Chinese Ministry of Health (1987-0792), the National Cancer Institute (USA, 1986), the National Institute for Occupational Health and Safety (USA, 1996), and the German BG-Institute for Occupational Safety and Health (BIA1074). Received: SeptemAccepted: MaPublished: April 17, 2012Ĭopyright: © 2012 Chen et al. PLoS Med 9(4):Īcademic Editor: Naftali Kaminski, University of Pittsburgh School of Medicine, United States of America (2012) Long-Term Exposure to Silica Dust and Risk of Total and Cause-Specific Mortality in Chinese Workers: A Cohort Study. The limitations of this study included a lack of data on dietary patterns and leisure time physical activity, possible underestimation of silica dust exposure for individuals who worked at the mines/factories before 1950, and a small number of deaths (4.3%) where the cause of death was based on oral reports from relatives.Ĭitation: Chen W, Liu Y, Wang H, Hnizdo E, Sun Y, Su L, et al. ![]() We estimated that 4.2% of deaths (231,104 cases) among Chinese workers were attributable to silica dust exposure. After adjustment for potential confounders, including smoking, silica dust exposure accounted for 15.2% of all deaths in this study. Significantly elevated standardized mortality ratios were observed for all causes (1.06, 95% confidence interval 1.01–1.11), ischemic heart disease (1.65, 1.35–1.99), and pneumoconiosis (11.01, 7.67–14.95) among workers exposed to respirable silica concentrations equal to or lower than 0.1 mg/m 3. We observed significant positive exposure–response relationships between CDE (measured in milligrams/cubic meter–years, i.e., the sum of silica dust concentrations multiplied by the years of silica exposure) and mortality from all causes (HR 1.026, 95% confidence interval 1.023–1.029), respiratory diseases (1.069, 1.064–1.074), respiratory tuberculosis (1.065, 1.059–1.071), and cardiovascular disease (1.031, 1.025–1.036). Mortality from all causes was higher among workers exposed to silica dust than among non-exposed workers (993 versus 551 per 100,000 person-years). We observed 19,516 deaths during 2,306,428 person-years of follow-up. The number of deaths attributable to silica dust exposure among Chinese workers was then calculated using the population attributable risk and the national mortality rate. The population attributable risks were estimated based on the prevalence of workers with silica dust exposure and HRs. Hazard ratios (HRs) for selected causes of death associated with CDE were estimated using the Cox proportional hazards model. We calculated standardized mortality ratios for underlying causes of death based on Chinese national mortality rates. We estimated the cumulative silica dust exposure (CDE) for each worker by linking work history to a job–exposure matrix. We studied 74,040 workers who worked at 29 metal mines and pottery factories in China for 1 y or more between January 1, 1960, and December 31, 1974, with follow-up until Decem(median follow-up of 33 y). ![]()
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