title: Exposures to silica mixed dust and cohort mortality study in tin mines: exposure-response analysis and risk assessment of lung cancer.
abstract: BACKGROUND
  Mineral dusts that contain crystalline silica have been associated directly or indirectly with the development of pneumoconiosis or silicosis, non-malignant respiratory diseases, lung cancer, and other diseases. The health impacts on workers with silica mixed dust exposure in tin mines and dose-response relationships between cumulative dust exposure and the mortality from lung cancer are investigated.
  
  
  METHODS
  A cohort of 7,837 workers registered in the employment records in 4 Chinese tin mines between 1972 and 1974 was identified for this study and the mortality follow-up was traced through 1994. Of the cohort, the cause of death was ascertained for 1,061 (97%) of the 1,094 deceased workers. Standardized mortality ratios (SMRs) were calculated for all workers, non-exposed workers, and dust-exposed workers with different exposure levels, silicotics, and non-silicotics based on Chinese national rates.
  
  
  RESULTS
  The mortality from all causes in four tin mines was nearly the same as the national mortality. Malignant neoplasm, cerebrovascular disease, and cardiovascular disease accounted for 68.6% of all deaths. Mortality excess from lung cancer, liver cancer, all malignant diseases, and non-malignant respiratory diseases was observed among dust-exposed workers; a 50-fold excess of pneumoconiosis was observed. There was an upward trend for SMRs of lung cancer was noted from no exposure to low, medium, and high exposure levels (SMRs=1.29, 2.65, 2.66, 3.33). The shape of the exposure-response curve for risk of lung cancer at high exposure levels was inconsistent in these four mines.
  
  
  CONCLUSIONS
  The findings indicated a positive dose-response relation between exposure to cumulative dust and the mortality of lung cancer. High arsenic content in dust particles, together with crystalline silica, may play an important role in causing increased mortality from lung cancer.
authors.affiliation: Department of Occupational and Environmental Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. wchen@mails.tjmu.edu.cn
authors.forename: Weihong
authors.initials: W
authors.lastname: Chen
authors.forename: Jian
authors.initials: J
authors.lastname: Yang
authors.forename: Jingqiong
authors.initials: J
authors.lastname: Chen
authors.forename: Joachim
authors.initials: J
authors.lastname: Bruch
mesh_terms: D000328:Adult; D002423:Cause of Death; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D004306:Dose-Response Relationship, Immunologic; D004391:Dust; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000209:etiology / Q000401:mortality*; D008297:Male; D008906:Mining; D016273:Occupational Exposure / Q000009:adverse effects*; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012822:Silicon Dioxide / Q000633:toxicity*; D012829:Silicosis / Q000150:complications / Q000401:mortality*; D014001:Tin / Q000633:toxicity*
chemical_list: D004391:Dust; D014001:Tin; D012822:Silicon Dioxide