Extended follow-up of lung cancer and non-malignant respiratory disease mortality among California diatomaceous earth workers

The updated analysis on mortality among 2343 California diatomaceous earth (DE) workers provides useful information and occupational crystalline silica on health.1

Previously followed through 1992,2 the mortality of this cohort was updated through 2011. Results most relevant to crystalline silica exposure are summarised below (table 1).

The deficit of lung cancer mortality in the update period appears to 'balance out' the earlier excess. For chronic obstructive pulmonary disease and pneumoconiosis, earlier increased mortality was not sustained.

Cox proportional hazards analyses controlling for other factors, but not smoking (unknown for half the workers), demonstrated that the earlier excesses of lung cancer and respiratory diseases were concentrated in the highest exposure groups. For lung cancer, only the highest exposure category (>5.6 mg/m³-years), lagged by 15 years, produced a statistically significant hazards ratio (HR) (2.2, 95% CI 1.07 to 4.5). HRs for non-malignant respiratory disease (NMRD) mortality, regardless...

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