Carcinoma of the lung in Ontario gold miners: possible aetiological factors.

Kusiak, Robert A.; Springer, Jochen; Ritchie, A. C.; Müller, Justus

doi:10.1136/oem.48.12.808

Cited by 33 publications

(23 citation statements)

References 14 publications

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“…The risk was highest among underground miners with 10-25 years of exposure and a top cumulative radon exposure not exceeding 90 WLM. Kusiak et al [1991] found an increased lung cancer mortality only among nickel miners engaged before 1936 (SMR: 142,95% CI: 105-184) and Ontario gold miners engaged before 1945 (SMR: 129, 95% CI: 115-145). However, they concluded that the excess of lung cancer in gold miners was more likely to be due to exposure to radon decay products and arsenic, found at relatively high levels in these mines, rather than to silica dust.…”

Section: Discussionmentioning

confidence: 93%

“…However, a total mortality close to or slightly lower than expected is not uncommon in other cohorts of metal miners or silica-exposed workers, mainly in those who began working after 1950 [Lawler et al, 1985;Thomas and Stewart, 1987;Battista et al, 1988;Kusiak et al, 1991;Chen et al, 19911. The overall cancer mortality was close to the expected numbers and mortality for respiratory diseases was significantly increased in both mines.…”

Section: Discussionmentioning

confidence: 98%

“…Maillard [ 19801 and Heppleston [ 19851 reached opposite conclusions, sug-gesting that the reported association between silica exposure, silicosis, and lung cancer could be the result of confounding by smoking and other occupational risk factors [McDonald, 19891. Although mixed coal mine dust contains, on average, more than 4% of free crystalline silica, results among coal miners and subjects with coal workers' pneumoconiosis are generally negative for an association with lung cancer mortality [Jacobsen, 1979;Rooke et al, 1979;Ames, 1983;Miller and Jacobsen, 1985;Atuhaire et al, 1986;Meijers et al, 19881. More recently, further conflicting results have been published on lung cancer risk among workers exposed to dust containing silica, with or without silicosis [Hessel et al, 1990;Hnizdo and Sluis-Cremer, 1991;Carta et al, 1991;Amandus and Costello, 1991;Ng et al, 1990;Chia et al, 1991;Meijers et al, 1990;Amandus et al, 1991;Ahlman et al, 1991;Kusiak et al, 1991;Chen et al, 1991;Mc Laughlin et al, 19921. In most studies no clear dose-response effect for exposure to silica was shown, although an association between silicosis and lung cancer has been observed in many of them.…”

Section: Introductionmentioning

confidence: 97%

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Lung cancer mortality and airways obstruction among metal miners exposed to silica and low levels of radon daughters

Carta

Cocco

Picchiri

1994

American J Industrial Med

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Starting from a cross-sectional survey in 1973, the mortality of two cohorts of Sardinian metal miners was followed through December 31, 1988. In mine A, the quartz concentration in respirable dust ranged between 0.2% and 2.0% and the exposure to radon daughters averaged 0.13 working level (WL), with the highest estimated cumulative exposure around 80-120 WLM. In mine B, the silica content was much higher (6.5-29%), but exposure to radon daughters was significantly lower than in mine A. More than 98% of the overall work force in 1973 (1,741 miners) entered the cohort, providing 25,842.5 person-years. Smoking, occupational history, chest radiographs, and lung function tests were available for the cohort members at admission. Mortality for all causes was slightly lower than expected. A significant excess for nonmalignant chronic respiratory diseases was noticed in both mines. Twenty-four subjects died of lung cancer, 17 from mine A (SMR: 128; 95% confidence interval [CI]: 75-205) and 7 from mine B (SMR: 85; 95% CI: 34-175). The SMR for lung cancer was highest among the underground workers from mine A (SMR: 148; 95% CI: 74-265), with a significant upward trend by duration of employment in underground jobs. Mine B underground miners showed lung cancer SMRs close to 100 without a significant trend by duration of employment. Among underground miners with spirometric airways obstruction in 1973, those from mine A showed the highest risk (SMR: 316; 95% CI: 116-687). The relationship did not change after adjusting for age and smoking. Based on the present findings, crystalline silica per se does not appear to affect lung cancer mortality. A slight association between lung cancer mortality and exposure to radon daughters, though within relatively low levels, may be considered for underground miners from mine A. Impaired pulmonary function may be an independent predictor of lung cancer and an important risk factor enhancing the residence time of inhaled carcinogens, i.e., alpha particles or PAHs, by impairing their bronchial and alveolar clearance.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 97%

See 1 more Smart Citation

Lung cancer mortality and airways obstruction among metal miners exposed to silica and low levels of radon daughters

Carta

Cocco

Picchiri

1994

American J Industrial Med

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“…Table I1 shows that miners who moved to Hamilton or Sault Ste-Marie had an increased risk of lung cancer compared to other residents (relative risk = 1.46). Kusiak et al [1991] conducted a cohort study of 54,000 Ontario miners. Increased lung cancer risk was observed for uranium miners, for gold miners who began gold mining before 1946 (standardised mortality ratio [SMR] = 129), and for nickel miners who began to mine nickel before 1936 (SMR = 141).…”

Section: Discussionmentioning

confidence: 99%

Occupational associations with lung cancer in two Ontario cities

Finkelstein¹

1995

American J Industrial Med

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A death certificate based case-control study of lung cancer in two Ontario cities was performed to estimate the risk of lung cancer attributable to occupation in Ontario, and to estimate the proportion of occupational lung cancers receiving compensation from the Workers' Compensation Board. Occupation and industry were identified from the death certificate. A priori occupations for analysis were those whose members had received compensation for occupational cancer from the Ontario Workers' Compensation Board. Population attributable risks were computed using the relative risks observed in this study and employment data from the 1986 Census of Canada. Subjects were all men (N = 967) between the ages of 45 and 75 years resident in the cities of Hamilton and Sault Ste-Marie who died of lung cancer from 1979 to 1988. Controls (2,821) were matched on age, year of death, and city of residence. In agreement with other studies, an increased risk of lung cancer was observed for workers in the construction sector, for miners, and for truck drivers. It was estimated that only a small proportion of lung cancers attributable to occupation are compensated in Ontario. It is believed that many occupational cancers go uncompensated because of the failure to file claims, rather than because claims are rejected by Compensation Boards. Physicians are in a position to advise patients about the possibility of compensable disease and to act as advocates for them. By recognizing compensable illness, physicians have the opportunity to ease the financial burden of patients and their families. The challenge is a difficult one, but it is well worth pursuing.

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“…The exposure to short lived radon decay products, even at relatively low levels, has been suggested as one of the main likely causes of the excess of lung cancer found in several studies of underground miners14 37 42 56 57 or of registered silicotic patients 49…”

Section: Discussionmentioning

confidence: 99%

Mortality from lung cancer among silicotic patients in Sardinia: an update study with 10 more years of follow up

Carta

Aru²,

Manca³

2001

Occup Environ Med

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Objectives-To evaluate the association between silica, silicosis and lung cancer, the mortality of 724 patients with silicosis, first diagnosed by standard chest x ray film between 1964 and 1970, has been analysed by a cohort study extended to 31 December 1997. Methods-Smoking and detailed occupational histories were available for each member of the cohort as well as the estimated lifetime exposure to respirable silica dust and radon daughters. Two independent readers blindly classified standard radiographs according to the 12 point International Labour Organisation (ILO) scale. Lung function tests meeting the American Thoracic Society's criteria were available for 665 patients. Standardised mortality ratios (SMRs) for selected causes of death were based on the age specific Sardinian regional death rates. Results-The mortality for all causes was significantly higher than expected (SMR 1.35, 95% confidence interval (95% CI) 1.24 to 1.46) mainly due to tuberculosis (SMR 22.0) and to non-malignant chronic respiratory diseases (NMCRD) (SMR 6.03). All cancer deaths were within the expected numbers (SMR 0.93; 95% CI 0.76 to 1.14). The SMR for lung cancer was 1.37 (95% CI 0.98 to 1.91, 34 observed), increasing to 1.65 (95% CI 0.98 to 2.77) allowing for 20 years of latency since the first diagnosis of silicosis. Although mortality from NMCRD was strongly associated to the severity of radiological silicosis and to the extent of the cumulative exposure to silica, SMR for lung cancer was weakly related to the ILO categories and to the cumulative exposure to silica dust only after 20 years of lag interval. A significant excess of deaths from lung cancer (SMR 2.35) was found among silicotic patients previously employed in underground metal mines characterised by a relatively high airborne concentration of radon daughters and among ever smokers who showed an airflow obstruction at the time of the first diagnosis of silicosis (SMR 3.29). Mortality for lung cancer related to exposure was evaluated with both the Cox's proportional hazards modelling within the entire cohort and a nested case-control study (34 cases of lung cancer and 136 matched controls). Both multivariate analyses did not show any significant association with cumulative exposure to silica or severity of silicosis, but confirmed the association between mortality for lung cancer and relatively high exposure to radon, smoking, and airflow obstruction as significant covariates. Conclusions-The findings indicate that the slightly increased mortality for lung cancer in this cohort of silicotic patients was significantly associated with other risk factors-such as cigarette smoking, airflow obstruction, and estimated exposure to radon daughters in underground mines-rather than to the severity of radiological silicosis or to the cumulative exposure to crystalline silica dust itself. (Occup Environ Med 2001;58:786-793)

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Carcinoma of the lung in Ontario gold miners: possible aetiological factors.

Cited by 33 publications

References 14 publications

Lung cancer mortality and airways obstruction among metal miners exposed to silica and low levels of radon daughters

Lung cancer mortality and airways obstruction among metal miners exposed to silica and low levels of radon daughters

Occupational associations with lung cancer in two Ontario cities

Mortality from lung cancer among silicotic patients in Sardinia: an update study with 10 more years of follow up

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