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01.08.2019 | Original Article | Ausgabe 1/2020

International Archives of Occupational and Environmental Health 1/2020

The impact of different approaches to exposure assessment on understanding non-malignant respiratory disease risk in taconite miners

Zeitschrift:
International Archives of Occupational and Environmental Health > Ausgabe 1/2020
Autoren:
Nnaemeka U. Odo, Jeffrey H. Mandel, Bruce H. Alexander, David M. Perlman, Richard F. MacLehose, Gurumurthy Ramachandran, Andrew D. Ryan, Yuan Shao
Wichtige Hinweise

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The online version of this article (https://​doi.​org/​10.​1007/​s00420-019-01465-w) contains supplementary material, which is available to authorized users.

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Abstract

Introduction

We examined the association between cumulative silica exposures in taconite mining and non-malignant respiratory disease (NMRD) using a comprehensive assessment of current and historical exposure measurements in a cross-sectional study of Minnesota taconite mining workers. We also explored the impact of exposure measurement methods by comparing estimated exposure risk from two different exposure measurement modeling approaches.

Methods

Miners were screened with an occupational and medical history questionnaire, spirometry testing and chest x-rays per ILO guidelines. Current and historical occupational exposure assessments were obtained, the former measuring about 679 personal samples over the period of the study for respirable dusts, including silica, in 28 major job functions. Cumulative silica exposure ((mg/m3) × years) was estimated as a cumulative product of time worked and year-specific silica job exposure concentrations. Chest x-ray abnormalities were based on B-reader agreement with a third B-reader for arbitration. Forced vital capacity (FVC) less than lower limits of normal for age, height, race and gender was used to determine spirometric restrictive ventilatory defect (RVD). Prevalence ratios (PR) of exposure-outcome associations, with 95% confidence intervals (CI), were estimated using multivariate Poisson regression.

Results

Cumulative silica exposure was associated with RVD prevalence (PR = 1.41, 95% CI = 1.09–1.81) and prevalence of parenchymal abnormalities on chest x-ray (PR = 1.30, 95% CI = 1.00–1.69) using exposure estimates based primarily on current study measurements, and assuming unchanged historical exposure trend. Conversely, when exposures were defined incorporating available actual historical values, no associations were observed between silica exposure and either RVD (PR = 0.76, 95% CI = 0.41–1.40) or parenchymal (PR = 0.87, 95% CI = 0.45–1.70) outcomes.

Conclusions

This study demonstrated that the estimated association between silica dust exposure and lung disease is highly sensitive to the approach used to estimate cumulative exposure. Cumulative values based on conservative estimates of past exposure, modeled from recently measured respirable silica, showed an association with restriction RVD on spirometry. Silica exposure was also significantly associated with increased parenchymal findings on chest x-ray using this approach. Conversely, these findings were absent when actual available historical data was used to estimate cumulative silica exposure. These differences highlight the challenges with estimating occupational dust exposure, the potential impact on calculated exposure risk and the need for long term quality exposure data gathering in industries prone to risk from inhaled respirable dusts.

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