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首页> 外文期刊>Occupational and environmental medicine >Exposure to crystalline silica, silicosis, and lung disease other than cancer in diatomaceous earth industry workers: a quantitative risk assessment.
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Exposure to crystalline silica, silicosis, and lung disease other than cancer in diatomaceous earth industry workers: a quantitative risk assessment.

机译：硅藻土工业工人除癌症外还接触结晶二氧化硅，矽肺病和肺部疾病：定量风险评估。

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OBJECTIVES: To estimate excess lifetime risk of (a) mortality from lung disease other than cancer (LDOC), and, (b) onset of radiographic silicosis, arising from occupational exposure to respirable crystalline silica dust. METHODS: Data from a cohort of California diatomaceous earth mining and processing workers exposed to crystalline silica dust (mainly as cristobalite) were reanalyzed with Poisson regression methods with internal and external adjustments for potential confounding by calendar time, age, smoking, Hispanic ethnicity, and time since first observation. Model fit was evaluated by comparing deviances and fitting cubic spline models. Lifetime risks of death from LDOC and radiographic silicosis were estimated up to age 85 with an actuarial approach accounting for competing causes of death. RESULTS: For deaths due to LDOC, a linear relative rate model gave the best fit in Poisson regression analyses. At the mean cumulative exposure of LDOC cases to silica, after adjustment for smoking, the estimated rate ratio was 4.2 (p<0.0001); at the maximum cumulative exposure of cases, the rate ratio was 18.4. The excess lifetime risk for white men exposed to respirable cristobalite dust for 45 years at the current permissible exposure limit (PEL; about 0.05 mg/m(3)) of the Occupational Safety and Health Administration was 54/1000 (95% confidence interval (95% CI) 17 to 150). For 70 incident cases of radiographic silicosis largely manifest before the end of employment, the best fit was also the linear relative rate model, predicting a rate ratio of 25.6 for silicosis at the mean cumulative exposure of the cases (p<0.0001). The excess lifetime risk for silicosis at the current PEL was 75/1000. CONCLUSION: Current occupational health standards for crystalline silica permit risks of lung disease other than cancer far in excess of what is usually considered acceptable by the Occupational Safety and Health Administration (a lifetime risk of less than one in a thousand deaths).
机译：目的：估算因职业性接触可吸入的结晶性硅尘而引起的（a）除癌症以外的肺部疾病（LDOC）致死和（b）放射影像学矽肺病的终身终生风险。方法：使用Poisson回归方法对来自加州硅藻土开采和加工工人的结晶硅粉尘（主要为方石英）的队列数据进行了重新分析，并通过日历时间，年龄，吸烟，西班牙裔种族和自第一次观察以来的时间。通过比较偏差和拟合三次样条模型评估模型拟合。估计到85岁时，由于LDOC和X线摄影性矽肺病导致的终生死亡风险，采用精算方法解决了相互竞争的死亡原因。结果：对于因LDOC导致的死亡，线性相对比率模型在Poisson回归分析中提供了最佳拟合。调整吸烟后，在LDOC病例平均累积暴露于二氧化硅的情况下，估计比率为4.2（p <0.0001）;在最大累积病例暴露下，比率为18.4。在职业安全与健康管理局的当前允许暴露极限下（PEL;约0.05 mg / m（3）），暴露于可吸入方石英粉尘中45年的白人男子的终身终生风险为54/1000（95％置信区间（ 95％CI）17至150）。对于70例放射影像学上的矽肺病病例，在雇用结束前已大体上表现出来，最合适的方法还是线性相对比率模型，在平均病例累积暴露下，矽肺病的比率为25.6（p <0.0001）。当前的PEL导致矽肺病的终身额外风险为75/1000。结论：结晶硅石的现行职业健康标准所允许的除癌症以外的肺部疾病风险远远超过了美国职业安全与健康管理局通常可接受的水平（一生中的死亡风险小于千分之一）。

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