From quartz hazard to quartz risk: the coal mines revisited.

Following the classification of quartz as a human carcinogen by the IARC, many standard-setting committees are currently trying to convert this hazard into their national or EU standards. Since human data to set a safe exposure limit for quartz are limited, we hypothesized that lung burden data on quartz in coal miners' lungs after lifetime exposure could be used to set a non-carcinogenic lung burden of quartz, and that this might be valid for other groups occupationally exposed to quartz. A review of data shows that lungs of coal miners with simple coal workers' pneumoconiosis (sCWP) typically contain up to 30 g of dust, and in one specific study lung burdens between 0.7 and 1.7 g of quartz were associated with macules only, and no sCWP. Assuming independent actions of coal and quartz and no clearance of quartz, and sCWP as a prerequisite for lung cancer due to quartz exposure in coal mine dust, a simple kinetic approach was applied. A no observed adverse effect level (NOAEL) for quartz of between 0.03 and 0.13 mg/m3 (40 yr exposure) is derived, but it is concluded that more refined physiologically based pharmacokinetic modelling is needed for a better estimate, also including interindividual differences in lung clearance. Considering the independent effects of, and the well-known interaction between coal and quartz, these data could be important to other workplaces with usual mixed-dust exposure.