Estimating Counterfactual Risk Under Hypothetical Interventions in the Presence of Competing Events: Crystalline Silica Exposure and Mortality from 2 Causes of Death

Details

• Personal Author:
  Brown DM ; Checkoway, Harvey ; Costello S ; Eisen EA ; Gallagher LE ; Neophytou AM ; Picciotto S
• Description:
  Exposure to silica has been linked to excess risk of lung cancer and nonmalignant respiratory disease mortality. In this study we estimated risk for both these outcomes in relation to occupational silica exposure as well as the reduction in risk that would result from hypothetical interventions on exposure in a cohort of exposed workers. Analyses were carried out using data from an all-male study population consisting of 2,342 California diatomaceous earth workers regularly exposed to crystalline silica and followed between 1942 and 2011. We estimated subdistribution risk for each event under the natural course and interventions of interest using the parametric g-formula to adjust for healthy-worker survivor bias. The risk ratio for lung cancer mortality, comparing an intervention in which a theoretical maximum exposure limit was set at 0.05 mg/m3 (the current US regulatory limit) with the observed exposure concentrations, was 0.86 (95% confidence interval: 0.63, 1.22). The corresponding risk ratio for nonmalignant respiratory disease mortality was 0.69 (95% confidence interval: 0.52, 0.93). Our findings suggest that risks from both outcomes would have been considerably lower if historical silica exposures in this cohort had not exceeded current regulatory limits. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Lung Lung Diseases Mortality Neoplasms Occupational Exposure Occupational Health Respiratory System Respiratory Tract Diseases Safety Silicon Dioxide

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• Keywords:
  Author Keywords: Competing Risks Cohort Studies Crystalline Silica G-formula Healthy-worker Effect Lung Cancer Mortality Rates Occupational Exposure Respiratory Diseases Silica Silica Dusts

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• ISSN:
  0002-9262
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; Massachusetts ; OSHA Region 1 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  187
• Issue:
  9
• NIOSHTIC Number:
  nn:20056602
• Citation:
  Am J Epidemiol 2018 Sep; 187(9):1942-1950
• Contact Point Address:
  Dr. Andreas M. Neophytou, Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, 50 University Hall #7360, Berkeley, CA 94720-7360
• Email:
  aneophytou@berkeley.edu
• CAS Registry Number:
  Quartz (SiO2) (CAS RN 14808-60-7)
• Federal Fiscal Year:
  2018
• Performing Organization:
  University of California, Berkeley
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  American Journal of Epidemiology
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:667d9d276d29ceca9e3a4dbf27e818f6e13fea7f4388c7e76d1d20c67e0ebb7bce272d6b03b049798ab77aa443194e35681aa0df3ddc0262cddac216bab1c67b
• Download URL:
  https://stacks.cdc.gov/view/cdc/214180/cdc_214180_DS1.pdf
• File Type:
  [PDF - 296.00 KB ]