Kidney Disease and Arthritis in a Cohort Study of Workers Exposed to Silica

Details

• Personal Author:
  Calvert, Geoffrey M. ; Sanderson, Wayne T. ; Steenland, Kyle
• Description:
  Silica exposure has been associated with kidney disease and rheumatoid arthritis; an autoimmune mechanism has been proposed. Approximately 2 million people are occupationally exposed to silica in the United States, 100,000 at more than twice the National Institute for Occupational Safety and Health recommended exposure limit of 0.05 mg/m(3). We examined renal disease morbidity and mortality, as well as arthritis mortality, in a cohort of 4,626 silica-exposed workers in the industrial sand industry (an industry previously unstudied). We compared the cohort with the U.S. population and also conducted internal exposure-response analyses using a job-exposure matrix based on more than 4,000 industrial hygiene samples. We found excess mortality from acute renal disease [standardized mortality ratio (SMR) = 2.61, 95% confidence intervals (95% Cls) = 1.49-4.24; 16 deaths], chronic renal disease (SMR = 1.61, 95% CI = 1.13-2.22; 36 deaths), and arthritis (SMR = 4.36, 95% CI = 2.76-6.54; 23 deaths) on the basis of multiple cause mortality data, which considered any mention of disease on a death certificate. Linking the cohort with the U.S. registry of end-stage renal disease for the years 1977-1996, we found an excess of end-stage renal disease incidence (standardized incidence ratio = 1.97, 95% CI = 1.25-2.96; 23 cases), which was highest fur glomerulonephritis (standardized incidence ratio = 3.85, 95% CI = 1.55-7.93; 7 cases). We found increasing end-stage renal disease incidence with increasing cumulative exposure; standardized rate ratios by quartile of cumulative exposure were 1.00, 3.09, 5.22, and 7.79. A positive exposure-response trend was also observed for rheumatoid arthritis on the basis of death certificate data. These data represent the largest number of kidney disease cases analyzed to date in a cohort with well-defined silica exposure and suggest a causal link between silica and kidney disease. Excess risk of end-stage renal disease due to a lifetime of occupational exposure at currently recommended limits is estimated to be 14%, above a background end-stage renal disease risk of 2%. [Description provided by NIOSH]
• Subjects:
  Dust Environmental Monitoring Kidney Diseases Musculoskeletal Diseases Musculoskeletal System Occupational Exposure Occupational Health Quartz Safety Silicon Dioxide Urogenital Diseases Urogenital System Workplace

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• Keywords:
  Arthritis Author Keywords: Silica Autoimmunity Bone-disorders Exposure-assessment Exposure-limits Kidney-disorders Kidney-toxins Morbidity Mortality Musculoskeletal-system-disorders Occupational-exposure Occupational Exposures Quartz-dust Renal Disease Silica-dusts Workplace-studies

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• ISSN:
  1044-3983
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Ohio ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DSHEFS - Division of Surveillance, Hazard Evaluations, and Field Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  405-412
• Volume:
  12
• Issue:
  4
• NIOSHTIC Number:
  nn:20021882
• Citation:
  Epidemiology 2001 Jul; 12(4):405-412
• Contact Point Address:
  NIOSH R13, Ctr Dis Control & Prevent, 4676 Columbia Pkwy, Cincinnati, OH 45226 USA
• Email:
  nks1@cdc.gov
• CAS Registry Number:
  Quartz (SiO2) (CAS RN 14808-60-7)
• Federal Fiscal Year:
  2001
• Peer Reviewed:
  True
• Source Full Name:
  Epidemiology
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a5766b540446c5cdb715d82e796a39e6d2a681cbc377fc03e55c649c2107dd203b951383d8b1a3ab8c81df06e946f0451d810585e039dea2520cab340aa74fd9
• Download URL:
  https://stacks.cdc.gov/view/cdc/198969/cdc_198969_DS1.pdf
• File Type:
  [PDF - 166.39 KB ]