8292541 Modeling long-term lung cancer risk from exposure to respirable crystalline silica. effect of lowering exposures over a 20 year period in the European minerals industry?

<h3>Objective</h3> Occupational exposure to respirable crystalline silica (RCS) is a well-established risk factor for lung cancer. Exposure to RCS however is still very prevalent and will not be easily phased-out. Though exposures are better controlled, health gain from these interventions remains unknown. To estimate the number of lung cancer cases prevented as a result of controlling exposure to RCS over two decades in an entire European industrial-sector. <h3>Material and Methods</h3> The Industrials Minerals Association Dust Monitoring Program (IMA-DMP) focused on lowering exposure to RCS. The IMA-DMP database was used to estimate cumulative RCS for the IMA cohort of approximately 75,000 workers. A simulation model was used to estimate the number of lung cancer cases for two scenarios: one without intervention with a Geometric Mean exposure of 14 µg/m3 throughout the entire period and one where exposures declined over time (intervention). <h3>Results</h3> Our study included 44,435 RCS measurements, for which we estimated a 4.5% decrease per year over the period 2002-2022. The estimated number of lung cancer cases prevented during this period totaled about 3 cases (2.4% of the total number of lung cancer cases attributable to silica exposure and 0.3% of the total number of lung cancer cases that would have occurred without the intervention). Estimated GM exposure levels in the cohort at the end of follow-up were estimated to be 60% lower than at the start, while GM cumulative exposures were 28% lower. <h3>Conclusions</h3> The results show a relatively small number of prevented lung cancer cases resulting from an industry-wide dust monitoring program. This is likely to be due to the relatively young age of the cohort and the limited follow-up. However, given that there is no threshold below which lung cancer will not occur there is a need to continue the IMA-DMP and lower (future) workers’ cumulative exposure in order to preserve workers’ health and life.