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Mortality in the German Porcelain Industry 1985–2005: First Results of an Epidemiological Cohort Study

Birk, Thomas Dipl rer soc; Mundt, Kenneth A. PhD; Guldner, Karlheinz PhD; Parsons, William MS; Luippold, Rose S. MS

Journal of Occupational and Environmental Medicine: March 2009 - Volume 51 - Issue 3 - p 373-385
doi: 10.1097/JOM.0b013e3181973e19
Original Articles

Objectives: To evaluate mortality due to lung cancer, silicosis, renal cancer, renal disease and other causes among German porcelain production workers potentially exposed to crystalline silica.

Methods: Seventeen thousand six hundred forty-four medical surveillance participants (1985–1987) were followed through 2005 for mortality. Cause-specific Standardized Mortality Ratios (SMR) and 95% confidence intervals were estimated.

Results: Women (SMR = 0.85; 95% CI = 0.78 to 0.93), but not men, demonstrated a healthy worker effect. Lung and renal cancers, and renal disease (non-malignant renal disease) were not associated with employment or exposure surrogates. Mortality was increased from silicosis (SMR = 7.20; 95% CI = 2.32 to 16.8) liver (SMR = 1.99; 95% CI = 1.29 to 2.93) and pancreatic (SMR = 1.71; 95% CI = 1.18 to 2.41) cancers among men, and diabetes among women (SMR = 1.74; 95% CI = 1.07 to 2.65). A sub-cohort of Bavarian workers generated similar but generally higher SMRs.

Conclusions: Silicosis mortality was increased in this, among the largest studies to date. However, associations previously observed between crystalline silica exposure and renal or lung cancers or non-malignant renal disease were not supported.

From Environ Germany GmbH (Mr Birk), Essen, Germany; Environ International Corporation (Dr Mundt, Mr Parsons, Ms Luippold), Amherst, Mass; and Berufsgenossenschaft der keramischen und Glas-Industrie (Dr Guldner), Wuerzburg, Germany.

Address correspondence to: Thomas Birk, Dipl rer soc, Environ Germany GmbH, Herbrueggenstrasse 106, 45359 Essen; E-mail:

©2009The American College of Occupational and Environmental Medicine