Aim of the study: Workers awarded compensation for silicosis have an increased lung cancer risk compared with that of the general population. In order to investigate the situation in Germany, workers from the industrial insurance institute for the stone and quarry industry awarded compensation for silicosis were investigated in a cohort study. Methods and collective: All workers awarded compensation between 1988 and 2000 were followed-up until the end of 2001. Their risk of mortality was compared with that for the general population of Germany. Information about their working history could be obtained from existing files. The occupational hygienists of the industrial insurance institutes estimated in conjunction with dust measurements the exposure for each job. Results: Altogether 440 workers were included. During the followup period 144 died. The increase in the mortality rate relative to that in the general population (SMR = 1.94; 95% CI: 1.63—2.28) was statistically significant. The lung cancer risk was also significantly increased (16 observed cases; SMR = 2.40; 95% CI: 1.37—3.90). The peak exposure was above 0.15 mg/m³ in all workers. In more than 50% of the workers the peak exposure was above 0.75 mg/m³. The cumulative exposure was above 2 mg/m³ × years with very few exceptions. The average exposure was above 0.1 mg/m³. Conclusions: Workers awarded compensation for silicosis have an increased mortality risk overall and for lung cancer relative to that for the general population. In order to reduce this risk, the peak exposure should remain below 0.15 mg/m³ and the cumulative exposure below 2 mg/m³ × years.
