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Change of Exposure Response over Time and Long-Term Risk of Silicosis among a Cohort of Chinese Pottery Workers
Institute for Occupational Safety and Health of the German Social Accident Insurance/Alte Heerstraße 111, 53757 Sankt Augustin, Germany
Institute of Occupational Medicine, Social Medicine and Social Hygiene, University of Cologne, Institute for Occupational Epidemiology and Risk Assessment of Evonik Industries, Kerpener Str. 62, 50937 Cologne, Germany
Institute of Medical Statistics and Epidemiology, Technical University of Munich/Ismaningerstr. 22, 81675 Munich, Germany
School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hongkong Road 13, Wuhan 430074, China
* Author to whom correspondence should be addressed.
Received: 1 June 2011; in revised form: 6 July 2011 / Accepted: 6 July 2011 / Published: 14 July 2011
Abstract: An analysis was conducted on a cohort of Chinese pottery workers to estimate the exposure-response relationship between respirable crystalline silica dust exposure and the incidence of radiographically diagnosed silicosis, and to estimate the long-term risk of developing silicosis until the age of 65. The cohort comprised 3,250 employees with a median follow-up duration of around 37 years. Incident cases of silicosis were identified via silicosis registries (Chinese X-ray stage I, similar to International Labor Organisation classification scheme profusion category 1/1). Individual exposure to respirable crystalline silica dust was estimated based on over 100,000 historical dust measurements. The association between dust exposure, incidence and long-time risk of silicosis was quantified by Poisson regression analysis adjusted for age and smoking. The risk of silicosis depended not only on the cumulative respirable crystalline silica dust exposures, but also on the time-dependent respirable crystalline silica dust exposure pattern (long-term average concentration, highest annual concentration ever experienced and time since first exposure). A long-term “excess” risk of silicosis of approximately 1.5/1,000 was estimated among workers with all annual respirable crystalline silica dust concentration estimates less than 0.1 mg/m3, using the German measurement strategy. This study indicates the importance of proper consideration of exposure information in risk quantification in epidemiological studies.
Keywords: respirable silica exposure; exposure pattern; exposure-response-relationship; excess risk; regulatory risk assessment
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Sun, Y.; Bochmann, F.; Morfeld, P.; Ulm, K.; Liu, Y.; Wang, H.; Yang, L.; Chen, W. Change of Exposure Response over Time and Long-Term Risk of Silicosis among a Cohort of Chinese Pottery Workers. Int. J. Environ. Res. Public Health 2011, 8, 2923-2936.
Sun Y, Bochmann F, Morfeld P, Ulm K, Liu Y, Wang H, Yang L, Chen W. Change of Exposure Response over Time and Long-Term Risk of Silicosis among a Cohort of Chinese Pottery Workers. International Journal of Environmental Research and Public Health. 2011; 8(7):2923-2936.
Sun, Yi; Bochmann, Frank; Morfeld, Peter; Ulm, Kurt; Liu, Yuewei; Wang, Heijiao; Yang, Lei; Chen, Weihong. 2011. "Change of Exposure Response over Time and Long-Term Risk of Silicosis among a Cohort of Chinese Pottery Workers." Int. J. Environ. Res. Public Health 8, no. 7: 2923-2936.