Assessment of spirometric decline from silica dust: threshold values and calculation methods for cumulative exposure

The results confirm that high silica dust exposure leads to an accelerated decline in lung function. Model 1 appears to be the most appropriate, despite limitations such as limited age range and sole focus on spirometry. The results demonstrate an association between cumulative silica dust exposure above approximately 0.09 mg/m³ and accelerated spirometric decline. Model 1 (constant annual threshold) provides the most consistent and biologically plausible results. These threshold estimates have high relevance in occupational health settings aimed at preventing workers exposed to silica dust from lung function decline. Study limitations include the limited follow up and lack of data on individuals reaching the cumulative threshold. The majority of included persons were smokers (84%), which also affected lung function.