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Combined effect of silica dust exposure and cigarette smoking on total and cause-specific mortality in iron miners: a cohort study.
Environ Health 2018; 17(1):46EH

Abstract

BACKGROUND

Both cigarette smoking and long-term exposure to crystalline silica dust were reported to be associated with increased mortality. However, the combined effect of both factors has not been well evaluated.

METHODS

We investigated a retro-prospective cohort of 7,665 workers from one Chinese iron mine with a median follow-up of 42.8 years. Cumulative silica exposure was estimated for each worker by linking work histories with a job-exposure matrix. Cigarette smoking information was collected through face-to-face questionnaires. Hazard ratios (HRs) for total and cause-specific mortality due to silica exposure and smoking were estimated using Cox proportional hazards models.

RESULTS

A total of 2,814 deaths occurred during 315,772.9 person-years of follow-up. Significantly elevated mortality from all causes, cardiovascular disease, non-malignant respiratory disease and lung cancer was observed among silica-exposed workers, while elevated mortality from non-malignant respiratory disease and lung cancer was observed among smokers. Combined exposure to silica dust and cigarette smoking elevated the proportion of mortality and accounted for 21.2, 76.0, 35.7 and 81.4% of all causes, non-malignant respiratory disease, cardiovascular disease, and lung cancer, respectively. Significant additive joint effects of silica exposure and cigarette smoking on mortality from lung cancer (HR 1.893, 95% CI 0.628 to 3.441) and pneumoconiosis (6.457, 0.725 to 39.114), together with a significant multiplicative joint effect from all causes (1.002, 1.000 to 1.004) were observed.

CONCLUSIONS

The present findings indicated that silica exposure in combination with cigarette smoking accounted for a fraction of extra deaths in our cohort. Our research showed the urgent need for smoking cessation and silica control among iron miners.

Authors+Show Affiliations

Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China. Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, Hubei, China.Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China. Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, Hubei, China.Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China. Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.Shenzhen Prevention and Treatment Center for Occupational Disease, Shenzhen, Guangdong, China.Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China. wchen@mails.tjmu.edu.cn. Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. wchen@mails.tjmu.edu.cn.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29743082

Citation

Lai, Hanpeng, et al. "Combined Effect of Silica Dust Exposure and Cigarette Smoking On Total and Cause-specific Mortality in Iron Miners: a Cohort Study." Environmental Health : a Global Access Science Source, vol. 17, no. 1, 2018, p. 46.
Lai H, Liu Y, Zhou M, et al. Combined effect of silica dust exposure and cigarette smoking on total and cause-specific mortality in iron miners: a cohort study. Environ Health. 2018;17(1):46.
Lai, H., Liu, Y., Zhou, M., Shi, T., Zhou, Y., Weng, S., & Chen, W. (2018). Combined effect of silica dust exposure and cigarette smoking on total and cause-specific mortality in iron miners: a cohort study. Environmental Health : a Global Access Science Source, 17(1), p. 46. doi:10.1186/s12940-018-0391-0.
Lai H, et al. Combined Effect of Silica Dust Exposure and Cigarette Smoking On Total and Cause-specific Mortality in Iron Miners: a Cohort Study. Environ Health. 2018 05 9;17(1):46. PubMed PMID: 29743082.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined effect of silica dust exposure and cigarette smoking on total and cause-specific mortality in iron miners: a cohort study. AU - Lai,Hanpeng, AU - Liu,Yuewei, AU - Zhou,Min, AU - Shi,Tingming, AU - Zhou,Yun, AU - Weng,Shaofan, AU - Chen,Weihong, Y1 - 2018/05/09/ PY - 2018/01/14/received PY - 2018/05/02/accepted PY - 2018/5/11/entrez PY - 2018/5/11/pubmed PY - 2018/12/18/medline KW - Cigarette smoking KW - Cohort KW - Joint effect KW - Mortality KW - Silica SP - 46 EP - 46 JF - Environmental health : a global access science source JO - Environ Health VL - 17 IS - 1 N2 - BACKGROUND: Both cigarette smoking and long-term exposure to crystalline silica dust were reported to be associated with increased mortality. However, the combined effect of both factors has not been well evaluated. METHODS: We investigated a retro-prospective cohort of 7,665 workers from one Chinese iron mine with a median follow-up of 42.8 years. Cumulative silica exposure was estimated for each worker by linking work histories with a job-exposure matrix. Cigarette smoking information was collected through face-to-face questionnaires. Hazard ratios (HRs) for total and cause-specific mortality due to silica exposure and smoking were estimated using Cox proportional hazards models. RESULTS: A total of 2,814 deaths occurred during 315,772.9 person-years of follow-up. Significantly elevated mortality from all causes, cardiovascular disease, non-malignant respiratory disease and lung cancer was observed among silica-exposed workers, while elevated mortality from non-malignant respiratory disease and lung cancer was observed among smokers. Combined exposure to silica dust and cigarette smoking elevated the proportion of mortality and accounted for 21.2, 76.0, 35.7 and 81.4% of all causes, non-malignant respiratory disease, cardiovascular disease, and lung cancer, respectively. Significant additive joint effects of silica exposure and cigarette smoking on mortality from lung cancer (HR 1.893, 95% CI 0.628 to 3.441) and pneumoconiosis (6.457, 0.725 to 39.114), together with a significant multiplicative joint effect from all causes (1.002, 1.000 to 1.004) were observed. CONCLUSIONS: The present findings indicated that silica exposure in combination with cigarette smoking accounted for a fraction of extra deaths in our cohort. Our research showed the urgent need for smoking cessation and silica control among iron miners. SN - 1476-069X UR - https://www.unboundmedicine.com/medline/citation/29743082/Combined_effect_of_silica_dust_exposure_and_cigarette_smoking_on_total_and_cause_specific_mortality_in_iron_miners:_a_cohort_study_ L2 - https://ehjournal.biomedcentral.com/articles/10.1186/s12940-018-0391-0 DB - PRIME DP - Unbound Medicine ER -