ArticleFrontiers in public health2025
Results of 15 years of extended follow-up of the German porcelain workers cohort study: lung cancer and silicosis.
Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review of the epidemiological evidence of associations between quantified occupational exposure to respirable crystalline silica and the risk of silicosis and lung cancer.Frontiers in public health · 2025Pooled it
- Challenges in defining thresholds for health effects: some considerations for asbestos and silica.Frontiers in epidemiology · 2025Review
- Risk characterization for silica-related silicosis and lung cancer in communities adjacent to sand and gravel extraction facilities: examining limitations in our current risk methods.Frontiers in public health · 2025Article
- Using threshold Cox models to estimate change points in exposure-response relationships in an occupational epidemiological study of respirable crystalline silica and silicosis risk.Frontiers in public health · 2025Article
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4 authors.
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Abstract
Objectives: To quantify, after extending follow-up 15 years, the relationship between occupational respirable crystalline silica (RCS) exposure and risk of silicosis diagnosis and lung cancer mortality in the German Porcelain Workers Cohort Study, and to estimate possible exposure thresholds for these. Methods: Porcelain workers enrolled between January 1, 1985, and December 31, 1987, in a mandatory medical surveillance program including triennial chest x-rays and alive at the end of the previous study follow-up (2005) were followed through December 2020, for lung cancer mortality and silicosis incidence. Cause of death was determined from death certificates. Silicosis cases were identified by re-reading x-rays of individuals remaining in the medical surveillance program or filing insurance claims for silicosis. RCS exposure was estimated for each cohort member using a job exposure matrix (JEM) based on about 8,000 historical industrial hygiene RCS measurements. Cause-specific standardized mortality ratios (SMRs) and Cox proportional hazards ratios (HRs) and their 95% confidence intervals (95% CIs) were estimated by cumulative and average exposure groups, controlling for age, sex, smoking status and employment duration. Exposure-response analyses were performed to identify possible exposure thresholds for lung cancer and silicosis risk. Results: Total deaths increased from 1,610 (9.1%) to 4,586 (26%) over 537,129 total person-years at risk. All-cause mortality was elevated among men (SMR = 1.10, 95% CI 1.06-1.14); however, a deficit was seen among women (SMR = 0.93, 95% CI 0.89-0.98). No statistically significantly increased mortality was seen due to lung cancer, renal cancer, or non-malignant renal disease - conditions reportedly associated with RCS exposure. Lung cancer mortality was unrelated to RCS exposure level. However, for silicosis cases classified using International Labor Organization (ILO) categories ≥1/1 or 1/0, risk was strongly associated with estimated average exposure >0.10 mg/m Conclusion: Despite the large number (
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