Department of Radiation Protection and Health, Federal Office for Radiation Protection, Neuherberg, Germany.
Occup Environ Med. 2013 Dec;70(12):869-75. doi: 10.1136/oemed-2013-101582. Epub 2013 Oct 14.
To quantify the relationship between death from non-malignant respiratory diseases (NMRD) and exposure to silica dust or radon in a cohort of 58,690 former German uranium miners.
In the follow-up period from 1946 to 2008, a total of 2336 underlying deaths from NMRDs occurred, including 715 deaths from chronic obstructive pulmonary diseases (COPD) and 975 deaths from silicosis or other pneumoconiosis. Exposure to respirable crystalline silica and radon was individually assessed by means of a comprehensive job-exposure matrix. Risk analyses were based on a linear Poisson regression model with the baseline stratified by age, calendar year and duration of employment.
There was no increase in risk of death from COPDs or any other NMRDs in relation to cumulative exposure to silica (mean=5.9, max=56 mg/m(3)-years), except in the group of deaths from silicosis or other pneumoconiosis. Here, a strong non-linear increase in risk was observed. Cumulative radon exposure (mean=280; max=3224 Working Level Months) was not related to death from COPDs or any other NMRDs.
The present findings do not indicate a relationship between mortality from COPD with silica dust or radon. However, validity of cause of death and lack of control for smoking remain potential sources of bias.
在一个由 58690 名前德国铀矿工组成的队列中,定量研究非恶性呼吸道疾病(NMRD)死亡与接触二氧化硅粉尘或氡之间的关系。
在 1946 年至 2008 年的随访期间,共有 2336 例 NMRD 死因,包括慢性阻塞性肺疾病(COPD)715 例和矽肺或其他尘肺 975 例。通过综合职业暴露矩阵单独评估可吸入结晶二氧化硅和氡的暴露情况。风险分析基于线性泊松回归模型,以年龄、日历年份和工龄分层为基础。
除矽肺或其他尘肺死亡组外,与累积暴露于二氧化硅(均值=5.9,最大值=56mg/m3-年)相关的 COPD 或任何其他 NMRD 死亡风险均无增加。在此,观察到风险呈强烈的非线性增加。累积氡暴露(均值=280;最大值=3224 工作水平月)与 COPD 或任何其他 NMRD 死亡无关。
目前的研究结果表明,COPD 的死亡率与二氧化硅粉尘或氡无关。然而,死因的有效性和缺乏对吸烟的控制仍然是潜在的偏倚来源。