Dust exposure and lung cancer mortality in tunnel workers.

The eastern part of the Toyama Prefecture in Japan is one of the high-incidence areas of silicosis due to tunnel construction. In 1977 and 1978, we conducted a questionnaire survey primarily concerning the occupational history of all male inhabitants over 30 years of age living in five villages in this area and found 603 tunnel workers and inhabitants without dust history. These workers have been followed up to 1994 for about 17 to 18 years to clarify the relationship between tunnel work and lung cancer mortality. The SMR's of workers with dust exposure for all causes and for lung cancer was 120 and 188, respectively, which was significantly higher than those of the Japanese general population. After adjustment for age and smoking habits using Cox's proportional hazard model, tunnel work showed a significant relationship to mortality. Mortality risk ratio of tunnel workers was 2.15 compared with that of inhabitants without dust exposure history.