Abstract
OBJECTIVES: To evaluate whether ceramic workers exposed to silica experience an excess of end stage renal disease. METHODS: On the basis of a health surveillance programme, a cohort of 2980 male ceramic workers has been enrolled during the period 1974-91 in Civitacastellana, Lazio, Italy. For each worker, employment history, smoking data, and x ray film readings were available. The vital status was ascertained for all cohort members. All 2820 people still alive and resident in the Lazio region as in June 1994 were searched for a match in the regional end stage renal diseases registry, which records (since June, 1994) all patients undergoing dialysis treatment in public and private facilities of the region. Expected numbers of prevalent cases from the cohort were computed by applying the rate of patients on dialysis treatment by the age distribution of the cohort. RESULTS: A total of six cases was detected when 1.87 were expected (observed/expected (O/E) = 3.21; 95% confidence interval (95% CI) 1.17 to 6.98). The excess risk was present among non-smokers (O = 2; O/E = 4.34) and smokers (O = 4; O/E = 2.83), as well as among workers without silicosis (O = 4; O/E = 2.78) and workers with silicosis (O = 2; O/E = 4.54). The risk was higher among subjects with < 20 years since first employment (O = 4; O/E = 4.65) than among those employed > 20 years. CONCLUSION: These results provide further evidence that exposure to silica dust among ceramic workers is associated with nephrotoxic effects.
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Selected References
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- Arnalich F., Lahoz C., Picazo M. L., Monereo A., Arribas J. R., Martínez Ara J., Vázquez J. J. Polyarteritis nodosa and necrotizing glomerulonephritis associated with long-standing silicosis. Nephron. 1989;51(4):544–547. doi: 10.1159/000185391. [DOI] [PubMed] [Google Scholar]
- Bolton W. K., Suratt P. M., Strugill B. C. Rapidly progressive silicon nephropathy. Am J Med. 1981 Nov;71(5):823–828. doi: 10.1016/0002-9343(81)90374-0. [DOI] [PubMed] [Google Scholar]
- Boujemaa W., Lauwerys R., Bernard A. Early indicators of renal dysfunction in silicotic workers. Scand J Work Environ Health. 1994 Jun;20(3):180–183. doi: 10.5271/sjweh.1411. [DOI] [PubMed] [Google Scholar]
- Calvert G. M., Steenland K., Palu S. End-stage renal disease among silica-exposed gold miners. A new method for assessing incidence among epidemiologic cohorts. JAMA. 1997 Apr 16;277(15):1219–1223. [PubMed] [Google Scholar]
- Cavariani F., Di Pietro A., Miceli M., Forastiere F., Biggeri A., Scavalli P., Petti A., Borgia P. Incidence of silicosis among ceramic workers in central Italy. Scand J Work Environ Health. 1995;21 (Suppl 2):58–62. [PubMed] [Google Scholar]
- Di Lallo D., Miceli M., Perucci C. A. Epidemiologia descrittiva dei pazienti con insufficienza renale in trattamento dialitico cronico. Risultati del Registro di Popolazione del Lazio. Il Registro Dialisi Lazio. Epidemiol Prev. 1997 Jul-Sep;21(3):194–201. [PubMed] [Google Scholar]
- Fubini B., Bolis V., Cavenago A., Volante M. Physicochemical properties of crystalline silica dusts and their possible implication in various biological responses. Scand J Work Environ Health. 1995;21 (Suppl 2):9–14. [PubMed] [Google Scholar]
- Haustein U. F., Ziegler V., Herrmann K., Mehlhorn J., Schmidt C. Silica-induced scleroderma. J Am Acad Dermatol. 1990 Mar;22(3):444–448. doi: 10.1016/0190-9622(90)70062-m. [DOI] [PubMed] [Google Scholar]
- Hnizdo E., Sluis-Cremer G. K. Risk of silicosis in a cohort of white South African gold miners. Am J Ind Med. 1993 Oct;24(4):447–457. doi: 10.1002/ajim.4700240409. [DOI] [PubMed] [Google Scholar]
- Hotz P., Gonzalez-Lorenzo J., Siles E., Trujillano G., Lauwerys R., Bernard A. Subclinical signs of kidney dysfunction following short exposure to silica in the absence of silicosis. Nephron. 1995;70(4):438–442. doi: 10.1159/000188642. [DOI] [PubMed] [Google Scholar]
- Ng T. P., Lee H. S., Phoon W. H. Further evidence of human silica nephrotoxicity in occupationally exposed workers. Br J Ind Med. 1993 Oct;50(10):907–912. doi: 10.1136/oem.50.10.907. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nuyts G. D., Van Vlem E., Thys J., De Leersnijder D., D'Haese P. C., Elseviers M. M., De Broe M. E. New occupational risk factors for chronic renal failure. Lancet. 1995 Jul 1;346(8966):7–11. doi: 10.1016/s0140-6736(95)92648-8. [DOI] [PubMed] [Google Scholar]
- Saldanha L. F., Rosen V. J., Gonick H. C. Silicon nephropathy. Am J Med. 1975 Jul;59(1):95–103. doi: 10.1016/0002-9343(75)90326-5. [DOI] [PubMed] [Google Scholar]
- Sanchez-Roman J., Wichmann I., Salaberri J., Varela J. M., Nuñez-Roldan A. Multiple clinical and biological autoimmune manifestations in 50 workers after occupational exposure to silica. Ann Rheum Dis. 1993 Jul;52(7):534–538. doi: 10.1136/ard.52.7.534. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Shoemaker D. A., Pretty J. R., Ramsey D. M., McLaurin J. L., Khan A., Teass A. W., Castranova V., Pailes W. H., Dalal N. S., Miles P. R. Particle activity and in vivo pulmonary response to freshly milled and aged alpha-quartz. Scand J Work Environ Health. 1995;21 (Suppl 2):15–18. [PubMed] [Google Scholar]
- Steenland K., Brown D. Mortality study of gold miners exposed to silica and nonasbestiform amphibole minerals: an update with 14 more years of follow-up. Am J Ind Med. 1995 Feb;27(2):217–229. doi: 10.1002/ajim.4700270207. [DOI] [PubMed] [Google Scholar]
- Steenland K., Brown D. Silicosis among gold miners: exposure--response analyses and risk assessment. Am J Public Health. 1995 Oct;85(10):1372–1377. doi: 10.2105/ajph.85.10.1372. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Steenland K., Goldsmith D. F. Silica exposure and autoimmune diseases. Am J Ind Med. 1995 Nov;28(5):603–608. doi: 10.1002/ajim.4700280505. [DOI] [PubMed] [Google Scholar]
- Steenland K., Nowlin S., Ryan B., Adams S. Use of multiple-cause mortality data in epidemiologic analyses: US rate and proportion files developed by the National Institute for Occupational Safety and Health and the National Cancer Institute. Am J Epidemiol. 1992 Oct 1;136(7):855–862. doi: 10.1093/aje/136.7.855. [DOI] [PubMed] [Google Scholar]
- Steenland N. K., Thun M. J., Ferguson C. W., Port F. K. Occupational and other exposures associated with male end-stage renal disease: a case/control study. Am J Public Health. 1990 Feb;80(2):153–157. doi: 10.2105/ajph.80.2.153. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wichmann I., Sanchez-Roman J., Morales J., Castillo M. J., Ocaña C., Nuñez-Roldan A. Antimyeloperoxidase antibodies in individuals with occupational exposure to silica. Ann Rheum Dis. 1996 Mar;55(3):205–207. doi: 10.1136/ard.55.3.205. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wilke R. A. Occupational exposure to silica and end-stage renal disease. JAMA. 1997 Aug 20;278(7):546–547. [PubMed] [Google Scholar]
- Wilke R. A. Occupational exposure to silica and end-stage renal disease. JAMA. 1997 Aug 20;278(7):546–547. [PubMed] [Google Scholar]
