title: Lung cancer incidence among an Icelandic cohort exposed to diatomaceous earth and cristobalite.
abstract: OBJECTIVE
  The objective of this study was to determine the cancer incidence of a cohort exposed to diatomaceous earth and cristobalite with special focus on lung cancer.
  
  
  METHODS
  The cohort was from a diatomaceous plant in northern Iceland and comprised 919 men and 423 women. Diatomite, when heated, is transformed from amorphous to crystalline silica with a high cristobalite content and traces of quartz. With the use of the identification number of all persons, a link was made with the Cancer Registry. The expected number of malignancies was calculated on the basis of person-years of observation for 5-year age categories during the respective calendar period of the study multiplied by the specific incidence of cancer site for men and women in Iceland.
  
  
  RESULTS
  There was no increased overall incidence of cancer in the study population; 5 cases of lung cancer were observed versus 4.4 expected, the standardized incidence ratio (SIR) was 1.14 [95% confidence interval (95% CI) 0.37-2.65]. When the men in the cohort were divided according to their length of employment, there was an excess of lung cancer (3 observed versus 1.28 expected, SIR 2.34, 95% CI 0.48-6.85), nonmelanoma skin cancer (2 observed versus 0.19 expected, SIR 10.53, 95% CI 1.27-38.02), and brain cancer (3 observed versus 0.30 expected, SIR 10.00, 95% CI 2.06-29.23) for those who had worked 5 years or longer. A special investigation of smoking habits among the cohort revealed a smoking pattern similar to that of the general population.
  
  
  CONCLUSIONS
  The results concerning lung cancer showed an excess risk for workers exposed to diatomaceous earth and cristobalite; the result was not, however, statistically significant. There was a trend towards a higher incidence of lung cancer with longer exposure to crystalline silica, and, in agreement with the results of a previous study from this industry, the findings indicate a causal relation.
authors.affiliation: Department of Occupational Medicine, Administration of Occupational Safety and Health, Reykjavik, Iceland.
authors.forename: V
authors.initials: V
authors.lastname: Rafnsson
authors.forename: H
authors.initials: H
authors.lastname: Gunnarsdóttir
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects*; D002274:Carcinogens, Environmental / Q000009:adverse effects*; D015331:Cohort Studies; D016001:Confidence Intervals; D007692:Diatomaceous Earth / Q000009:adverse effects; D005260:Female; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D009369:Neoplasms / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data; D012042:Registries; D012189:Retrospective Studies; D017678:Sex Distribution; D012822:Silicon Dioxide / Q000009:adverse effects*; D012907:Smoking / Q000453:epidemiology; D013997:Time Factors
chemical_list: D000393:Air Pollutants; D002274:Carcinogens, Environmental; D007692:Diatomaceous Earth; D012822:Silicon Dioxide