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Respirable Crystalline Silica Exposure–Response Evaluation of Silicosis Morbidity and Lung Cancer Mortality in the German Porcelain Industry Cohort

Mundt, Kenneth A PhD; Birk, Thomas Dipl rer soc; Parsons, William MS; Borsch-Galetke, Elisabeth PhD, MD; Siegmund, Klaus MD; Heavner, Karyn PhD; Guldner, Karlheinz PhD


Kenneth A. Mundt, PhD, Thomas Birk, Dipl rer soc, and Lori Crawford, MS

While conducting more advanced analyses of the German Porcelain Industry Cohort data the authors uncovered an error in the coding of person-time for the non-silicosis cases. Specifically, in the original version, person-time was accrued until end of follow-up instead of the date of the last available negative radiograph, as stated in the text. The more advanced data analyses included treatment of age as a time-dependent parameter (vs. age at end of follow-up in the original report). Results due to the treatment of age were negligibly different. A corrected version of Table 3 is provided, as well as a new set of supplemental tables (see Supplemental Digital Content Table A at , Table B at , and Table C at ), both of which include age as a time-dependent variable.

Journal of Occupational and Environmental Medicine. 54(10):1309, October 2012.

Journal of Occupational and Environmental Medicine: March 2011 - Volume 53 - Issue 3 - p 282–289
doi: 10.1097/JOM.0b013e31820c2bff
Original Articles

Objective: To quantify silicosis and lung cancer risks among porcelain workers occupationally exposed to respirable crystalline silica.

Methods: We reread historical radiographs to identify silicosis and estimated exposure on the basis of detailed work history and about 8000 industrial hygiene measurements. Cox proportional hazards models estimated risks by cumulative and average exposure.

Results: Adjusted silicosis hazards ratios were 5.3 (95% confidence interval [CI], 1.6 to 17.3); 7.3 (95% CI, 2.6 to 20.8); and 6.8 (95% CI, 3.0 to 15.3) for cumulative exposures >4 to 5; >5 to 6; and >6 mg/m3-years, and 3.3 (95% CI, 0.8 to 14.7), 13.6 (95% CI, 4.2 to 44.4) and 23.2 (95% CI, 8.2 to 65.8) for average exposures >0.1 to 0.15; >0.15 to 0.2 and >0.2 mg/m3, respectively. Exposure was not associated with any cause of death including lung cancer.

Conclusions: Respirable crystalline silica exposure more than 4 mg/m3-years (cumulative) or more than 0.15 mg/m3 (average) were strongly associated with silicosis, but unrelated to lung cancer risks.

Supplemental Digital Content is available in the text.

From the ENVIRON International Corporation (Dr Mundt, Mr Parsons, Dr Heavner), Amherst, Mass; ENVIRON Germany, GmbH (Mr Birk), Essen, Germany; Institute of Occupational and Social Medicine (Dr Borsch-Galetke, Dr Siegmund), Heinrich Heine University, Düsseldorf, Germany; and Verwaltungs-Berufsgenossenschaft (Dr Guldner), Würzburg, Germany.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Address correspondence to: Kenneth A. Mundt, PhD, ENVIRON International Corporation, 28 Amity St, Ste 2A, Amherst, Massachusetts; E-mail:

©2011The American College of Occupational and Environmental Medicine