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Lung cancer in relation to exposure to silica dust, silicosis and uranium production in South African gold miners.
Thorax 1997; 52(3):271-5T

Abstract

BACKGROUND

A nested case-control study for lung cancer was performed on a cohort of 2260 South African gold miners in whom an association between exposure to silica dust and risk of lung cancer was previously reported. The objective was to investigate an expanded set of risk factors and also cancer cell type.

METHODS

The 78 cases of lung cancer found during the follow up period from 1970 to 1986 were matched with 386 controls. Risk of lung cancer was related to smoking, exposure to silica dust, incidence of silicosis, and uranium production and the uranium content of the mine ore.

RESULTS

The risk of lung cancer was associated with tobacco smoking, cumulative dust exposure, duration of underground mining, and with silicosis. The best predictive model included pack years of cigarette consumption (adjusted relative risk (RR) = 1.0 for < 6.5 pack years, 3.5 (95% confidence interval (CI) 0.7 to 16.8) for 6.5-20 pack years, 5.7 (95% CI 1.3 to 25.8) for 21-30 pack years, and 13.2 (95% CI 3.1 to 56.2) for more than 30 pack years) and silicosis (RR = 2.45 (95% CI 1.2 to 5.2)). No association was found with uranium production. The lung tumour cell type distribution was 40.3% small cell carcinoma, 38.8% squamous cell, 16.4% adenocarcinoma, and 4.5% large cell carcinoma. Small and large cell cancer combined were associated with exposure to dust.

CONCLUSIONS

The results cannot be interpreted definitively in terms of causal association. Possible interpretations are: (1) subjects with high dust exposure who develop silicosis are at increased risk of lung cancer; (2) high levels of exposure to silica dust on its own is important in the pathogenesis of lung cancer and silicosis is coincidental; and (3) high levels of silica dust exposure may be a surrogate for the exposure to radon daughters.

Authors+Show Affiliations

National Centre for Occupational Health, Johannesburg, South Africa.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9093345

Citation

Hnizdo, E, et al. "Lung Cancer in Relation to Exposure to Silica Dust, Silicosis and Uranium Production in South African Gold Miners." Thorax, vol. 52, no. 3, 1997, pp. 271-5.
Hnizdo E, Murray J, Klempman S. Lung cancer in relation to exposure to silica dust, silicosis and uranium production in South African gold miners. Thorax. 1997;52(3):271-5.
Hnizdo, E., Murray, J., & Klempman, S. (1997). Lung cancer in relation to exposure to silica dust, silicosis and uranium production in South African gold miners. Thorax, 52(3), pp. 271-5.
Hnizdo E, Murray J, Klempman S. Lung Cancer in Relation to Exposure to Silica Dust, Silicosis and Uranium Production in South African Gold Miners. Thorax. 1997;52(3):271-5. PubMed PMID: 9093345.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lung cancer in relation to exposure to silica dust, silicosis and uranium production in South African gold miners. AU - Hnizdo,E, AU - Murray,J, AU - Klempman,S, PY - 1997/3/1/pubmed PY - 1997/3/1/medline PY - 1997/3/1/entrez SP - 271 EP - 5 JF - Thorax JO - Thorax VL - 52 IS - 3 N2 - BACKGROUND: A nested case-control study for lung cancer was performed on a cohort of 2260 South African gold miners in whom an association between exposure to silica dust and risk of lung cancer was previously reported. The objective was to investigate an expanded set of risk factors and also cancer cell type. METHODS: The 78 cases of lung cancer found during the follow up period from 1970 to 1986 were matched with 386 controls. Risk of lung cancer was related to smoking, exposure to silica dust, incidence of silicosis, and uranium production and the uranium content of the mine ore. RESULTS: The risk of lung cancer was associated with tobacco smoking, cumulative dust exposure, duration of underground mining, and with silicosis. The best predictive model included pack years of cigarette consumption (adjusted relative risk (RR) = 1.0 for < 6.5 pack years, 3.5 (95% confidence interval (CI) 0.7 to 16.8) for 6.5-20 pack years, 5.7 (95% CI 1.3 to 25.8) for 21-30 pack years, and 13.2 (95% CI 3.1 to 56.2) for more than 30 pack years) and silicosis (RR = 2.45 (95% CI 1.2 to 5.2)). No association was found with uranium production. The lung tumour cell type distribution was 40.3% small cell carcinoma, 38.8% squamous cell, 16.4% adenocarcinoma, and 4.5% large cell carcinoma. Small and large cell cancer combined were associated with exposure to dust. CONCLUSIONS: The results cannot be interpreted definitively in terms of causal association. Possible interpretations are: (1) subjects with high dust exposure who develop silicosis are at increased risk of lung cancer; (2) high levels of exposure to silica dust on its own is important in the pathogenesis of lung cancer and silicosis is coincidental; and (3) high levels of silica dust exposure may be a surrogate for the exposure to radon daughters. SN - 0040-6376 UR - https://www.unboundmedicine.com/medline/citation/9093345/Lung_cancer_in_relation_to_exposure_to_silica_dust_silicosis_and_uranium_production_in_South_African_gold_miners_ L2 - http://thorax.bmj.com/cgi/pmidlookup?view=long&amp;pmid=9093345 DB - PRIME DP - Unbound Medicine ER -