Association between Silica Exposure and Cardiovascular Disease Mortality: A Meta-Analysis
Abstract
Background: Silica exposure is detrimental to health and has, thus, been a global health concern. We performed a systematic review and meta-analysis of existing articles to assess the involvement of silica exposure in cardiovascular disease (CVD) mortality.
Methods: Electronic databases including Web of Sciences, Scopus, PubMed, and Google Scholar were searched for eligible publication until December 2019. The pooled standard mortality ratio (SMR) and the 95% confidence interval (CI) were used to detect the association between silica exposure and CVD mortality.
Results: The pooled estimates of SMR indicated a nonsignificant association between silica exposure and CVD mortality (SMR: 1.26; 95% CI: 0.88-1.63). The subgroup analysis based on the type of CVD indicated a significant positive association between silica exposure and mortality from hypertensive heart disease (SMR: 2.45; 95% CI: 2.16 -2.74) and pulmonary heart disease (SMR: 4.03; 95% CI: 3.87-4.20).
Conclusion: This study confirmed that silica exposure is associated with an enhanced risk of mortality of hypertensive and pulmonary heart diseases. The verification of these results may have important effects on basic preventive strategies for health-care providers. Because of the mismatch in the silica exposure classification, some works in the literature were excluded. Also, the years of silica exposure may be important in CVD mortality. We suggest that these potential confounders be considered in future research.
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4. Guo J, Shi T, Cui X, Rong Y, Zhou T, Zhang Z, Liu Y, Shen Y, Chen W. Effects of silica exposure on the cardiac and renal inflammatory and fibrotic response and the antagonistic role of interleukin-1 beta in C57BL/6 mice. Arch Toxicol 2016;90:247-258.
5. De Berardis B, Incocciati E, Massera S, Gargaro G, Paoletti L. Airborne silica levels in an urban area. Sci Total Environ 2007;382:251-258.
6. Liu Y, Rong Y, Steenland K, Christiani DC, Huang X, Wu T, Chen W. Long-term exposure to crystalline silica and risk of heart disease mortality. Epidemiology 2014;25:689-696.
7. The Global Occupational Health Network. Elimination of silicosis. https://b2n.ir/438391 (5 Dec 2019).
8. Mehri F, Jenabi E, Bashirian S, Shahna FG, Khazaei S. The association between occupational exposure to silica and risk of developing rheumatoid arthritis: a meta-analysis. Saf Health Work 2020;11:136-142.
9. Steenland K, Sanderson W, Calvert GM. Kidney disease and arthritis in a cohort study of workers exposed to silica. Epidemiology 2001;12:405-412.
10. Fang SC, Cassidy A, Christiani DC. A systematic review of occupational exposure to particulate matter and cardiovascular disease. Int J Environ Res Public Health 2010;7:1773-1806.
11. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 2009;6:e1000100.
12. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003;327:557-560.
13. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994;50:1088-1101.
14. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315:629-634.
15. Sterne JA, Egger M. Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol 2001;54:1046-1055.
16. Chen W, Liu Y, Wang H, Hnizdo E, Sun Y, Su L, Zhang X, Weng S, Bochmann F, Hearl FJ, Chen J, Wu T. Long-term exposure to silica dust and risk of total and cause-specific mortality in Chinese workers: a cohort study. PLoS Med 2012;9:e1001206.
17. Weiner J, Barlow L, Sjögren B. Ischemic heart disease mortality among miners and other potentially silica-exposed workers. Am J Ind Med 2007;50:403-408.
18. Fan C, Graff P, Vihlborg P, Bryngelsson IL, Andersson L. Silica exposure increases the risk of stroke but not myocardial infarction-a retrospective cohort study. PLoS One 2018;13:e0192840.
19. Merlo F, Fontana L, Reggiardo G, Ceppi M, Barisione G, Garrone E, Doria M. Mortality among silicotics in Genoa, Italy, from 1961 to 1987. Scand J Work Environ Health 1995;21 Suppl:77-80.
20. Miller BG, MacCalman L. Cause-specific mortality in British coal workers and exposure to respirable dust and quartz. Occup Environ Med 2010;67:270-276.
21. Puntoni R, Goldsmith DF, Valerio F, Vercelli M, Bonassi S, Di Giorgio F, Ceppi M, Stagnaro E, Filiberti R, Santi L. A cohort study of workers employed in a refractory brick plant. Tumori 1988;74:27-33.
22. Moulin JJ, Wild P, Mantout B, Fournier-Betz M, Mur JM, Smagghe G. Mortality from lung cancer and cardiovascular diseases among stainless-steel producing workers. Cancer Causes Control 1993;4:75-81.
23. Redon J, Tellez-Plaza M, Orozco-Beltran D, Gil-Guillen V, Pita Fernandez S, Navarro-Pérez J, Pallares V, Valls F, Fernandez A, Perez-Navarro AM, Sanchis C, Dominguez-Lucas A, Sanz G, Martin-Moreno JM; ESCARVAL Study Group. Impact of hypertension on mortality and cardiovascular disease burden in patients with cardiovascular risk factors from a general practice setting: the ESCARVAL-risk study. J Hypertens 2016;34:1075-1083.
24. De Miguel C, Rudemiller NP, Abais JM, Mattson DL. Inflammation and hypertension: new understandings and potential therapeutic targets. Curr Hypertens Rep 2015;17:507.
25. Rodrigo R, González J, Paoletto F. The role of oxidative stress in the pathophysiology of hypertension. Hypertens Res 2011;34:431-440.
26. Orman A, Kahraman A, Cakar H, Ellidokuz H, Serteser M. Plasma malondialdehyde and erythrocyte glutathione levels in workers with cement dust-exposure [corrected]. Toxicology 2005;207:15-20.
27. Fubini B, Hubbard A. Reactive oxygen species (ROS) and reactive nitrogen species (RNS) generation by silica in inflammation and fibrosis. Free Radic Biol Med 2003;34:1507-1516.
28. Zelko IN, Zhu J, Roman J. Role of SOD3 in silica-related lung fibrosis and pulmonary vascular remodeling. Respir Res 2018;19:221.
29. Sellamuthu R, Umbright C, Roberts JR, Chapman R, Young SH, Richardson D, Cumpston J, McKinney W, Chen BT, Frazer D, Li S, Kashon M, Joseph P. Transcriptomics analysis of lungs and peripheral blood of crystalline silica-exposed rats. Inhal Toxicol 2012;24:570-579.
30. Nemmar A, Vanbilloen H, Hoylaerts MF, Hoet PH, Verbruggen A, Nemery B. Passage of intratracheally instilled ultrafine particles from the lung into the systemic circulation in hamster. Am J Respir Crit Care Med 2001;164:1665-1668.
31. Zelko IN, Zhu J, Ritzenthaler JD, Roman J. Pulmonary hypertension and vascular remodeling in mice exposed to crystalline silica. Respir Res 2016;17:160.
32. Tang M, Batty JA, Lin C, Fan X, Chan KE, Kalim S. Pulmonary hypertension, mortality, and cardiovascular disease in CKD and ESRD patients: a systematic review and meta-analysis. Am J Kidney Dis 2018;72:75-83.
33. Shin JT, Semigran MJ. Heart failure and pulmonary hypertension. Heart Fail Clin 2010;6:215-222.
34. Evers H, Liehs F, Harzbecker K, Wenzel D, Wilke A, Pielesch W, Schauer J, Nahrendorf W, Preisler J, Luther R. Screening of pulmonary hypertension in chronic obstructive pulmonary disease and silicosis by discriminant functions. Eur Respir J 1992;5:444-451.
35. Liu K, Mu M, Fang K, Qian Y, Xue S, Hu W, Ye M. Occupational exposure to silica and risk of heart disease: a systematic review with meta-analysis. BMJ Open 2020;10:e029653.
36. Liu Y, Zhou Y, Hnizdo E, Shi T, Steenland K, He X, Chen W. Total and cause-specific mortality risk associated with low-level exposure to crystalline silica: a 44-year cohort study from China. Am J Epidemiol 2017;186:481-490.
37. Murray J, Reid G, Kielkowski D, de Beer M. Cor pulmonale and silicosis: a necropsy based case-control study. Br J Ind Med 1993;50:544-548.
38. Dong D, Xu G, Sun Y, Hu P. Lung cancer among workers exposed to silica dust in Chinese refractory plants. Scand J Work Environ Health 1995;21 Suppl 2:69-72.
39. Chen G. Study on tissue Doppler imaging in diagnosis of right ventricular hypertrophy in patients with silicosis complicated by chronic pulmonary heart disease. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2014;32:931-933.
40. Swanepoel AJ, Rees D, Renton K, Swanepoel C, Kromhout H, Gardiner K. Quartz exposure in agriculture: literature review and South African survey. Ann Occup Hyg 2010;54:281-292.
41. Steenland K, Ward E. Silica: a lung carcinogen. CA Cancer J Clin 2014;64:63-69.
2. World Health Organization. Global status report on noncommunicable diseases 2010. https://b2n.ir/900199 (5 Dec 2019).
3. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, Amann M, Anderson HR, Andrews KG, Aryee M, Atkinson C, Bacchus LJ, Bahalim AN, Balakrishnan K, Balmes J, Barker-Collo S, Baxter A, Bell ML, Blore JD, Blyth F, Bonner C, Borges G, Bourne R, Boussinesq M, Brauer M, Brooks P, Bruce NG, Brunekreef B, Bryan-Hancock C, Bucello C, Buchbinder R, Bull F, Burnett RT, Byers TE, Calabria B, Carapetis J, Carnahan E, Chafe Z, Charlson F, Chen H, Chen JS, Cheng AT, Child JC, Cohen A, Colson KE, Cowie BC, Darby S, Darling S, Davis A, Degenhardt L, Dentener F, Des Jarlais DC, Devries K, Dherani M, Ding EL, Dorsey ER, Driscoll T, Edmond K, Ali SE, Engell RE, Erwin PJ, Fahimi S, Falder G, Farzadfar F, Ferrari A, Finucane MM, Flaxman S, Fowkes FG, Freedman G, Freeman MK, Gakidou E, Ghosh S, Giovannucci E, Gmel G, Graham K, Grainger R, Grant B, Gunnell D, Gutierrez HR, Hall W, Hoek HW, Hogan A, Hosgood HD 3rd, Hoy D, Hu H, Hubbell BJ, Hutchings SJ, Ibeanusi SE, Jacklyn GL, Jasrasaria R, Jonas JB, Kan H, Kanis JA, Kassebaum N, Kawakami N, Khang YH, Khatibzadeh S, Khoo JP, Kok C, Laden F, Lalloo R, Lan Q, Lathlean T, Leasher JL, Leigh J, Li Y, Lin JK, Lipshultz SE, London S, Lozano R, Lu Y, Mak J, Malekzadeh R, Mallinger L, Marcenes W, March L, Marks R, Martin R, McGale P, McGrath J, Mehta S, Mensah GA, Merriman TR, Micha R, Michaud C, Mishra V, Mohd Hanafiah K, Mokdad AA, Morawska L, Mozaffarian D, Murphy T, Naghavi M, Neal B, Nelson PK, Nolla JM, Norman R, Olives C, Omer SB, Orchard J, Osborne R, Ostro B, Page A, Pandey KD, Parry CD, Passmore E, Patra J, Pearce N, Pelizzari PM, Petzold M, Phillips MR, Pope D, Pope CA 3rd, Powles J, Rao M, Razavi H, Rehfuess EA, Rehm JT, Ritz B, Rivara FP, Roberts T, Robinson C, Rodriguez-Portales JA, Romieu I, Room R, Rosenfeld LC, Roy A, Rushton L, Salomon JA, Sampson U, Sanchez-Riera L, Sanman E, Sapkota A, Seedat S, Shi P, Shield K, Shivakoti R, Singh GM, Sleet DA, Smith E, Smith KR, Stapelberg NJ, Steenland K, Stöckl H, Stovner LJ, Straif K, Straney L, Thurston GD, Tran JH, Van Dingenen R, van Donkelaar A, Veerman JL, Vijayakumar L, Weintraub R, Weissman MM, White RA, Whiteford H, Wiersma ST, Wilkinson JD, Williams HC, Williams W, Wilson N, Woolf AD, Yip P, Zielinski JM, Lopez AD, Murray CJ, Ezzati M, AlMazroa MA, Memish ZA. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380:2224-2260.
4. Guo J, Shi T, Cui X, Rong Y, Zhou T, Zhang Z, Liu Y, Shen Y, Chen W. Effects of silica exposure on the cardiac and renal inflammatory and fibrotic response and the antagonistic role of interleukin-1 beta in C57BL/6 mice. Arch Toxicol 2016;90:247-258.
5. De Berardis B, Incocciati E, Massera S, Gargaro G, Paoletti L. Airborne silica levels in an urban area. Sci Total Environ 2007;382:251-258.
6. Liu Y, Rong Y, Steenland K, Christiani DC, Huang X, Wu T, Chen W. Long-term exposure to crystalline silica and risk of heart disease mortality. Epidemiology 2014;25:689-696.
7. The Global Occupational Health Network. Elimination of silicosis. https://b2n.ir/438391 (5 Dec 2019).
8. Mehri F, Jenabi E, Bashirian S, Shahna FG, Khazaei S. The association between occupational exposure to silica and risk of developing rheumatoid arthritis: a meta-analysis. Saf Health Work 2020;11:136-142.
9. Steenland K, Sanderson W, Calvert GM. Kidney disease and arthritis in a cohort study of workers exposed to silica. Epidemiology 2001;12:405-412.
10. Fang SC, Cassidy A, Christiani DC. A systematic review of occupational exposure to particulate matter and cardiovascular disease. Int J Environ Res Public Health 2010;7:1773-1806.
11. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 2009;6:e1000100.
12. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003;327:557-560.
13. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics 1994;50:1088-1101.
14. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315:629-634.
15. Sterne JA, Egger M. Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol 2001;54:1046-1055.
16. Chen W, Liu Y, Wang H, Hnizdo E, Sun Y, Su L, Zhang X, Weng S, Bochmann F, Hearl FJ, Chen J, Wu T. Long-term exposure to silica dust and risk of total and cause-specific mortality in Chinese workers: a cohort study. PLoS Med 2012;9:e1001206.
17. Weiner J, Barlow L, Sjögren B. Ischemic heart disease mortality among miners and other potentially silica-exposed workers. Am J Ind Med 2007;50:403-408.
18. Fan C, Graff P, Vihlborg P, Bryngelsson IL, Andersson L. Silica exposure increases the risk of stroke but not myocardial infarction-a retrospective cohort study. PLoS One 2018;13:e0192840.
19. Merlo F, Fontana L, Reggiardo G, Ceppi M, Barisione G, Garrone E, Doria M. Mortality among silicotics in Genoa, Italy, from 1961 to 1987. Scand J Work Environ Health 1995;21 Suppl:77-80.
20. Miller BG, MacCalman L. Cause-specific mortality in British coal workers and exposure to respirable dust and quartz. Occup Environ Med 2010;67:270-276.
21. Puntoni R, Goldsmith DF, Valerio F, Vercelli M, Bonassi S, Di Giorgio F, Ceppi M, Stagnaro E, Filiberti R, Santi L. A cohort study of workers employed in a refractory brick plant. Tumori 1988;74:27-33.
22. Moulin JJ, Wild P, Mantout B, Fournier-Betz M, Mur JM, Smagghe G. Mortality from lung cancer and cardiovascular diseases among stainless-steel producing workers. Cancer Causes Control 1993;4:75-81.
23. Redon J, Tellez-Plaza M, Orozco-Beltran D, Gil-Guillen V, Pita Fernandez S, Navarro-Pérez J, Pallares V, Valls F, Fernandez A, Perez-Navarro AM, Sanchis C, Dominguez-Lucas A, Sanz G, Martin-Moreno JM; ESCARVAL Study Group. Impact of hypertension on mortality and cardiovascular disease burden in patients with cardiovascular risk factors from a general practice setting: the ESCARVAL-risk study. J Hypertens 2016;34:1075-1083.
24. De Miguel C, Rudemiller NP, Abais JM, Mattson DL. Inflammation and hypertension: new understandings and potential therapeutic targets. Curr Hypertens Rep 2015;17:507.
25. Rodrigo R, González J, Paoletto F. The role of oxidative stress in the pathophysiology of hypertension. Hypertens Res 2011;34:431-440.
26. Orman A, Kahraman A, Cakar H, Ellidokuz H, Serteser M. Plasma malondialdehyde and erythrocyte glutathione levels in workers with cement dust-exposure [corrected]. Toxicology 2005;207:15-20.
27. Fubini B, Hubbard A. Reactive oxygen species (ROS) and reactive nitrogen species (RNS) generation by silica in inflammation and fibrosis. Free Radic Biol Med 2003;34:1507-1516.
28. Zelko IN, Zhu J, Roman J. Role of SOD3 in silica-related lung fibrosis and pulmonary vascular remodeling. Respir Res 2018;19:221.
29. Sellamuthu R, Umbright C, Roberts JR, Chapman R, Young SH, Richardson D, Cumpston J, McKinney W, Chen BT, Frazer D, Li S, Kashon M, Joseph P. Transcriptomics analysis of lungs and peripheral blood of crystalline silica-exposed rats. Inhal Toxicol 2012;24:570-579.
30. Nemmar A, Vanbilloen H, Hoylaerts MF, Hoet PH, Verbruggen A, Nemery B. Passage of intratracheally instilled ultrafine particles from the lung into the systemic circulation in hamster. Am J Respir Crit Care Med 2001;164:1665-1668.
31. Zelko IN, Zhu J, Ritzenthaler JD, Roman J. Pulmonary hypertension and vascular remodeling in mice exposed to crystalline silica. Respir Res 2016;17:160.
32. Tang M, Batty JA, Lin C, Fan X, Chan KE, Kalim S. Pulmonary hypertension, mortality, and cardiovascular disease in CKD and ESRD patients: a systematic review and meta-analysis. Am J Kidney Dis 2018;72:75-83.
33. Shin JT, Semigran MJ. Heart failure and pulmonary hypertension. Heart Fail Clin 2010;6:215-222.
34. Evers H, Liehs F, Harzbecker K, Wenzel D, Wilke A, Pielesch W, Schauer J, Nahrendorf W, Preisler J, Luther R. Screening of pulmonary hypertension in chronic obstructive pulmonary disease and silicosis by discriminant functions. Eur Respir J 1992;5:444-451.
35. Liu K, Mu M, Fang K, Qian Y, Xue S, Hu W, Ye M. Occupational exposure to silica and risk of heart disease: a systematic review with meta-analysis. BMJ Open 2020;10:e029653.
36. Liu Y, Zhou Y, Hnizdo E, Shi T, Steenland K, He X, Chen W. Total and cause-specific mortality risk associated with low-level exposure to crystalline silica: a 44-year cohort study from China. Am J Epidemiol 2017;186:481-490.
37. Murray J, Reid G, Kielkowski D, de Beer M. Cor pulmonale and silicosis: a necropsy based case-control study. Br J Ind Med 1993;50:544-548.
38. Dong D, Xu G, Sun Y, Hu P. Lung cancer among workers exposed to silica dust in Chinese refractory plants. Scand J Work Environ Health 1995;21 Suppl 2:69-72.
39. Chen G. Study on tissue Doppler imaging in diagnosis of right ventricular hypertrophy in patients with silicosis complicated by chronic pulmonary heart disease. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2014;32:931-933.
40. Swanepoel AJ, Rees D, Renton K, Swanepoel C, Kromhout H, Gardiner K. Quartz exposure in agriculture: literature review and South African survey. Ann Occup Hyg 2010;54:281-292.
41. Steenland K, Ward E. Silica: a lung carcinogen. CA Cancer J Clin 2014;64:63-69.
| Files | ||
| Issue | Vol 15 No 4 (2020): J Teh Univ Heart Ctr | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/jthc.v15i4.5940 | |
| Keywords | ||
| Silicosis Cardiovascular diseases Coronary artery disease Angina pectoris | ||
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How to Cite
1.
Esfahani M, Bashirian S, Mehri F, Khazaei S. Association between Silica Exposure and Cardiovascular Disease Mortality: A Meta-Analysis. J Tehran Heart Cent. 2020;15(4):151-157.
