Silicosis and end-stage renal disease
Scandinavian Journal of Work, Environment and Health
and end-stage renal disease. Scand J Work Environ Health 2002;28(6):439-442. Objectives The objective of this study was to determine the incidence of renal disease among workers with silicosis. Methods A population of 1328 workers with definite silicosis and adequate work history information, drawn from three states with silicosis surveillance systems, was followed. Renal disease was ascertained via linkage of the cohort with a United States register (which has existed since 1977) of end-stage
... 1977) of end-stage renal disease. Results In the first analysis, it was assumed that the risk of end-stage renal disease began upon exposure to silica. In this analysis 12 cases of end-stage renal disease were found versus 15.6 expected, for a rate ratio of 0.77. Four cases of glomerular end-stage renal disease were found (standardized incidence ratio 2.65, 95% confidence interval 0.56-5.25). It is possible that some persons with end-stage renal disease died before being entered into the silicosis registers. In a second analysis, person-time at risk was assumed to begin at the date of entry into the silicosis register. A rate ratio of 1.67 (95% confidence interval 0.76-3.17) was found for end-stage renal disease on the basis of nine observed cases. Conclusions The results do not clearly show that patients with silicosis have an excess of end-state renal disease, although they do suggest an excess of glomerular end-stage renal disease. Analyses were limited by small numbers and possible selection biases.