Coal Mine Dust Exposure and Cancer Mortality in German Coal Miners

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Abstract
Exposure to quartz dust or quartz-containing dusts is suspected to initiate or promote the development of cancer, especially lung cancer. In Germany, coal miners of the Saar area are exposed to respirable coal mine dust with a quartz content of about 12 percent. An historical followup study was conducted on a group of 4628 Saar coal miners who worked at least 5 years underground. External comparisons with the male Saar area population were performed by SMR and RSMR (= SMRspec/SMRoverall) analyses. Three hundred and seventeen deaths occurred in the study period between January 1,1980 and December 31, 1991. The SMR (with 0.95 confidence limits) was estimated as 0.63 (0.6–0.7) for overall mortality, 0.65 (0.5–0.8) for cancer mortality, 0.70 (0.5–1.0) for lung cancer mortality, 0.62 (0.2–1.4) for stomach cancer mortality, and 1.27 (0.7–2.2) for malignancies of the lymphatic and hematopoietic tissue. RSMRs were not significantly different from expected except for malignancies of the lymphatic and hematopoietic tissue. Breaking down RSMRs by time since first exposure indicates a rising risk for malignancies of the lymphatic and hematopoietic tissue, but no association was found for cancer or lung cancer risk. Taking into account that smokers are more frequent among coalminers (≈ 50%) than in the general male population of the Saar area (≈ 33%), no indication of an increased cancer or lung cancer risk in coal miners was found (even when considering RSMRs to adjust for the pronounced healthy worker selection). In general, these results are in line with findings from Great Britain, the United States, and The Netherlands. Not-significant results for stomach cancer and malignancies of the lymphatic and hematopoietic tissue suffer from small numbers. A further followup and a more detailed analysis of the healthy worker selection effects are necessary to validate these results.

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