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A mortality analysis was conducted for a large group of workers exposed to high concentrations of crystalline silica (14808607) in Poland. Special emphasis was placed on pneumoconiotics and the risk of death from lung cancer. Male workers diagnosed with silicosis or coal workers' pneumoconiosis between the years 1970 to 1985, were selected from the National Register of Occupational Diseases. Pneumoconiosis was diagnosed by chest X- rays and simple spirometric tests. There were 11,935 men who were divided into four occupational subcohorts: coal miners; underground workers in other work enterprises; metallurgical industry and iron foundry workers; and refractory materials, china, ceramics, and quarry workers. All of the workers had been exposed to crystalline silica for 20 years or more. The lowest concentration of silica dust was found in coal mines and the highest in refractory materials worksites. Data regarding cause of death was obtained from death certificates. Standardized mortality ratio (SMR) was used as a measure of the relative risk. During the observation period, 3,355 men died (29.9% of the study group), with 3,141 being less than age 80 years old. The mean age of death was 61 years. Among the occupational subcohorts, the death rate varied from 38.5% among metallurgical workers to 26.5% among coal miners. The main causes of death were circulatory system diseases, respiratory system diseases, and malignant neoplasms. SMR was significantly increased in all of the subcohorts (SMR range 105 to 136). Excess deaths were attributed to respiratory diseases in all subcohorts (SMR range 383 to 588); infectious diseases (largely tuberculosis) in metallurgy/foundry workers (SMR 503) and refractory materials workers (SMR 286); and lung cancer in metallurgy/foundry workers (SMR 159). There was a significantly lowered mortality from diseases of the cardiovascular system, injuries and poisonings in coal miners, and cerebrovascular diseases, injuries and poisonings in metallurgy/foundry workers. The authors conclude that this study does not confirm an association between crystalline silica exposure and the induction of lung cancer.
American Journal of Industrial Medicine, 30(6):718-725, 1996. (35 references)
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