Dataset Information

Estimating the Impact of Changes to Occupational Standards for Silica Exposure on Lung Cancer Mortality.

ABSTRACT: BACKGROUND:Respiratory exposure to silica is associated with the risk of death owing to malignant and nonmalignant disease. 2.3 million US workers are exposed to silica. Occupational exposure limits for silica are derived from a number of lines of evidence, including observational studies. Observational studies may be subject to healthy worker survivor bias, which could result in underestimates of silica's impact on worker mortality and, in turn, bias risk estimates for occupational exposure limits. METHODS:Using data on 65,999 workers pooled across multiple industries, we estimate the impacts of several hypothetical occupational exposure limits on silica exposure on lung cancer and all-cause mortality. We use the parametric g-formula, which can account for healthy worker survivor bias. RESULTS:Assuming we could eliminate occupational exposure, we estimate that there would be 20.7 fewer deaths per 1,000 workers in our pooled study by age 80 (95% confidence interval = 14.5, 26.8), including 3.91 fewer deaths owing to lung cancer (95% CI = 1.53, 6.30). Less restrictive interventions demonstrated smaller but still substantial risk reductions. CONCLUSIONS:Our results suggest that occupational exposure limits for silica can be further strengthened to reduce silica-associated mortality and illustrate how current risk analysis for occupational limits can be improved.

SUBMITTER: Keil AP

PROVIDER: S-EPMC6066423 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Estimating the Impact of Changes to Occupational Standards for Silica Exposure on Lung Cancer Mortality.

Keil Alexander P AP Richardson David B DB Westreich Daniel D Steenland Kyle K

Epidemiology (Cambridge, Mass.) 20180901 5

<h4>Background</h4>Respiratory exposure to silica is associated with the risk of death owing to malignant and nonmalignant disease. 2.3 million US workers are exposed to silica. Occupational exposure limits for silica are derived from a number of lines of evidence, including observational studies. Observational studies may be subject to healthy worker survivor bias, which could result in underestimates of silica's impact on worker mortality and, in turn, bias risk estimates for occupational expo ...[more]

PMID: 29870429

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Project description:ObjectiveThe aim of this study was to estimate the fraction of lung cancer incidence in Iran attributed to occupational exposures to the well-established lung cancer carcinogens, including silica, cadmium, nickel, arsenic, chromium, diesel fumes, beryllium, and asbestos.MethodsNationwide exposure to each of the mentioned carcinogens was estimated using workforce data from the Iranian population census of 1995, available from the International Labor Organization (ILO) website. The prevalence of exposure to carcinogens in each industry was estimated using exposure data from the CAREX (CARcinogen EXposure) database, an international occupational carcinogen information system kept and maintained by the European Union. The magnitude of the relative risk of lung cancer for each carcinogen was estimated from local and international literature. Using the Levin modified population attributable risk (incidence) fraction, lung cancer incidence (as estimated by the Tehran Population-Based Cancer Registry) attributable to workplace exposure to carcinogens was estimated.ResultsThe total workforce in Iran according to the 1995 census identified 12,488,020 men and 677,469 women. Agriculture is the largest sector with 25% of the male and 0.27% of female workforce. After applying the CAREX exposure estimate to each sector, the proportion exposed to lung carcinogens was 0.08% for male workers and 0.02% for female workers. Estimating a relative risk of 1.9 (95% CI of 1.7-2.1) for high exposure and 1.3 (95% CI 1.2-1.4) for low exposure, and employing the Levin modified formula, the fraction of lung cancer attributed to carcinogens in the workplace was 1.5% (95% CI of 1.2-1.9) for females and 12% (95% CI of 10-15) for males. These fractions correspond to an estimated incidence of 1.3 and 0.08 cases of lung cancer per 100,000 population for males and females, respectively.ConclusionThe incidence of lung cancer due to occupational exposure is low in Iran and, as in other countries, more lung cancer is due to occupational exposure among males than females.

Dataset Information

Estimating the Impact of Changes to Occupational Standards for Silica Exposure on Lung Cancer Mortality.

Publications

Estimating the Impact of Changes to Occupational Standards for Silica Exposure on Lung Cancer Mortality.

Similar Datasets

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