title: Prediction models and risk assessment for silicosis using a retrospective cohort study among workers exposed to silica in China.
abstract: This study aims to develop a prognostic risk prediction model for the development of silicosis among workers exposed to silica dust in China. The prediction model was performed by using retrospective cohort of 3,492 workers exposed to silica in an iron ore, with 33 years of follow-up. We developed a risk score system using a linear combination of the predictors weighted by the LASSO penalized Cox regression coefficients. The model's predictive accuracy was evaluated using time-dependent ROC curves. Six predictors were selected into the final prediction model (age at entry of the cohort, mean concentration of respirable silica, net years of dust exposure, smoking, illiteracy, and no. of jobs). We classified workers into three risk groups according to the quartile (Q1, Q3) of risk score; 203 (23.28%) incident silicosis cases were derived from the high risk group (risk score ≥ 5.91), whilst only 4 (0.46%) cases were from the low risk group (risk score < 3.97). The score system was regarded as accurate given the range of AUCs (83-96%). This study developed a unique score system with a good internal validity, which provides scientific guidance to the clinicians to identify high-risk workers, thus has important cost efficient implications.
authors.affiliation: Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, HKSAR, China.
authors.forename: Lap Ah
authors.initials: LA
authors.lastname: Tse
authors.affiliation: 1] Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, HKSAR, China [2] Department of Epidemiology and Biostatistics, Collaborative Innovation Center of Cancer Medicine, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: Juncheng
authors.initials: J
authors.lastname: Dai
authors.affiliation: Division of Occupational and Environmental Health, JC 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.affiliation: Department of Occupational &Environmental Health and MOE Key lab of Environmental and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Yuewei
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Occupational &Environmental Health and MOE Key lab of Environmental and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, HKSAR, China.
authors.forename: Tze Wai
authors.initials: TW
authors.lastname: Wong
authors.affiliation: Pneumoconiosis Clinic, Department of Health, HKSAR, China.
authors.forename: Chi Chiu
authors.initials: CC
authors.lastname: Leung
authors.affiliation: Institute for Risk Assessment Sciences, Utrecht University, Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Kromhout
authors.affiliation: Pneumoconiosis Clinic, Department of Health, HKSAR, China.
authors.forename: Evert
authors.initials: E
authors.lastname: Meijer
authors.affiliation: Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, HKSAR, China.
authors.forename: Su
authors.initials: S
authors.lastname: Liu
authors.affiliation: Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, HKSAR, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Wang
authors.affiliation: 1] Division of Occupational and Environmental Health, JC School of Public Health and Primary Care, the Chinese University of Hong Kong, HKSAR, China [2] Hong Kong Academy of Occupational and Environmental Health.
authors.forename: Ignatius Tak-sun
authors.initials: IT
authors.lastname: Yu
authors.affiliation: Department of Epidemiology and Biostatistics, Collaborative Innovation Center of Cancer Medicine, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: Hongbing
authors.initials: H
authors.lastname: Shen
authors.affiliation: Department of Occupational &Environmental Health and MOE Key lab of Environmental and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Weihong
authors.initials: W
authors.lastname: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D000066949:Biobehavioral Sciences; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012822:Silicon Dioxide / Q000009:adverse effects*; D012829:Silicosis / Q000453:epidemiology* / Q000209:etiology
chemical_list: D012822:Silicon Dioxide