{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T13:06:51Z","timestamp":1784725611263,"version":"3.55.0"},"reference-count":22,"publisher":"BMJ","issue":"4","funder":[{"name":"Ontario Ministry of Labour, Immigration, Training, and Skills Development","award":["#14-R-030"],"award-info":[{"award-number":["#14-R-030"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2026,5,18]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Inhalation of crystalline silica dust causes lung cancer, although evidence assessing risk at low levels of exposure is needed. We sought to estimate the association between cumulative silica exposure and lung cancer risk in a cohort of miners in Ontario, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cohort of 48\u2009772 hard rock miners enumerated from a medical surveillance programme was followed for lung cancer diagnoses in the Ontario Cancer Registry from 1964 through 2022. Silica dust exposure was estimated using a linear prediction model based on 12\u2009325 personal sampling measurements from Ontario mines. Exposure\u2013response associations were estimated, with adjustments for uranium mining, arsenic dust and screening CXR. Probabilistic bias analysis was used to evaluate differential outcome misclassification due to loss to follow-up using a known bias parameter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      3218 lung cancer cases were diagnosed during a median of 44 years of follow-up. Positive associations between cumulative silica exposure and incident lung cancer rates were observed in all categories of exposure, with 0.5\u20132.0 mg\/m\n                      <jats:sup>3<\/jats:sup>\n                      -years of exposure associated with 1.33 times (95%\u2009CI 1.06 to 1.66)\u2009the adjusted rate of lung cancer compared with&lt;0.5 mg\/m\n                      <jats:sup>3<\/jats:sup>\n                      -years. The positive exposure\u2013response association remained after excluding known silicotics and increased in magnitude when excluding radon-exposed uranium miners. Bias adjustment for outcome misclassification increased the monotonicity and slope of the exposure\u2013response relationship, but attenuated the IRR in the 0.5\u20132.0 mg\/m\n                      <jats:sup>3<\/jats:sup>\n                      -year category to 1.08.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Silica exposure was positively associated with lung cancer risk at low levels of cumulative exposure in a universally exposed population of miners. Findings were robust to suspected sources of bias.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/oemed-2026-110906","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T19:20:15Z","timestamp":1781119215000},"page":"188-194","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Quantitative silica dust exposure and lung cancer incidence in hard rock miners: 1.6 million person-years of follow-up in the Mining Master File cohort study"],"prefix":"10.1136","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5087-107X","authenticated-orcid":false,"given":"Nathan L","family":"DeBono","sequence":"first","affiliation":[{"name":"Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2028-4886","authenticated-orcid":false,"given":"Louis","family":"Everest","sequence":"additional","affiliation":[{"name":"Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Berriault","sequence":"additional","affiliation":[{"name":"Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9587-4207","authenticated-orcid":false,"given":"Victoria H","family":"Arrandale","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A","family":"Demers","sequence":"additional","affiliation":[{"name":"Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy L","family":"Kirkham","sequence":"additional","affiliation":[{"name":"Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"2026072205351194000_83.4.188.1","first-page":"11","article-title":"Arsenic, metals, fibres, and dusts","volume":"100","year":"2012","journal-title":"IARC Monogr Eval Carcinog Risks Hum"},{"key":"2026072205351194000_83.4.188.2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201910-1926OC"},{"key":"2026072205351194000_83.4.188.3","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwt139"},{"key":"2026072205351194000_83.4.188.4","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2012.374"},{"key":"2026072205351194000_83.4.188.5","doi-asserted-by":"publisher","DOI":"10.1023\/A:1012214102061"},{"key":"2026072205351194000_83.4.188.6","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-009-9296-0"},{"key":"2026072205351194000_83.4.188.7","unstructured":"CAREX Canada . Silica - occupational exposures. Silica (Crystalline) occupational exposures, Available: https:\/\/www.carexcanada.ca\/profile\/silica_crystalline-occupational-exposures\/ [Accessed 07 Jan 2026]."},{"key":"2026072205351194000_83.4.188.8","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1093\/annweh\/wxab118","article-title":"Artificial Stone Silicosis: Need for Improved Controls","volume":"66","author":"Jones","year":"2022","journal-title":"Ann Work Expo Health"},{"key":"2026072205351194000_83.4.188.9","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1001\/jamainternmed.2023.3295","article-title":"Silicosis Among Immigrant Engineered Stone (Quartz) Countertop Fabrication Workers in California","volume":"183","author":"Fazio","year":"2023","journal-title":"JAMA Intern Med"},{"key":"2026072205351194000_83.4.188.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2019.03.016"},{"key":"2026072205351194000_83.4.188.11","first-page":"478","article-title":"Silica, silicosis and lung cancer: what level of exposure is acceptable?","volume":"109","author":"Manno","year":"2018","journal-title":"Med Lav"},{"key":"2026072205351194000_83.4.188.12","first-page":"920","article-title":"Mortality from lung cancer in Ontario uranium miners","volume":"50","author":"Kusiak","year":"1993","journal-title":"Br J Ind Med"},{"key":"2026072205351194000_83.4.188.13","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1093\/annweh\/wxab033","article-title":"Estimating Historical Exposure to Respirable Crystalline Silica in the Mining Industry in Ontario, Canada Using a Newly Developed Exposure Database","volume":"65","author":"Blagrove-Hall","year":"2021","journal-title":"Ann Work Expo Health"},{"key":"2026072205351194000_83.4.188.14","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyad053"},{"key":"2026072205351194000_83.4.188.15","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2016-103836"},{"key":"2026072205351194000_83.4.188.16","unstructured":"Berrington de Gonz\u00e1lez A , Richardson DB , Schubauer-Berigan MK . Chapter 1. IARC scientific publication no. 171. In: Statistical methods in cancer research volume v: bias assessment in case\u2013control and cohort studies for hazard identification. 2024. Available: https:\/\/publications.iarc.who.int\/Book-And-Report-Series\/Iarc-Scientific-Publications\/Statistical-Methods-In-Cancer-Research-Volume-V-Bias-Assessment-In-Case%E2%80%93Control-And-Cohort-Studies-For-Hazard-Identification-2024"},{"key":"2026072205351194000_83.4.188.17","doi-asserted-by":"publisher","DOI":"10.1097\/HP.0b013e3181b8ce81"},{"key":"2026072205351194000_83.4.188.18","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1093\/annweh\/wxae094","article-title":"Recent trends in respirable crystalline silica and elemental carbon exposure in the Ontario, Canada mining industry","volume":"69","author":"Arrandale","year":"2025","journal-title":"Ann Work Expo Health"},{"key":"2026072205351194000_83.4.188.19","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0274(200003)37:3<252::AID-AJIM2>3.0.CO;2-#"},{"key":"2026072205351194000_83.4.188.20","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys042"},{"key":"2026072205351194000_83.4.188.21","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1097\/01.ede.0000248515.28903.3c","article-title":"Occupational exposure to crystalline silica and risk of lung cancer: a multicenter case-control study in Europe","volume":"18","author":"Cassidy","year":"2007","journal-title":"Epidemiology (Sunnyvale)"},{"key":"2026072205351194000_83.4.188.22","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-10-0015"}],"container-title":["Occupational and Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/oemed-2026-110906","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T12:35:48Z","timestamp":1784723748000},"score":1,"resource":{"primary":{"URL":"https:\/\/oem.bmj.com\/lookup\/doi\/10.1136\/oemed-2026-110906"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,10]]},"references-count":22,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,7,22]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/oemed-2026-110906"],"URL":"https:\/\/doi.org\/10.1136\/oemed-2026-110906","relation":{},"ISSN":["1351-0711","1470-7926"],"issn-type":[{"value":"1351-0711","type":"print"},{"value":"1470-7926","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,10]]}}}