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:ObjectivesExposures to respirable crystalline silica (RCS) and respirable dust (RD) were investigated during demolition, crushing, and chipping at several Massachusetts construction sites.MethodsPersonal breathing zone samples (n = 51) were collected on operating engineers working at demolition and crushing sites, laborers performing miscellaneous tasks at demolition sites, crushing machine tenders at crushing sites, and chipping workers at substructure bridge repair sites. Area samples (n = 33) were collected at the perimeter of demolition and crushing sites to assess potential bystanders' exposures. Exposures 'with' and 'without' the use of dust suppression methods were compared when possible. RD samples were analyzed for crystalline silica content with Fourier Transform Infrared Spectrophotometry (FT-IR) according to the National Institute for Occupational Safety and Health (NIOSH) Method 7602. Statistical analyses of the exposure data were performed in SAS version 9.4.ResultsChipping workers had the highest exposure levels [the geometric mean (GM) time-weighted average (TWA) for RCS was 527 µg/m3 and the GM for RD was 4750 µg/m3]. The next highest exposures were among crushing machine tenders (RCS GM of 93.3 µg/m3 and RD GM of 737.6 µg/m3), while laborers and operating engineers had the lowest exposures (RCS GM of 17.0 and 6.2 µg/m3, respectively). Personal 8-h TWA RCS exposures were higher than the new OSHA permissible exposure limit (PEL) of 50 µg/m3 for 80% of samples collected on chipping workers (n = 31) and 50% of samples collected on crushing machine tenders (n = 8). Operating engineers (n = 9) and laborers (n = 3) had RCS exposures lower than OSHA PEL. The highest concentrations measured would have exceeded the PEL within 15 min chipping and within 2 h of crushing with no further exposure. Chipping workers' RCS exposures were higher than OSHA PEL even when they were adjusted to account for the assigned protection factor of the half-face N95 cartridge respirators used during chipping. Exposures of crushing tenders were reduced to levels under the OSHA PEL when a water spraying system in crushing machines was utilized, but not when a water cannon machine was used. Area samples at demolition and crushing sites indicate overall lower exposures than the PEL, however, bystander workers at crushing sites could be exposed to higher levels compared to demolition sites. Real-time dust monitoring during demolition indicate very high short-term peak exposures.ConclusionsControlling or reducing crystalline silica exposures to levels under the new OSHA PEL of 50 µg/m3 remains challenging for chipping workers and crushing machine tenders. Even with the use of dust suppression controls, respiratory protection may be required for various tasks.

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.

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