Silicosis Mortality Surveillance in the United States, 1968–1990

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Abstract
The temporal, demographic, geographic, and occupational patterns of silicosis mortality in the United States were examined based on the national multiple-cause-of-death data available since 1968 from the National Center for Health Statistics. Since silicosis is an occupational lung disease, decedents less than 15 years old were excluded. The total number of deaths with silicosis was 13,744 for the period 1968 to 1990, and silicosis was the underlying cause of death in approximately 46 percent of these deaths. Approximately 98 percent of deaths with silicosis occurred in males. The racial distribution of decedents with silicosis was 88.4 percent white, 11.3 percent black, and 0.3 percent other races. An annual maximum of 1157 silicosis deaths occurred in 1968 and a minimum of 301 occurred in 1988. The annual age-adjusted mortality rate per million population declined from a maximum of 5.64 in 1968 to a minimum of 0.96 in 1988 and 1989. In recent years the annual silicosis death counts and rates have not evidenced continued declines. Deaths with silicosis were concentrated in 12 states: California, Colorado, Florida, Illinois, Michigan, New Jersey, New York, Ohio, Pennsylvania, Virginia, West Virginia, and Wisconsin accounted for 68 percent of all silicosis deaths. Based on a subset of the national data for which usual industry and occupation information was available, the construction industry accounted for the highest proportion of silicosis deaths—over 10 percent of the total. By occupation, silicosis proportionate mortality ratios (PMRs) were highest in metal/plastic processing machine operators (PMR = 330, 95% confidence interval = 142 to 650), although all of the ten highest occupation-specific PMRs were statistically significant. These silicosis mortality data can be utilized to develop hypotheses for further research, to target and prioritize interventions to prevent silicosis, and to evaluate the effectiveness of silicosis prevention efforts. Bang, K.M.; Althouse, R.B.; Kim, J.H.; Game, S.R.; Castellan, R.M.: Silicosis Mortality Surveillance in the United States, 1968–1990. Appl. Occup. Environ. Hyg. 10(12):1070–1074;1995.