Silicosis Incidence and Mortality after Occupational Exposure with Silica Dust: A Systematic Review and Dose-Response Meta-Analysis.

Background: We conducted a systematic review of all published epidemiological research related to the relationship between occupational silica exposure and the rates of silicosis incidence and mortality. Methods: We searched Scopus, PubMed, and Web of Sciences up to 11/07/2023, for original in any language. The search start date was not limited Observational studies, including cohort, case-control, and cross-sectional that have reported risk estimates for the association between silica exposure and silicosis mortality and incidence rates were considered. The methodological quality of the included articles was assessed using the Newcastle-Ottawa scale. Pooled estimates were calculated using the random effects model. Dose-response relations were explored through a two-stage random-effects model with "drmeta" command in Stata software version 14. Results: Nineteen observational studies were included in the present systematic review and meta-analysis. Based on the linear dose-response analysis, with each mg/m3 increase in daily occupational exposure to silica, the mortality risk of silicosis, the odds and risk of silicosis occurrence significantly increased by 10.19%, 360.02%, and 4.43 × 108%, respectively. Conclusion: This review revealed that there is a linear dose-response relationship between occupational exposure to silica and incidence and mortality from silicosis. Our findings could have practical applications for occupational and public health. Considering the direct relationship between occupational silica exposure and high incidence and mortality rates of silicosis, the level of silica dust should be decreased in different industries.