Nasrullah-M; Mazurek-JM; Wood-JM; Bang-KM; Kreiss-K
Am J Epidemiol 2011 Oct; 174(7):839-848
The presence of tuberculosis (TB) in patients with silicosis increases mortality risk. To characterize silicosis-respiratory TB comortality in the United States, the authors used 1968-2006 National Center for Health Statistics multiple cause-of-death data for decedents aged greater than or equal to 25 years. The authors calculated proportionate mortality ratios (PMRs) using available information on decedents' industries and occupations reported from 26 states from 1985 through 1999. Among 16,648 silicosis deaths, 2,278 (13.7 percent) had respiratory TB listed on the death certificate. Of silicosis-respiratory TB deaths, 1,666 decedents (73.1 percent) were aged greater than or equal to 65 years, 2,255 (99.0 percent) were male, and 1,893 (83.1 percent were white. Silicosis-respiratory TB deaths declined 99.5 percent during the study period (P less than 0.001 for time-related trend), from 239.8 per year during 1968-1972 to 1.2 per year during 2002-2006, with no reported deaths in 2006. Silicosis-respiratory TB deaths reported from Pennsylvania (n = 525; 1.29 per million population), Ohio (n = 258; 0.81 per million), and West Virginia (n = 146; 2.35 per million) accounted for 40.8 percent of all such deaths in the United States. The highest PMR for silicosis-respiratory TB death was associated with the "miscellaneous nonmetallic mineral and stone products" industry (PMR = 73.7, 95 percent confidence interval: 33.8, 139.8). In the United States, 2006 marked the first year since 1968 with no silicosis-respiratory TB deaths. The substantial decline in silicosis-respiratory TB comortality probably reflects prevention and control measures for both diseases.
Epidemiology; Respiratory-system-disorders; Pulmonary-system-disorders; Lung-disease; Silicosis; Silica-dusts; Risk-factors; Mortality-data; Mortality-rates; Age-groups; Statistical-analysis; Information-retrieval-systems; Surveillance-programs;
Author Keywords: industry; mortality; occupational exposure; occupations; silicosis; tuberculosis
M. Nasrullah, Centers for Disease Control and Prevention, Division of HIV AIDS Prevention, Epidemic Intelligence Service, 1600 Clifton Road NE, Mailstop E46, Atlanta, GA 30333
American Journal of Epidemiology