title: Laryngeal cancer and silica dust exposure: a systematic review and meta-analysis.
abstract: BACKGROUND
  Individual epidemiological studies generally lack the power to examine the association between silica exposure or silicosis and laryngeal cancer. We summarized pertinent evidence from published literature by using meta-analysis.
  
  
  METHODS
  A systematic literature search was performed to identify cohort and case-control studies, and the method of meta-analysis was used to combine standardized mortality ratios (SMRs) or standardized incidence ratios (SIRs) from cohort studies and odds ratios (ORs) from case-control studies.
  
  
  RESULTS
  A significantly increased risk of laryngeal cancer (pooled OR = 1.39, 95% confidence interval (95% CI): 1.17-1.67) among workers exposed to silica dust was observed by combining six case-control studies with adjustment for smoking and alcohol consumption. A similarly increased but statistically non-significant risk estimate was observed from cohort studies, with a pooled SMR of 1.38 (95% CI: 0.79-1.96) for silicosis cases; and a pooled SMR of 1.13 (95% CI: 0.82-1.45) and a pooled SIR of 1.50 (95% CI: 0.59-2.42) for workers with silica dust exposure.
  
  
  CONCLUSIONS
  This systematic review demonstrated a weak association between silica or silicosis and laryngeal cancer. Owing to the inherent limitations of the original studies, interpretation of the results of this meta-analysis should be cautious.
authors.affiliation: The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China.
authors.forename: Minghui
authors.initials: M
authors.lastname: Chen
authors.forename: Lap Ah
authors.initials: LA
authors.lastname: Tse
mesh_terms: D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D004391:Dust; D006801:Humans; D007822:Laryngeal Neoplasms / Q000139:chemically induced* / Q000150:complications; D009784:Occupational Diseases / Q000139:chemically induced*; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D012822:Silicon Dioxide / Q000009:adverse effects*; D012829:Silicosis / Q000150:complications
chemical_list: D000395:Air Pollutants, Occupational; D004391:Dust; D012822:Silicon Dioxide