Pooled Analyses of Renal Disease Mortality and Crystalline Silica Exposure in Three Cohorts

Details

• Personal Author:
  Attfield, Michael ; Manejte A ; Steenland, Kyle
• Description:
  Respirable crystalline silica exposure bas been associated with renal disease in recent literature. Approximately 2000000 people are occupationally exposed to silica in the USA, 100000 at more than twice the NIOSH recommended exposure limit of 0.05 mg/m3. We have examined renal disease mortality in three silica-exposed cohorts totaling 13382 workers; 51 died with renal disease (ICD codes 580-587, 9th revision) as the underlying cause and 153 others had renal disease as a contributory cause on their death certificates. All three of these cohorts had job- exposure matrices that enabled estimation of exposure over time; all three also had data on multiple cause mortality, particularly desirable for kidney disease, which may not be the under- lying cause of death. Results from two cohorts have been published previously; follow-up for one has been extended by 6 yr. Using both underlying cause and contributory analyses (multiple cause), we compared renal disease in these cohorts with the US population and also conducted exposure-response analyses. We found excess mortality from renal disease [standard mortality ratio (SMR) 1.41,95% CI 1.05-1.85] as the underlying cause and also using multiple cause analysis (SMR 1.28, 95% CI 1.10-1.47). Exposure-response analyses showed a monotonic increase in renal disease mortality with increasing exposure. Odds ratios by quartile of cumulative exposure were 1.00, 1.24, 1.77 and 2.86 (P = 0.0002) for multiple cause analyses and 1.00, 1.88, 1.96 and 3.93 (P = 0.03) for underlying cause analysis. Pooled analyses provide large sample sizes; these data represent the largest number of renal disease deaths analyzed to date in workers with well defined silica exposure and suggest a causal link between occupational exposure to silica and renal disease. Excess risk of death from renal disease (underlying cause) by age 75 due to a lifetime of occupational exposure at 0.1 mg/m3 (the OSHA standard when reparable dust is 100% silica) is estimated to be 1.8% (95% CI 0.8-9.7%), above a background Risk of 0.3%. [Description provided by NIOSH]
• Subjects:
  Kidney Diseases Mortality Occupational Exposure Occupational Health Safety Silicon Dioxide Urogenital Diseases Urogenital System
• Keywords:
  Author Keywords: Renal Disease Diseases Exposure-levels Kidney-disorders Mortality-data Occupational-exposure Renal-toxicity Silica Silica-dusts
• ISSN:
  0003-4878
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Ohio ; OSHA Region 3 ; OSHA Region 5 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DSHEFS - Division of Surveillance, Hazard Evaluations, and Field Studies ; DRDS - Division of Respiratory Disease Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  4-9
• Volume:
  46
• NIOSHTIC Number:
  nn:20022266
• Citation:
  Ann Occup Hyg, Inhaled Particles IX, 2002 Dec; 46(Suppl 1):4-9
• Contact Point Address:
  KYLE Steenland, National Institute for Occupational Safety and Health, Centers for Disease Control, NIOSH R13, 4676 Columbia Parkway, Cincinnati, OH 45226
• Editor(s):
  Ogden T; Donaldson K; Cherry N
• Federal Fiscal Year:
  2003
• NORA Priority Area:
  Research Tools and Approaches: Exposure Assessment Methods
• Peer Reviewed:
  True
• Source Full Name:
  Annals of Occupational Hygiene, Inhaled Particles IX
• Supplement:
  1
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a46e92d9dff1ebf65745d485c084ba54b4b86011f8c4eb7ef4243617bac79dca5f2b82af7805b157dd64589772bc2cc526f0d50e068e5bf1d9a0f299590293ba
• Download URL:
  https://stacks.cdc.gov/view/cdc/199098/cdc_199098_DS1.pdf
• File Type:
  [PDF - 95.19 KB ]