Dataset Information

Occupational exposure to respirable crystalline silica and chronic non-malignant renal disease: systematic review and meta-analysis.

ABSTRACT:

Background

While occupational exposure to respirable silica is known to lead to lung disease, most notably silicosis, its association with chronic kidney disease is unclear.

Objectives

This review explores the association between occupational exposure to respirable silica and chronic non-malignant renal disease such as glomerulonephritis. The evidence has been collected and compiled. Possible sources of bias are thoroughly discussed.

Methods

Cohort studies with silica exposure and case-control studies of renal disease were searched in PubMed until January 2015. Two authors independently abstracted data; any disagreement was resolved by consulting a third reviewer. A meta-analysis was performed to evaluate the association to silica exposure.

Results

A total of 23 cohort and four case-control studies were included in the analysis. The meta-analysis of cohort studies yielded elevated overall SMRs for renal disease. Some studies, however, included dose-response analyses, most of which did not show a positive trend. The approaches and results of the case-control studies were very heterogeneous.

Conclusions

While the studies of cohorts exposed to silica found elevated SMRs for renal disease, no clear evidence of a dose-response relationship emerged. The elevated risk may be attributed to diagnostic and methodological issues. In order to permit a reliable estimation of a possible causal link, exposed cohorts should be monitored for renal disease, as the information from mortality studies is hardly reliable in this field.

SUBMITTER: Mohner M

PROVIDER: S-EPMC5583269 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Publications

Occupational exposure to respirable crystalline silica and chronic non-malignant renal disease: systematic review and meta-analysis.

Möhner Matthias M Pohrt Anne A Gellissen Johannes J

International archives of occupational and environmental health 20170413 7

<h4>Background</h4>While occupational exposure to respirable silica is known to lead to lung disease, most notably silicosis, its association with chronic kidney disease is unclear.<h4>Objectives</h4>This review explores the association between occupational exposure to respirable silica and chronic non-malignant renal disease such as glomerulonephritis. The evidence has been collected and compiled. Possible sources of bias are thoroughly discussed.<h4>Methods</h4>Cohort studies with silica expos ...[more]

PMID: 28409224

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Project description:Silicosis and other respirable crystalline silica-associated diseases, most notably tuberculosis, have long been substantial causes of morbidity and mortality in South Africa. For the mining and non-mining industries, silicosis elimination programmes have been developed with milestones regarding reduction of levels of exposure to respirable crystalline silica (RCS) and targets regarding the date of eradication. The present paper explores the feasibility of achieving these targets by investigating the evidence that levels of exposure and silicosis incidence rates have declined by an appraisal of the methods for data collection and reporting. In the mining industry the silicosis elimination programme is supported by the development and advocacy of leading practices to reduce the exposure. RCS exposure data are routinely collected according to a Code of Practice (CoP) and the results are reported to the Mine Health and Safety Inspectorate. As the CoP and the actual workplace practices have been demonstrated to have some flaws, there is some concern about the accuracy of the actual exposure data and the data interpretation. The annually reported levels of exposure suggest a decline, however, the actual levels of RCS as well as the number of exposed workers, were not reported over the last few years. With regard to the silicosis incidence rates, a steady decline of new cases is reported. However, there is a risk of under-diagnosis and- reporting especially in former miners. In the non-mining industries, a systematic baseline of RCS exposure levels and silicosis incidence is lacking. The reporting by industries on assigning of the workforce to exposure categories seems to be fragmented and incomplete. Consequently, any evidence of progress toward achieving the silicosis elimination target cannot be documented. Both the silicosis elimination target and the exposure milestone are aspirational but are unlikely to be achieved. Nevertheless, the formal mining industry may get close. Exposure control interventions, especially in the non-mining industries, should be developed and implemented and pragmatic methods need to be put in place to identify sources of new silicosis cases for targeted intervention.

Project description:ObjectiveTo search for evidence of the relationship between occupational silica exposure and heart disease.DesignA systematic review and meta-analysis.BackgroundGrowing evidence suggests a relationship between occupational silica exposure and heart disease; however, the link between them is less clear.Data sourcesPubMed, ScienceDirect, Springer and EMBASE were searched for articles published between 1 January 1995 and 20 June 2019. Articles that investigated the effects of occupational silica exposure on the risk of heart disease were considered.Study selectionWe included cohort studies, including prospective, retrospective and retroprospective studies.Data extraction and synthesisWe extracted data using a piloted data collection form and conducted random-effects meta-analysis and exposure-response analysis. The meta-relative risk (meta-RR), a measure of the average ratio of heart disease rates in those with and without silica exposure, was used as an inverse variance-weighted average of relative risks from the individual studies. The Newcastle-Ottawa Quality Assessment Scale for cohort studies was used for study quality assessment.Outcome measureWe calculated the risk of heart diseases such as pulmonary heart disease, ischaemic heart disease and others.ResultsTwenty cohort studies were included. The results suggest a significant increase in the risk of overall heart disease (meta-RR=1.08, 95% CI 1.03 to 1.13). Stronger evidence of association with pulmonary heart disease was found in the risk estimate of both categories of heart disease (meta-RR=1.24, 95% CI 1.08 to 1.43) and in the exposure-response analysis (meta-RR=1.39, 95% CI 1.19 to 1.62). Our subgroup analyses also revealed that the statistical heterogeneity among studies could be attributed mainly to the diversity in reference group, occupation and study quality score.ConclusionsSilica-exposed workers are at an increased risk for overall heart disease, especially pulmonary heart disease. Further research is needed to better clarify the relationship between occupational silica exposure and ischaemic heart disease.Prospero registration numberCRD42019124673.

Dataset Information

Occupational exposure to respirable crystalline silica and chronic non-malignant renal disease: systematic review and meta-analysis.

Background

Objectives

Methods

Results

Conclusions

Publications

Occupational exposure to respirable crystalline silica and chronic non-malignant renal disease: systematic review and meta-analysis.

Similar Datasets

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