Abstract
OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
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