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

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. (J Occup Environ Med. 2009;51: 373-385)