According to the report of centers for disease control and prevention in US, smoking causes about 90% of all lung cancer deaths and about 80% of all death from chronic obstructive pulmonary disease (COPD). ![]() As we know, cigarette smoking has been confirmed to be the main cause of lung cancer and respiratory diseases mortality. Meanwhile, studies revealed that smoking also play an important role in the occurrence and progress of these diseases (Duncan et al., 2019 Hirsch et al., 2017). And we found positive association between silica dust exposure and mortality of respiratory diseases, lung cancer and CVDs. In our previous study, we have explored the association between silica dust exposure and total and specific mortality among 74,040 workers (Chen et al., 2012). Long-term exposure to silica dust has been established to be associated with higher mortality of silicosis (Mundt et al., 2011), cardiovascular diseases (CVDs) (Liu et al., 2014), lung cancer (Liu et al., 2013) and other respiratory diseases (Chiazze et al., 2002). The adverse health effects of silica exposure are an increasing public health concern for decades. It is estimated that tens of millions of workers worldwide (Leung et al., 2012) and 23 million Chinese workers are exposed to silica dust. Long-term silica dust exposure is associated with increased mortality in the absence of cigarette smoking.Ĭrystalline silica is one of the commonest minerals on earth, and silica dust has been reported to be one of the most serious occupational hazards in the workplace (Steenland and Ward, 2014). With regard to lung cancer, compared with unexposed group, the HRs and 95% CI were 0.94 (0.52–1.71), 1.86 (1.15–3.00), 1.65 (0.95–2.86) for low, medium, and high exposed workers, respectively. In addition, we estimated that 4.19%, 20.69%, 7.48% and 34.06% of deaths for all cause, respiratory tuberculosis, CVDs, and diseases of the respiratory system among Chinese workers were attributed to silica, after adjusting for other covariates. We found higher standardized mortality ratios for respiratory tuberculosis (2.62, 2.32–2.95), CVDs (1.43, 1.32–1.54), and pneumoconiosis (77.75, 68.21–88.25) among silica dust exposed workers. We observed 3937 deaths during 589,357.26 person-years of follow-up. Cumulative respirable silica dust exposure (CDE) was estimated by linking a job-exposure matrix to personal work history. We studied 17,130 workers employed for at least 1 year between Januand December 31, 1974, with follow-up until the end of 2013. We aimed to evaluate the association of silica dust exposure with mortality among never smokers. The association of silica dust exposure with mortality among never smokers has not been well established.
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