• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of brjindmedLink to Publisher's site
Br J Ind Med. Feb 1991; 48(2): 122–129.
PMCID: PMC1035332

Mortality from lung cancer among Sardinian patients with silicosis.

Abstract

The mortality of 724 subjects with silicosis, first diagnosed in 1964-70 in the Sardinia region of Italy, was followed up through to 31 December 1987. Smoking, occupational history, chest x ray films, and data on lung function were available from clinical records for each member of the cohort. The overall cohort accounted for 10,956.5 person-years. The standardised mortality ratios (SMRs) for selected causes of death (International Classification of Diseases (ICD) eighth revision) were based on the age specific regional death rates for each calendar year. An excess of deaths for all causes (SMR = 1.40) was found, mainly due to chronic obstructive lung disease, silicosis, and tuberculosis with an upward trend of the SMR with increasing severity of the International Labour Office (ILO) radiological categories. Twenty two subjects died from lung cancer (SMR = 1.29, 95% confidence interval (95% CI) = 0.8-2.0). The risk increased after a 10 and 15 year latency but the SMR never reached statistical significance. No correlation was found between lung cancer and severity of the radiological category, the type of silica (coal or metalliferous mines, quarries etc), or the degree of exposure to silica dust. A significant excess of deaths from lung cancer was found among heavy smokers (SMR = 4.11) and subjects with airflow obstruction (SMR = 2.83). A nested case-control study was planned to investigate whether the association between lung cancer and airway obstruction was due to confounding by smoking. No association was found with the ILO categories of silicosis or the estimated cumulative exposure to silica. The risk estimate for lung cancer by airflow obstruction after adjusting by cigarette consumption was 2.86 for a mild impairment and 7.23 for a severe obstruction. The results do not show any clear association between exposure to silica, severity of silicosis, and mortality from lung cancer. Other environmental or individual factors may act as confounders in the association between silicosis and lung cancer. Among them, attention should be given to chronic airways obstruction as an independent risk factor for lung cancer in patients with silicosis.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.1M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Goldsmith DF, Guidotti TL, Johnston DR. Does occupational exposure to silica cause lung cancer? Am J Ind Med. 1982;3(4):423–440. [PubMed]
  • Maillard JM. Silicose et cancer bronchique. Poumon Coeur. 1980 Jan-Feb;36(1):41–48. [PubMed]
  • Heppleston AG. Silica, pneumoconiosis, and carcinoma of the lung. Am J Ind Med. 1985;7(4):285–294. [PubMed]
  • Wilson T, Scheuchenzuber WJ, Eskew ML, Zarkower A. Comparative pathological aspects of chronic olivine and silica inhalation in mice. Environ Res. 1986 Apr;39(2):331–344. [PubMed]
  • Saffiotti U. Attività cancerogena della silice e possibile ruolo patogenetico della reazione cellulare fibrogena. Med Lav. 1985 Sep-Oct;76(5):351–357. [PubMed]
  • Westerholm P. Silicosis. Observations on a case register. Scand J Work Environ Health. 1980;6 (Suppl 2):1–86. [PubMed]
  • Finkelstein M, Kusiak R, Suranyi G. Mortality among miners receiving workmen's compensation for silicosis in Ontario: 1940-1975. J Occup Med. 1982 Sep;24(9):663–667. [PubMed]
  • Forastiere F, Lagorio S, Michelozzi P, Cavariani F, Arca' M, Borgia P, Perucci C, Axelson O. Silica, silicosis and lung cancer among ceramic workers: a case-referent study. Am J Ind Med. 1986;10(4):363–370. [PubMed]
  • Finkelstein M, Liss GM, Krammer F, Kusiak RA. Mortality among workers receiving compensation awards for silicosis in Ontario 1940-85. Br J Ind Med. 1987 Sep;44(9):588–594. [PMC free article] [PubMed]
  • Zambon P, Simonato L, Mastrangelo G, Winkelmann R, Saia B, Crepet M. Mortality of workers compensated for silicosis during the period 1959-1963 in the Veneto region of Italy. Scand J Work Environ Health. 1987 Apr;13(2):118–123. [PubMed]
  • Mastrangelo G, Zambon P, Simonato L, Rizzi P. A case-referent study investigating the relationship between exposure to silica dust and lung cancer. Int Arch Occup Environ Health. 1988;60(4):299–302. [PubMed]
  • Rimington J. Smoking, chronic bronchitis, and lung cancer. Br Med J. 1971 May 15;2(5758):373–375. [PMC free article] [PubMed]
  • Cohen BH, Ball WC, Jr, Brashears S, Diamond EL, Kreiss P, Levy DA, Menkes HA, Permutt S, Tockman MS. Risk factors in chronic obstructive pulmonary disease (COPD). Am J Epidemiol. 1977 Mar;105(3):223–232. [PubMed]
  • Cohen BH. Chronic obstructive pulmonary disease: a challenge in genetic epidemiology. Am J Epidemiol. 1980 Aug;112(2):274–288. [PubMed]
  • Beaty TH, Cohen BH, Newill CA, Menkes HA, Diamond EL, Chen CJ. Impaired pulmonary function as a risk factor for mortality. Am J Epidemiol. 1982 Jul;116(1):102–113. [PubMed]
  • Carta P, Aru G, Barbieri MT, Bario P, Casciu G, Cocco PL, Casula D. Cause di morte nei silicotici della Sardegna (1964-1977). Med Lav. 1988 Nov-Dec;79(6):431–443. [PubMed]
  • Rogan JM, Attfield MD, Jacobsen M, Rae S, Walker DD, Walton WH. Role of dust in the working environment in development of chronic bronchitis in British coal miners. Br J Ind Med. 1973 Jul;30(3):217–226. [PMC free article] [PubMed]
  • Lubin JH, Gail MH. Biased selection of controls for case-control analyses of cohort studies. Biometrics. 1984 Mar;40(1):63–75. [PubMed]
  • MANTEL N, HAENSZEL W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959 Apr;22(4):719–748. [PubMed]
  • Miettinen O. Estimability and estimation in case-referent studies. Am J Epidemiol. 1976 Feb;103(2):226–235. [PubMed]
  • Hessel PA, Sluis-Cremer GK, Hnizdo E. Silica exposure, silicosis, and lung cancer: a necropsy study. Br J Ind Med. 1990 Jan;47(1):4–9. [PMC free article] [PubMed]
  • Jacobsen M. Lung cancer and coal workers' pneumoconiosis. Br Med J. 1979 Jul 21;2(6183):208–208. [PMC free article] [PubMed]
  • Rooke GB, Ward FG, Dempsey AN, Dowler JB, Whitaker CJ. Carcinoma of the lung in Lancashire coalminers. Thorax. 1979 Apr;34(2):229–233. [PMC free article] [PubMed]
  • Miller BG, Jacobsen M. Dust exposure, pneumoconiosis, and mortality of coalminers. Br J Ind Med. 1985 Nov;42(11):723–733. [PMC free article] [PubMed]
  • Duggan MJ, Soilleux PJ, Strong JC, Howell DM. The exposure of United Kingdom miners to radon. Br J Ind Med. 1970 Apr;27(2):106–109. [PMC free article] [PubMed]
  • Ames RG. Does coal workers' pneumoconiosis predict to lung cancer? Some evidence from a case-control study. J Soc Occup Med. 1983 Jul;33(3):141–144. [PubMed]
  • Davis LK, Wegman DH, Monson RR, Froines J. Mortality experience of Vermont granite workers. Am J Ind Med. 1983;4(6):705–723. [PubMed]
  • Steenland K, Beaumont J. A proportionate mortality study of granite cutters. Am J Ind Med. 1986;9(2):189–201. [PubMed]
  • Costello J, Graham WG. Vermont granite workers' mortality study. Am J Ind Med. 1988;13(4):483–497. [PubMed]
  • Koskela RS, Klockars M, Järvinen E, Kolari PJ, Rossi A. Cancer mortality of granite workers. Scand J Work Environ Health. 1987 Feb;13(1):26–31. [PubMed]
  • Harber P, Oren A, Mohsenifar Z, Lew M. Obstructive airway disease as a risk factor for asbestos-associated malignancy. J Occup Med. 1986 Feb;28(2):82–86. [PubMed]
  • Skillrud DM, Offord KP, Miller RD. Higher risk of lung cancer in chronic obstructive pulmonary disease. A prospective, matched, controlled study. Ann Intern Med. 1986 Oct;105(4):503–507. [PubMed]
  • Tockman MS, Anthonisen NR, Wright EC, Donithan MG. Airways obstruction and the risk for lung cancer. Ann Intern Med. 1987 Apr;106(4):512–518. [PubMed]
  • Anthonisen NR. Prognosis in chronic obstructive pulmonary disease: results from multicenter clinical trials. Am Rev Respir Dis. 1989 Sep;140(3 Pt 2):S95–S99. [PubMed]
  • McDonald JC. Silica, silicosis, and lung cancer. Br J Ind Med. 1989 May;46(5):289–291. [PMC free article] [PubMed]

Articles from British Journal of Industrial Medicine are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...