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Nested case‐control study of esophageal cancer in relation to occupational exposure to silica and other dusts
Author(s) -
Pan Guowei,
Takahashi Ken,
Feng Yiping,
Liu Liming,
Liu Tiefu,
Zhang Shujuan,
Liu Ning,
Okubo Toshiteru,
Goldsmith David F.
Publication year - 1999
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/(sici)1097-0274(199903)35:3<272::aid-ajim7>3.0.co;2-t
Subject(s) - medicine , environmental health , job exposure matrix , nested case control study , confounding , occupational exposure , odds ratio , risk factor , asbestos , case control study , cohort study , toxicology , metallurgy , materials science , biology
Background Standardized proportionate mortality ratio (SPMR) was found to be 2.2 (95% CI > 1.3–3.5) for esophageal cancer (EC) among workers exposed to refractory brick dust in a large iron‐steel complex in China. Methods A nested case‐control design within a cohort of industrial workers. One hundred and twenty‐five EC cases and 250 controls were identified from the death registry file. Interviews were conducted of the next of kin for past exposure information on job, domestic, and lifestyle factors. History of occupational exposure to various dusts was reconstructed from personnel files and by interviewing colleagues utilizing a job‐exposure matrix. Results After adjusting for confounders, occupational exposure to silica dust was the most important risk factor among all variables investigated, with a 2.8‐fold risk and a clear dose–response by length of exposure. Alcohol drinking (OR > 1.8) and coal cooking (OR > 2.0) were risk factors and high consumption of fruit diet (OR > 0.5) and meat diet (OR > 0.6) were protective factors. Conclusions The relationship between occupational exposure to silica dust and the risk of EC found in an earlier SPMR study was confirmed. Ingestion of silica particles after lung clearance may increase the risk of EC among workers exposed to silica. Am. J. Ind. Med. 35:272–280, 1999. © 1999 Wiley‐Liss, Inc.