title: Silicosis mortality with respiratory tuberculosis in the United States, 1968-2006.
abstract: 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.
authors.affiliation: Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA. snasrullah@cdc.gov
authors.forename: Muazzam
authors.initials: M
authors.lastname: Nasrullah
authors.forename: Jacek M
authors.initials: JM
authors.lastname: Mazurek
authors.forename: John M
authors.initials: JM
authors.lastname: Wood
authors.forename: Ki Moon
authors.initials: KM
authors.lastname: Bang
authors.forename: Kathleen
authors.initials: K
authors.lastname: Kreiss
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007221:Industry / Q000145:classification; D008297:Male; D008875:Middle Aged; D009309:National Center for Health Statistics, U.S.; D009784:Occupational Diseases / Q000453:epidemiology / Q000401:mortality; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data; D012829:Silicosis / Q000150:complications* / Q000453:epidemiology / Q000401:mortality*; D014376:Tuberculosis / Q000150:complications* / Q000453:epidemiology / Q000401:mortality*; D014481:United States / Q000453:epidemiology