Walsh S J
Department of Community Medicine, School of Medicine, University of Connecticut Health Center, Farmington 06030-6205, USA.
J Rheumatol. 1999 Oct;26(10):2179-85.
Studies report an association between mining related silica exposure and systemic sclerosis (SSc). This study evaluated associations between non-mining occupational silica exposure, silicosis, and SSc.
The US National Institute for Occupational Safety and Health (NIOSH) recently identified 36 non-mining occupations in which workers face the "potential for substantial silica exposure." Data from death certificates in 25 US states during 1985-92 were analyzed to determine whether excess proportional mortality from silicosis or SSc occurred among those who worked in these occupations.
Proportional mortality from silicosis in the occupations identified by NIOSH was significantly elevated among men [proportional mortality ratio (PMR) = 1.4; p < 0.0001] and women (PMR = 7.1; p = 0.002). The proportional mortality from SSc was not elevated among men (PMR = 1.0; p = 0.90) and was lower than expected among women (PMR = 0.8; p = 0.39).
When cited on death certificates, the non-mining occupational categories identified by NIOSH reflect prior silica exposure; however, no evidence of excess mortality from SSc was observed in these occupations. The reported increased frequency of SSc among miners may depend on a level or mode of silica exposure unique to the mining industry.
研究报告了与采矿相关的二氧化硅暴露和系统性硬化症（SSc）之间的关联。本研究评估了非采矿职业性二氧化硅暴露、矽肺和SSc之间的关联。
美国国家职业安全与健康研究所（NIOSH）最近确定了36种非采矿职业，这些职业的工人面临“大量接触二氧化硅的可能性”。分析了1985 - 1992年期间美国25个州死亡证明的数据，以确定在这些职业中工作的人是否存在矽肺或SSc导致的超额比例死亡率。
在NIOSH确定的职业中，男性矽肺的比例死亡率显著升高[比例死亡率（PMR）= 1.4；p < 0.0001]，女性也显著升高（PMR = 7.1；p = 0.002）。男性SSc的比例死亡率没有升高（PMR =
