title: Respirable crystalline silica exposure-response evaluation of silicosis morbidity and lung cancer mortality in the German porcelain industry cohort.
abstract: OBJECTIVE
  To quantify silicosis and lung cancer risks among porcelain workers occupationally exposed to respirable crystalline silica.
  
  
  METHODS
  We reread historical radiographs to identify silicosis and estimated exposure on the basis of detailed work history and about 8000 industrial hygiene measurements. Cox proportional hazards models estimated risks by cumulative and average exposure.
  
  
  RESULTS
  Adjusted silicosis hazards ratios were 5.3 (95% confidence interval [CI], 1.6 to 17.3); 7.3 (95% CI, 2.6 to 20.8); and 6.8 (95% CI, 3.0 to 15.3) for cumulative exposures >4 to 5; >5 to 6; and >6 mg/m-years, and 3.3 (95% CI, 0.8 to 14.7), 13.6 (95% CI, 4.2 to 44.4) and 23.2 (95% CI, 8.2 to 65.8) for average exposures >0.1 to 0.15; >0.15 to 0.2 and >0.2 mg/m, respectively. Exposure was not associated with any cause of death including lung cancer.
  
  
  CONCLUSIONS
  Respirable crystalline silica exposure more than 4 mg/m-years (cumulative) or more than 0.15 mg/m (average) were strongly associated with silicosis, but unrelated to lung cancer risks.
authors.affiliation: ENVIRON International Corporation, Amherst, Massachusetts, USA. kmundt@environcorp.com
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Mundt
authors.forename: Thomas
authors.initials: T
authors.lastname: Birk
authors.forename: William
authors.initials: W
authors.lastname: Parsons
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Borsch-Galetke
authors.forename: Klaus
authors.initials: K
authors.lastname: Siegmund
authors.forename: Karyn
authors.initials: K
authors.lastname: Heavner
authors.forename: Karlheinz
authors.initials: K
authors.lastname: Guldner
mesh_terms: D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005858:Germany; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D008175:Lung Neoplasms / Q000139:chemically induced* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D016016:Proportional Hazards Models; D011859:Radiography; D012306:Risk; D012822:Silicon Dioxide / Q000009:adverse effects*; D012829:Silicosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000401:mortality
chemical_list: D012822:Silicon Dioxide