These findings caution against surgeons' underestimation of the potential radiation risk and insufficient promotion of safe work practices by their health care institutions.

Our findings confirm previous epidemiological evidence and are supported by recent observations that cigarette smoke, cotton and organic farm dust contain the same powerful pro-inflammatory agents, and that organic dust and irritant gas induce bronchitis by triggering the same effector molecules as cigarette smoke.

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The results of the study showed a large mortal ity excess for infectious diseases (180 observed versus 9.5 expected), due to silicotuberculosis, and for diseases of the respiratory system (270 observed versus 33.5 expected) due to silicosis. An elevated standardized mortality ra tio of 239 (70 observed versus 29.3 expected) from lung cancer was also detected. An increasing pattern was observed with time since first exposure, while the relationship with employment category and dur ation of expos ure was less clear-cut. The lung cancer excess was also strongly associated with cigarette smoking, there being a dose-respon se relationship with daily cigarette consumption . The study confirms the results from other epidemiolo gic studies on silicotics which show this pathol ogical condition to be associated with increased lung cancer mortality.