Silicosis Mortality Research Articles

Former jean sandblasters die younger.

Silicosis remains a critical public and occupational health issue, exacerbated by its expansion into non-traditional industries and resulting in significant global morbidity and mortality. This study aims to investigate the death rates associated with silicosis from jean sandblasting by comparing the results of diagnosed individuals to those of the general population. Conducted from 2008 to 2023 in Taşlıçay and Toklular villages, Bingöl City, Turkey, this retrospective cohort study analysed mortality among 220 diagnosed males versus 2851 undiagnosed residents. Data were derived from the Cohort database and validated with the Bingöl Provincial Health Directorate and the Turkish Statistical Institute. Statistical analysis involved univariate comparisons and survival analysis, utilizing the Mann-Whitney U-test, Kruskal-Wallis test and Cox proportional hazards model, with significance set at P < 0.05. The analysis revealed a silicosis mortality rate of 10% in diagnosed individuals over 15 years, notably higher than the 4% in the general population. Higher radiological profusions and younger ages at diagnosis were significant mortality factors. A radiological profusion above five notably increased the mortality risk by 1.37 times, with age and radiological density proving critical in survival rates. This research highlights the increased mortality risk in silicosis patients, particularly among former jean sandblasters, underscoring the significant effects of radiological density and early age exposure on mortality, thereby addressing a crucial gap in understanding the impact of silicosis on life expectancy and community health.

Silicosis mortality in Spain (1999-2020): A temporal and geographical approach.

Silicosis is an occupational respiratory disease linked to silica dust inhalation. The main driver was traditional coal mining, but in recent decades, new sources of exposure have emerged. Our aim in this study was to assess the temporal and spatial distribution of mortality due to this disease over a 22-year period in Spain. Silicosis records, as an Underlying Cause of Death, were extracted from the National Institute of Statistics from 1999 to 2020 using the International Classification of Diseases 10th revision (code J62.8). Age- and sex-adjusted mortality rates per 1,000,000 inhabitants were calculated for the territory and by province. A geographic analysis was performed, and clusters of deaths were identified at the municipal level, and then the outcomes were compared in two periods of 11 years. There were 2618 deaths due to silicosis in Spain. The mean age of death increased significantly by 0.66% annually from 1999 to 2013. The age-adjusted mortality rate decreased by 7.30% per year, falling from 3.00 to 0.65 per 1,000,000 inhabitants. The temporal pattern showed a significant decrease of mortality rate in 31% of the provinces (16 out of 52), while it increased in Pontevedra. Regarding the spatial analysis, 11 clusters were found in both periods, but some variations were observed in terms of their distribution in the Spanish territory, as well as in the affected municipalities. The decrease in mortality due to Silicosis could be related to less exposure to silica dust over the years and an improvement in the survival of those affected. It is thus essential to analyze the role of preventive measures for this occupational disease.

Mortality from silicosis in Brazil: Temporal trends in the period 1980-2017.

Silicosis is the most prevalent pneumoconiosis in Brazil. We aimed to estimate mortality rates and temporal trends for silicosis, and to identify areas of highest mortality. Records of silicosis as the underlying (1980-2017) or contributory (2000-2017) cause of death in adults aged 20 years and older were retrieved from the Brazilian Mortality Database. Age-standardized mortality rates (ASMR) were calculated. The annual trend in ASMR was analyzed by joinpoint regression. Mortality rates per 100,000 person-years were calculated for each municipality. We analyzed temporal trends in municipalities where similar activities with exposure to silica were performed. There were 3164 death records (96.6% men) distributed over 14% of the municipalities. Mean age of death was 59.2 (SD 15.1) and mean ASMR was 0.085/100,000 (confidence interval 0.080-0.091). Joinpoint regression showed a significant increase in ASMR from 1980 to 2006 and a significant decrease after 2006 driven by a decline in deaths of individuals younger than 70 years. The highest mortality rate was 21.83/100,000 person-years, in a municipality with small mining operations for gems. Gold mining municipalities showed the highest composite death rate, 4.0/100,000 person-years. Tuberculosis was the main cause of death when silicosis was a contributing cause. In contrast with developed countries, silicosis mortality in Brazil increased to 2006 and subsequently started to drop, mostly from a plateau or decrease in deaths occurring in municipalities which regulated economic activities. However, this decrease did not occur in the older age group nor in the unregulated sector, the latter being the main challenge for exposure control and surveillance.

Surveillance for Silicosis Deaths Among Persons Aged 15-44 Years - United States, 1999-2015.

Silicosis is usually a disease of long latency affecting mostly older workers; therefore, silicosis deaths in young adults (aged 15-44 years) suggests acute or accelerated disease.* To understand the circumstances surrounding silicosis deaths among young persons, CDC analyzed the underlying and contributing causes† of death using multiple cause-of-death data (1999-2015) and industry and occupation information abstracted from death certificates (1999-2013). During 1999-2015, among 55 pneumoconiosis deaths of young adults with International Classification of Diseases, Tenth Revision (ICD-10) code J62 (pneumoconiosis due to dust containing silica),§ 38 (69%) had code J62.8 (pneumoconiosis due to other dust containing silica), and 17 (31%) had code J62.0 (pneumoconiosis due to talc dust) listed on their death certificate. Decedents whose cause of death code was J62.8 most frequently worked in the manufacturing and construction industries and production occupations where silica exposure is known to occur. Among the 17 decedents who had death certificates listing code J62.0 as cause of death, 13 had certificates with an underlying or a contributing cause of death code listed that indicated multiple drug use or drug overdose. In addition, 13 of the 17 death certificates listing code J62.0 as cause of death had information on decedent's industry and occupation; among the 13 decedents, none worked in talc exposure-associated jobs, suggesting that their talc exposure was nonoccupational. Examining detailed information on causes of death (including external causes) and industry and occupation of decedents is essential for identifying silicosis deaths associated with occupational exposures and reducing misclassification of silicosis mortality.

Mortality from Silicosis in Italy: Temporal Trends and Spatial Distribution

INTRODUCTION: Silicosis, an occupational preventable lung disease due to exposure to free crystalline silica, is still diagnosed worldwide: thousands of workers die every year in many countries. This study is aimed at evaluating silicosis mortality in Italy at national, regional and municipal levels. METHODS: Mortality data were extracted from the Italian National Mortality Database (NMD) for the period 1990-2012. The NMD contains the underlying cause of death, which until 2003 was coded using the ICD, 9th revision (ICD-9; mortality for silicosis; code 502); since then, ICD-10 has been used (code J62). Age-standardized death rates (ASRs) were computed to evaluate temporal trends. Standardized Mortality Ratios were computed, using regional rates as reference, to identify municipalities with excess deaths due to silicosis. A cluster analysis was carried out to identify groups of municipalities with major departures from the expected regional figures. RESULTS: In the study period, the number of deaths from silicosis in Italy were 4,590 (4,494 men, 96 women), corresponding to ASR of 0.33 per 100,000 per year and an average age at death of 79.86 (DS 5.76). In the period 1990-2012, ASRs in men dropped down from 1.07 to 0.20, but they were still over 2.0 in 2012 in the regions of Abruzzo and Sardinia. The risk of mortality at municipality level is generally low and diffuse. Many of the clusters are composed of several municipalities. DISCUSSION: The applied epidemiological surveillance approach allowed, on one side to observe the decline over time of the impact of silicosis in Italy, on the other side to identify areas at higher risk in the recent years. The presence of areas at higher risk could be due to the concurrence of occupational exposures and inadequate preventive activities. Furthermore, it is possible that, in some areas, mortality from silicosis is over-diagnosed due to a local high sensitivity to social security aspects.

Risk Assessment of Exposure to Silica Dust in Building Demolition Sites.

BackgroundBuilding demolition can lead to emission of dust into the environment. Exposure to silica dust may be considered as an important hazard in these sites. The objectives of this research were to determine the amount of workers' exposure to crystalline silica dust and assess the relative risk of silicosis and the excess lifetime risk of mortality from lung cancer in demolition workers.MethodsFour sites in the Tehran megacity region were selected. Silica dust was collected using the National Institute for Occupational Safety and Health method 7601 and determined spectrophotometrically. The Mannetje et al and Rice et al models were chosen to examine the rate of silicosis-related mortality and the excess lifetime risk of mortality from lung cancer, respectively.ResultsThe amount of demolition workers' exposure was in the range of 0.085–0.185 mg/m3. The range of relative risk of silicosis related mortality was increased from 1 in the workers with the lowest exposure level to 22.64/1,000 in the employees with high exposure level. The range of the excess lifetime risk of mortality from lung cancer was in the range of 32–60/1,000 exposed workers.ConclusionGeometric and arithmetic mean of exposure was higher than threshold limit value for silica dust in all demolition sites. The risk of silicosis mortality for many demolition workers was higher than 1/1,000 (unacceptable level of risk). Estimating the lifetime lung cancer mortality showed a higher risk of mortality from lung cancer in building demolition workers.

Silicosis Mortality With Respiratory Tuberculosis in the United States, 1968-2006

The presence of tuberculosis (TB) in patients with silicosis increases mortality risk. To characterize silicosis-respiratory TB comortality in the United States, the authors used 1968-2006 National Center for Health Statistics multiple cause-of-death data for decedents aged ≥25 years. The authors calculated proportionate mortality ratios (PMRs) using available information on decedents' industries and occupations reported from 26 states from 1985 through 1999. Among 16,648 silicosis deaths, 2,278 (13.7%) had respiratory TB listed on the death certificate. Of silicosis-respiratory TB deaths, 1,666 decedents (73.1%) were aged ≥65 years, 2,255 (99.0%) were male, and 1,893 (83.1%) were white. Silicosis-respiratory TB deaths declined 99.5% during the study period (P < 0.001 for time-related trend), from 239.8 per year during 1968-1972 to 1.2 per year during 2002-2006, with no reported deaths in 2006. Silicosis-respiratory TB deaths reported from Pennsylvania (n = 525; 1.29 per million population), Ohio (n = 258; 0.81 per million), and West Virginia (n = 146; 2.35 per million) accounted for 40.8% of all such deaths in the United States. The highest PMR for silicosis-respiratory TB death was associated with the "miscellaneous nonmetallic mineral and stone products" industry (PMR = 73.7, 95% confidence interval: 33.8, 139.8). In the United States, 2006 marked the first year since 1968 with no silicosis-respiratory TB deaths. The substantial decline in silicosis-respiratory TB comortality probably reflects prevention and control measures for both diseases.

National trends in silicosis mortality in the United States, 1981–2004

This article describes trends in mortality with silicosis and identifies industries and occupations with elevated silicosis mortality. A total of 6,326 deaths with silicosis for 1981-2004 were analyzed for trends and association with occupation and industry. Annual mortality rates were age-adjusted to the U.S. Year 2000 population. A linear regression model was used for analyzing mortality trends. Proportionate mortality ratios (PMRs) were based on 1,440 deaths with information on usual industry and occupation. Overall age-adjusted mortality rates per million declined from 2.4 in 1981 to 0.7 in 2004. Industries having significantly elevated PMRs for silicosis included mining and quarrying. Occupations with elevated PMRs included those associated with metal and mineral processing. The results suggest that considerable progress has been made towards elimination of this preventable disease. However, about 30 silicosis deaths per year have been recorded since 1995 among those of working age, warranting continued efforts to effectively limit workplace exposures.

Silicosis mortality among young adults in the United States, 1968–2004

To describe silicosis deaths in young (aged 15-44) adults in the U.S. during 1968-2004. We analyzed the National Center for Health Statistics multiple cause-of-death records. Compared with silicosis decedents aged >or=45 years (n = 15,643), young decedents (n = 237) were more likely to have silicosis listed as the underlying cause of death (74.3% vs. 48.2%, P < 0.001), to be female (9.3% vs. 2.2%, P < 0.001) and black (37.1% vs. 11.7%, P < 0.001). Twenty-nine young silicosis decedents had industry and occupation information available. Occupations in construction and manufacturing industries were associated with significantly elevated proportionate mortality ratios for young silicosis deaths. Silicosis deaths occur among young adults. Because these deaths are likely to reflect more intense and recent exposures, the follow-back investigations into the work sites where these individuals were exposed to silica should be conducted.

Exposure–Response of Silicosis Mortality in Swedish Iron Ore Miners

To assess the exposure-response relationship between exposure to quartz and fatal silicosis. The mortality from silicosis in 7729 miners was analyzed and compared to their estimated exposure to respirable quartz. The miners had been working as a miner for at least 1 year between 1923 and 1996. Their mortality between 1952 and 2001 was studied by using information from the national cause of death register. Both underlying and contributing causes of death were considered in the analysis. The exposure to quartz was estimated from job titles and using 3239 measurements of personal exposure to respirable quartz from 1965 to 1999. The mortality rates were adjusted to attained age and years of birth using a Poisson regression. The median cumulative exposure among the 7729 miners was 0.9 mg x years m(-3). There were 58 deaths from silicosis. Their median cumulative exposure was 4.8 mg x years m(-3). The crude mortality rate was 53 cases per 100,000 person-years with an exposure-response relationship. There seems to be an increased risk of fatal silicosis at exposure levels around 3 mg x years m(-3) for respirable quartz.

Silicosis Mortality, Prevention, and Control—United States, 1968-2002

Silicosis is a preventable occupational lung disease caused by inhaling dust containing crystalline silica; no effective treatment for silicosis is available. Deaths from inhalation of silica-containing dust can occur after a few months' exposure (1). Crystalline silica exposure and silicosis have been associated with work in mining, quarrying, tunneling, sandblasting, masonry, foundry work, glass manufacture, ceramic and pottery production, cement and concrete production, and work with certain materials in dental laboratories. To describe patterns of silicosis mortality in the United States, CDC analyzed data from the National Institute for Occupational Safety and Health (NIOSH) National Occupational Respiratory Mortality System (NORMS) for 1968-2002. This report summarizes the results of that analysis, which indicated a decline in silicosis mortality during 1968-2002 and suggested that progress has been made in reducing the incidence of silicosis in the United States. However, silicosis deaths and new cases still occur, even in young workers. Because no effective treatment for silicosis is available, effective control of exposure to crystalline silica in the workplace is crucial.

Exposure-response analysis and risk assessment for silica and silicosis mortality in a pooled analysis of six cohorts

Aims: To study the relation between exposure to crystalline silica and silicosis mortality. Although mortality is an important endpoint for regulators, there have been no exposure-response studies for silicosis mortality,...

Cohort Mortality Study of North American Industrial Sand Workers. III. Estimation of Past and Present Exposures to Respirable Crystalline Silica

Lung cancer and silicosis mortality were examined longitudinally and by a case-referent analysis in a cohort of workers selected from the North American industrial sand industry. Date of hire in the case-referent sub-cohort extended as far back as the second decade of the twentieth century.The aim of this study component was to develop estimates of average and cumulative exposure to respirable crystalline silica for the 342 selected cases and referents.Process and dust control histories were developed for each plant, and quantitative exposure data obtained from each of them and from a trade organization. An algorithm was developed to convert historical exposures reported in particle count concentrations to modern measures of mass concentration of respirable crystalline silica. Personal exposures were adjusted for use of protective equipment based on frequency of use and type of protection.Between 1974 and 1998, a total of 14249 exposure measurements had been taken using a cyclone and membrane filter and gave an overall geometric mean of 42 microg/m3. The only exposure data identified earlier were based on approximately 500 samples collected across the industry between 1947 and 1955 using the Greenburg-Smith impinger, with analysis by microscopy. These data were converted to modern measures using a factor of 1 mppcf = 276 microg/m3 respirable dust and then adjusting for percentage silica. In general, the highest exposures occurred in bagging and bulk-loading operations and the lowest in wet processing of sand.There has been a substantial decline in exposure levels in this industry over time. The decline was rapid between the 1940s and 1970s and current exposures are, on average, less than 50 microg/m3. The use of personal protective equipment was judged to have had little impact on exposure before the 1970s.

Cohort Mortality Study of North American Industrial Sand Workers. III. Estimation of Past and Present Exposures to Respirable Crystalline Silica

Background: Lung cancer and silicosis mortality were examined longitudinally and by a case-referent analysis in a cohort of workers selected from the North American industrial sand industry. Date of hire in the case-referent sub-cohort extended as far back as the second decade of the twentieth century.Objective: The aim of this study component was to develop estimates of average and cumulative exposure to respirable crystalline silica for the 342 selected cases and referents.Methods: Process and dust control histories were developed for each plant, and quantitative exposure data obtained from each of them and from a trade organization. An algorithm was developed to convert historical exposures reported in particle count concentrations to modern measures of mass concentration of respirable crystalline silica. Personal exposures were adjusted for use of protective equipment based on frequency of use and type of protection.Findings: Between 1974 and 1998, a total of 14 249 exposure measurements had been taken using a cyclone and membrane filter and gave an overall geometric mean of 42 μg/m3. The only exposure data identified earlier were based on approximately 500 samples collected across the industry between 1947 and 1955 using the Greenburg–Smith impinger, with analysis by microscopy. These data were converted to modern measures using a factor of 1 mppcf = 276 μg/m3 respirable dust and then adjusting for percentage silica. In general, the highest exposures occurred in bagging and bulk-loading operations and the lowest in wet processing of sand.Conclusions: There has been a substantial decline in exposure levels in this industry over time. The decline was rapid between the 1940s and 1970s and current exposures are, on average, less than 50 μg/m3. The use of personal protective equipment was judged to have had little impact on exposure before the 1970s.

Cohort Mortality Study of North American Industrial Sand Workers. II. Case-referent Analysis of Lung Cancer and Silicosis Deaths

A cohort mortality study of 2670 men in nine North American industrial sand plants resulted in 83 deaths from lung cancer 20 or more years after hire (standardized mortality ratio 139) and 37 deaths from silicosis (including seven from silico-tuberculosis). The lung cancer excess was unrelated to duration of employment and not found in all plants. The primary aim was to determine whether lung cancer risk among these employees was related to quantitative estimates of crystalline silica exposure, after allowance for cigarette smoking. A secondary aim was to do the same for silicosis mortality, partly as a means of validating the estimated levels of exposure. A nested case-referent study was undertaken with cases matched with up to two controls on plant, age and date of first employment from men who survived the case. Exposures were estimated by linking work histories to a job-exposure matrix, undertaken separately. Cigarette smoking information was obtained from medical records and other sources, blind as to case-control status. Matched statistical analyses were conducted using conditional logistic regression. Odds ratios for silicosis mortality were significantly related to cumulative silica exposures and tended to a relationship with category of average crystalline silica concentration, but inconsistently with length of employment. After accounting for a strong effect of cigarette smoking, odds ratios for lung cancer were related to cumulative crystalline silica exposure and to average silica concentration, but not to length of employment. These findings support a causal relationship between lung cancer and quartz exposure after allowance for cigarette smoking, in the absence of cristobalite or other known occupational carcinogens.

Cohort Mortality Study of North American Industrial Sand Workers. II. Case-referent Analysis of Lung Cancer and Silicosis Deaths

Background: A cohort mortality study of 2670 men in nine North American industrial sand plants resulted in 83 deaths from lung cancer 20 or more years after hire (standardized mortality ratio 139) and 37 deaths from silicosis (including seven from silico-tuberculosis). The lung cancer excess was unrelated to duration of employment and not found in all plants.Objectives: The primary aim was to determine whether lung cancer risk among these employees was related to quantitative estimates of crystalline silica exposure, after allowance for cigarette smoking. A secondary aim was to do the same for silicosis mortality, partly as a means of validating the estimated levels of exposure.Methods: A nested case-referent study was undertaken with cases matched with up to two controls on plant, age and date of first employment from men who survived the case. Exposures were estimated by linking work histories to a job-exposure matrix, undertaken separately. Cigarette smoking information was obtained from medical records and other sources, blind as to case-control status. Matched statistical analyses were conducted using conditional logistic regression.Findings: Odds ratios for silicosis mortality were significantly related to cumulative silica exposures and tended to a relationship with category of average crystalline silica concentration, but inconsistently with length of employment. After accounting for a strong effect of cigarette smoking, odds ratios for lung cancer were related to cumulative crystalline silica exposure and to average silica concentration, but not to length of employment.Conclusion: These findings support a causal relationship between lung cancer and quartz exposure after allowance for cigarette smoking, in the absence of cristobalite or other known occupational carcinogens.

Recent trends of age-specific pneumoconiosis mortality rates in the United States, 1985-1996: coal workers' pneumoconiosis, asbestosis, and silicosis.

The authors examined the temporal trends of age-specific pneumoconiosis mortality from coal worker's pneumoconiosis (CWP), asbestosis, and silicosis in the United States in 1985-1996. Mortality data were derived from the National Center for Health Statistics multiple causes of death files for the period. Age-specific mortality rates were computed for three age groups (15-44, 45-64, and > or = 65 years) among decedents with mention of CWP, asbestosis, or silicosis. Linear regression analysis was performed to examine the annual changes in age-specific mortality rates, by age group, with each specific condition. The CWP mortality rates declined significantly (p = 0.0001) in the groups 45 years old and older, but not in the age group 15-44. Asbestosis mortality rates declined significantly (p = 0.005) for the age group 45-64, while increasing (p = 0.0001) for those aged 65 years and older. However, in the younger age group 15-44, the rates showed no significant trend. Silicosis mortality rates declined significantly (p = 0.0001) for all groups. The continued occurrence of deaths from CWP, asbestosis, and silicosis among young adults may be the result of high levels of exposure to occupational risks. These results suggest that pneumoconiosis surveillance may help to evaluate the temporal pneumoconiosis mortality patterns in the United States.

Silicosis Mortality Surveillance in the United States, 1968–1990

Abstract The temporal, demographic, geographic, and occupational patterns of silicosis mortality in the United States were examined based on the national multiple-cause-of-death data available since 1968 from the National Center for Health Statistics. Since silicosis is an occupational lung disease, decedents less than 15 years old were excluded. The total number of deaths with silicosis was 13,744 for the period 1968 to 1990, and silicosis was the underlying cause of death in approximately 46 percent of these deaths. Approximately 98 percent of deaths with silicosis occurred in males. The racial distribution of decedents with silicosis was 88.4 percent white, 11.3 percent black, and 0.3 percent other races. An annual maximum of 1157 silicosis deaths occurred in 1968 and a minimum of 301 occurred in 1988. The annual age-adjusted mortality rate per million population declined from a maximum of 5.64 in 1968 to a minimum of 0.96 in 1988 and 1989. In recent years the annual silicosis death counts and rates ha...

Silicosis and Other Pneumoconioses in Sweden

This recent book by 3 outstanding authorities on the pneumoconioses and beautifully translated into English, represents a thorough and detailed summation of the silicosis morbidity and mortality in Sweden in the 25-year interval from 1931 to 1956. To this has been added the Swedish experience with other pneumoconioses, such as asbestosis, talcosis, siderosis, and so forth. The material for this study was obtained from cases which were reported to insurance companies for compensation for disability due to these occupational lung diseases. In many individual cases the authors were permitted to make new and complete examinations and chest roentgenograms for comparison with earlier records and films. In this way, they are able to show the frequency, severity, and tendency to progression of the various pneumoconioses. One of the most impressive features of this book is the section of reproductions of the chest roentgenograms of some of the patients referred to in