Chen W, Zhuang Z, Attfield M D, Chen B T, Gao P, Harrison J C, Fu C, Chen J Q, Wallace W E
Department of Labor Health and Occupational Diseases, School of Public Health, Tonji Medical University, 13 Hang Kong Lu, Wuhan, Hubei, People's Republic of China.
Occup Environ Med. 2001 Jan;58(1):31-7. doi: 10.1136/oem.58.1.31.
To investigate the risk of silicosis among tin miners and to investigate the relation between silicosis and cumulative exposure to dust (Chinese total dust and respirable crystalline silica dust).
A cohort study of 3010 miners exposed to silica dust and employed for at least 1 year during 1960-5 in any of four Chinese tin mines was conducted. Historical total dust data from China were used to create a job exposure matrix for facility, job title, and calendar year. The total dust exposure data from China were converted to estimates of exposure to respirable crystalline silica for comparison with findings from other epidemiological studies of silicosis. Each worker's work history was abstracted from the complete employment records in mine files. Diagnoses of silicosis were based on 1986 Chinese pneumoconiosis Roentgen diagnostic criteria, which classified silicosis as stages I-III-similar to an International Labour Organisation (ILO) classification of 1/1 or greater.
There were 1015 (33.7%) miners identified with silicosis, who had a mean age of 48.3 years, with a mean of 21.3 years after first exposure (equivalent to 11.0 net years in a dusty job). Among those who had silicosis, 684 miners (67.4%) developed silicosis after exposure ended (a mean of 3.7 years after). The risk of silicosis was strongly related to cumulative exposure to silica dust and was well fitted by the Weibull distribution, with the risk of silicosis less than 0.1% when the Chinese measure of cumulative exposure to total dust (CTD) was under 10 mg/m(3)-years (or 0.36 mg/m(3)-years of respirable crystalline silica), increasing to 68.7% when CTD exposure was 150 mg/m(3)-years (or 5.4 mg/m(3)-years of respirable crystalline silica). Latency period was not correlated to the risk of silicosis or cumulative dose of exposure. This study predicts about a 36% cumulative risk of silicosis for a 45 year lifetime exposure to these tin mine dusts at the CTD exposure standard of 2 mg/m(3), and a 55% risk at 45 years exposure to the current United States Occupational Safety and Health Administration and Mine Safety and Health Administration standards of 0.1 mg/m(3) 100% respirable crystalline silica dust.
A clear exposure-response relation was detected for silicosis in Chinese tin miners. The study results were similar to most, but not all, findings from other large scale exposure-response studies.
调查锡矿矿工患矽肺病的风险，并研究矽肺病与粉尘（中国总粉尘和可吸入结晶二氧化硅粉尘）累积暴露之间的关系。
对3010名在1960年至1965年期间于中国四个锡矿中的任何一个接触二氧化硅粉尘且工作至少1年的矿工进行了队列研究。利用来自中国的历史总粉尘数据，针对工厂、职位和历年创建了工作暴露矩阵。将来自中国的总粉尘暴露数据转换为可吸入结晶二氧化硅暴露的估计值，以便与其他矽肺病流行病学研究的结果进行比较。从矿井档案中的完整就业记录中提取了每名工人的工作经历。矽肺病的诊断依据1986年中国尘肺病X线诊断标准，该标准将矽肺病分为I - III期，类似于国际劳工组织（ILO）1/1或更高的分类。
有1015名（33.7%）矿工被确诊患有矽肺病，他们的平均年龄为48.3岁，首次接触后平均21.3年（相当于在有粉尘工作岗位上净工作11.0年）。在患有矽肺病的矿工中，684名（67.4%）在接触结束后患上矽肺病（平均在接触结束后3.7年）。矽肺病风险与二氧化硅粉尘的累积暴露密切相关，并且很好地符合威布尔分布，当中国总粉尘累积暴露量（CTD）低于10 mg/m³ - 年（或可吸入结晶二氧化硅0.36 mg/m³ - 年）时，矽肺病风险低于0.1%，当CTD暴露量为150 mg/m³ - 年（或可吸入结晶二氧化硅5.4 mg/m³ - 年）时，风险增至68.7%。潜伏期与矽肺病风险或累积暴露剂量无关。本研究预测，按照CTD暴露标准2 mg/m³，在45年的工作寿命中接触这些锡矿粉尘，矽肺病的累积风险约为36%；按照美国职业安全与健康管理局和矿山安全与健康管理局目前0.1 mg/m³ 100%可吸入结晶二氧化硅粉尘的标准，45年接触的风险为55%。
在中国锡矿矿工中检测到了明显的矽肺病暴露 - 反应关系。该研究结果与其他大规模暴露 - 反应研究的大多数（但并非全部）结果相似。
