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Exposure-response analysis and risk assessment for lung cancer in relationship to silica exposure: a 44-year cohort study of 34,018 workers.

Authors
Liu-Y; Steenland-K; Rong-Y; Hnizdo-E; Huang-X; Zhang-H; Shi-T; Yi-S; Wu-T; Chen-W
Source
Am J Epidemiol 2013 Nov; 178(9):1424-1433
NIOSHTIC No.
20043159
Abstract
Crystalline silica has been classified as a human carcinogen by the International Agency for Research on Cancer (Lyon, France); however, few previous studies have provided quantitative data on silica exposure, silicosis, and/or smoking. We investigated a cohort in China (in 1960-2003) of 34,018 workers without exposure to carcinogenic confounders. Cumulative silica exposure was estimated by linking a job-exposure matrix to work history. Cox proportional hazards model was used to conduct exposure-response analysis and risk assessment. During a mean 34.5-year follow-up, 546 lung cancer deaths were identified. Categorical analyses by quartiles of cumulative silica exposure (using a 25-year lag) yielded hazard ratios of 1.26, 1.54, 1.68, and 1.70, respectively, compared with the unexposed group. Monotonic exposure-response trends were observed among nonsilicotics (P for trend < 0.001). Analyses using splines showed similar trends. The joint effect of silica and smoking was more than additive and close to multiplicative. For workers exposed from ages 20 to 65 years at 0.1 mg/m3 of silica exposure, the estimated excess lifetime risk (through age 75 years) was 0.51%. These findings confirm silica as a human carcinogen and suggest that current exposure limits in many countries might be insufficient to protect workers from lung cancer. They also indicate that smoking cessation could help reduce lung cancer risk for silica-exposed individuals.
Keywords
Epidemiology; Cancer; Cancer-rates; Silica-dusts; Silicosis; Carcinogens; Smoking; Cigarette-smoking; Exposure-assessment; Dose-response; Analytical-processes; Analytical-models; Quantitative-analysis; Job-analysis; Lung-cancer; Respiratory-system-disorders; Pulmonary-system-disorders; Mortality-data; Mortality-rates; Employee-exposure; Humans; Exposure-limits; Lifespan; Surveillance; Author Keywords: cohort; exposure-response analysis; lung cancer; risk assessment; silica; silicosis
Contact
Dr. Weihong Chen, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, Hubei 430030, China
CODEN
AJEPAS
CAS No.
14808-60-7; 7631-86-9
Publication Date
20131101
Document Type
Journal Article
Email Address
wchen@mails.tjmu.edu.cn
Fiscal Year
2014
NTIS Accession No.
NTIS Price
Identifying No.
M102013
Issue of Publication
9
ISSN
0002-9262
NIOSH Division
DRDS
Priority Area
Construction; Mining
Source Name
American Journal of Epidemiology
State
GA; WV
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