Mortality on malignant and non-malignant diseases of respiratory tract in persons with acknowledged silicosis in the Czech Republic

Czech version

Authors: A. Šplíchalová ^1,3; H. Tomášková ^1,3; Z. Jirák ²
Authors‘ workplace: Ústav epidemiologie a ochrany veřejného zdraví, Lékařská fakulta, Ostravská univerzita Ostrava, vedoucí prof. MUDr. Vladimír Janout, CSc. ¹; Katedra fyziologie a patofyziologie, Lékařská fakulta, Ostravská univerzita Ostrava, vedoucí prof. MUDr. Zdeněk Jirák, CSc. ²; Zdravotní ústav se sídlem v Ostravě, ředitel RNDr. Petr Hapala ³
Published in: Pracov. Lék., 62, 2010, No. 4, s. 170-178.
Category: Original Papers

Overview

The aim of this study was to compare mortality from malignant and non-malignant respiratory diseases in workers with acknowledged silicosis and non-exposed general population of men in the Czech Republic. The study sample included 797 men newly registered with silicosis in the National Registry of Occupational Diseases in the period 1992–2001.

Basic data on the study sample obtained from the National Registry of Occupational Diseases were combined with data from the National Population Registry. Comparison of mortality of the study sample and the Czech men population was evaluated by calculation of SMR (Standardized Mortality Ratio) in the period 1992–2006. Average age of the study sample at time of diagnosed silicosis was 60.4 years; average exposure was 24.2 years. Of the total number of 797 men, 335 men died (42.0%) in the period 1992–2006; average age at time of death was 70.8 years. Significantly higher mortality from non-malignant (SMR = 4.3, 95% CI 3.2–5.6) and malignant respiratory diseases (SMR = 2.4, 95% CI 1.8–3.2) was confirmed in workers with silicosis compared to the general Czech men population. Significantly higher non-malignant respiratory diseases mortality was associated especially with silicosis mortality (SMR = 353.0, 95% CI 226,2–534.8), prevalence of which in general population is rare, than lung tuberculosis mortality (SMR=25.0; 95% CI 7.9–60.3), and chronic obstructive pulmonary disease mortality (SMR = 2.5; 95% CI 1.3–4.5). Non-malignant respiratory diseases mortality increased in relation to the degree of severity of silicosis accordin to ILO classification in the study sample and in the category of progressive massive fibrosis was more than 8 times higher compared to the general population (SMR = 8.4, 95% CI 5.0–13.3). Malignant respiratory diseases mortality increased with the level of silica dust exposure and the highest risk was found in the group with the highest exposure (SMR = 3.1, 95% CI 1.6–5.3). The lung cancer mortality was found 4.5 times higher in smokers compared to non-smokers in the study sample. This relationship was not confirmed for non-malignant respiratory diseases mortality.

Key words:
mortality, silicosis, lung cancer, lung tuberculosis, chronic obstructive pulmonary disease, smoking

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Article was published in

Occupational Medicine

2010 Issue 4