Lessons from silicosis control in China

Prevalence characteristics and prediction of coal workers' pneumoconiosis in the Tiefa Colliery in China

To explore characteristics of the development of coal workers' pneumoconiosis (CWP) at present and trend in the future, we investigated 16,154 coal miners exposed to dust for at least 1 yr in the Tiefa Colliery in China. Occupational categories were divided into tunneling, mining, combining and helping. Four cohorts (before 1958, 1958-, 1968-, and after 1978) were created according to years of first exposure. Life-Table Method was used to calculate cumulative incidence rates of CWP adjusted by duration of dust exposure and predict the number of the new CWP patients. Results indicated that cumulative incidence rates of CWP in four cohorts were 26.65%, 18.94%, 1.15%, and 0.06%, respectively (Chi(2)=493.57, p<0.0001). The 55-yr cumulative rate of CWP of tunneling miners (25.90%) or that of combining miners (14.53%) was statistically higher than that of mining miners (7.26%) or that of helping miners (0.89%). The number of new CWP patients predicted in future was approximately 77. New CWP patients predicted would mainly occur among coal miners with first dust exposure in 1958-1967 and those working at tunneling. Most of them could be diagnosed in the age group from 45 to 75 and in the period of the next 20 yr from 2008 to 2028.

Exposures to silica mixed dust and cohort mortality study in tin mines: exposure-response analysis and risk assessment of lung cancer

BACKGROUND

Mineral dusts that contain crystalline silica have been associated directly or indirectly with the development of pneumoconiosis or silicosis, non-malignant respiratory diseases, lung cancer, and other diseases. The health impacts on workers with silica mixed dust exposure in tin mines and dose-response relationships between cumulative dust exposure and the mortality from lung cancer are investigated.

METHODS

A cohort of 7,837 workers registered in the employment records in 4 Chinese tin mines between 1972 and 1974 was identified for this study and the mortality follow-up was traced through 1994. Of the cohort, the cause of death was ascertained for 1,061 (97%) of the 1,094 deceased workers. Standardized mortality ratios (SMRs) were calculated for all workers, non-exposed workers, and dust-exposed workers with different exposure levels, silicotics, and non-silicotics based on Chinese national rates.

RESULTS

The mortality from all causes in four tin mines was nearly the same as the national mortality. Malignant neoplasm, cerebrovascular disease, and cardiovascular disease accounted for 68.6% of all deaths. Mortality excess from lung cancer, liver cancer, all malignant diseases, and non-malignant respiratory diseases was observed among dust-exposed workers; a 50-fold excess of pneumoconiosis was observed. There was an upward trend for SMRs of lung cancer was noted from no exposure to low, medium, and high exposure levels (SMRs=1.29, 2.65, 2.66, 3.33). The shape of the exposure-response curve for risk of lung cancer at high exposure levels was inconsistent in these four mines.

CONCLUSIONS

The findings indicated a positive dose-response relation between exposure to cumulative dust and the mortality of lung cancer. High arsenic content in dust particles, together with crystalline silica, may play an important role in causing increased mortality from lung cancer.

Lung cancer among tin miners in southeast China: silica exposure, silicosis, and cigarette smoking

The Dachang Tin Mine is an industrial facility with high rates of lung cancer compared to the resident population in Guangxi province in southern China. Historically, exposure to silica dust was very high in the 1950s, falling in recent years to levels in keeping with international standards. Radon levels in the mine are low. We report the findings of a case-control study nested into a cohort study on miners working in Dachang. Cases of lung cancer among miners incident from 1973-1989 were obtained from local comprehensive medical records covering workers employed at the mine. These were matched approximately 3 to 1 with miners randomly chosen from the district surrounding the mine within the same birth decade. Matched odds ratios of 2.42 (95% confidence limit [CL] 1.3, 4.4) for underground employment, 3.52 (95% CL 1.7, 7.5) for smoking, and 2.04 (95%) CL 1.2, 3.7) for silicosis as determined on chest film were noted. Multifactor analysis of unconditional logistic regression showed that among the risk factors for excess mortality from lung cancer only the years spent drilling underground and the cumulative smoking index (product of daily cigarette consumption and number of years smoking) were independent contributors to risk and there was no interaction observed. The presence of silicosis did not contribute to predicting risk independently of the years spent underground.

Heavy metal and selenium levels in feathers of young egrets and herons from Hong Kong and Szechuan, China

Several species of herons and egrets frequently nest in colonies in areas where humans also concentrate. Since the birds feed on intermediate-sized fish that themselves concentrate pollutants, they can be used not only to assess the levels of contaminants in avian tissues but as indicators of contaminants in the environment. The concentration of heavy metals and selenium in the breast feathers of fledgling black-crowned night herons Nycticorax nycticorax and Chinese pond herons Ardeola bacchus from the Tu Jing Yan heronry outside Chengdu, Szechuan Province in China; and from fledgling black-crowned night heron, little egret Egretta garzetta, great egret Egretta alba and cattle egret Bubulcus ibis from the Mai Po heronry in Hong Kong, were determined. Breast feathers were also collected from adult great egrets in Hong Kong. Adult great egrets had significantly higher levels of all heavy metals than did young great egrets. There were no significant interspecific differences in metal levels among the young at Szechuan China, except for chromium (pond herons had higher levels). There were significant differences among the young nesting at Hong Kong for all metals examined. Great egrets had lower, and night herons had higher, levels of lead than the other young. Night herons also had the highest levels of cadmium, manganese, and selenium compared to the other young. Great egret chicks had the lowest mercury levels, while little egret had the highest levels. Lead levels for all the birds in both Hong Kong and Szechuan were among the highest in the world, and this was attributed to the continued use of leaded gasoline.