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CA Engineered Stone Silicosis Dashboard - About the Data and Instructions

Occupational Health Branch

California Engineered Stone (ES) Silicosis Surveillance

About the Data

Background

Silicosis is an occupational lung disease caused by inhalation of dust containing respirable crystalline silica. Silicosis is a progressive, incurable, and potentially fatal disease. In recent years, silicosis has been identified among young engineered stone (ES) countertop workers in California.

Case Definition

Confirmed ES-Silicosis case:

Meets the NIOSH case definition of silicosis (see below).
Has silica exposures associated with countertop fabrication.

NIOSH Case Definition of Silicosis:
History of occupational exposure to airborne silica dust and either or both: Imaging showing abnormalities interpreted as consistent with silicosis or lung histopathology consistent with silicosis. View Silicosis Reporting Guidelines (NIOSH). Only Confirmed ES cases are displayed on the dashboard, which are a subset of all silicosis cases identified in California.

Data sources for reports of engineered stone silicosis cases:

Silicosis is a reportable disease in California. Title 17 Reportable Condition: The California Code of Regulations, Title 17, Section 2505 requires reporting of certain diseases of public health importance to the local health department. Results are transmitted to CDPH from local health departments via The California Reportable Disease Information Exchange (CalREDIE) or through another pre-determined mechanism if a local health department does not use CalREDIE.

Statewide hospital utilization records from the California Department of Health Care Access and Information (HCAI). Any encounter including a silicosis diagnosis (ICD-10: J62.8) in any of the diagnosis code fields is included in the surveillance system:

Inpatient Discharge (PDD) Data: nonpublic dataset of inpatient data collected from California-licensed hospitals in California. The dataset consists of a record for each inpatient discharged from a California-licensed hospital, including general acute care, acute psychiatric, chemical dependency recovery, and psychiatric health facilities.
Emergency Department (ED) encounter data: nonpublic dataset of emergency care data collected from hospital emergency departments. Reportable ED encounters include only those patients who had face-to-face contact with a provider.
Electronic Case Reporting (eCR)/Reportable Conditions Knowledge Management System (RCKMS): System that enables automated eCR to public health agencies via electronic health records, using previously established criteria. Participating healthcare organizations automatically generate and send an initial case report when trigger criteria, such as diagnosis codes or laboratory results, are met within electronic health records. In the context of silicosis, any healthcare encounter from a participating healthcare organization that includes a silicosis diagnosis in the patient's problem list is sent to CDPH for silicosis surveillance.
Voluntary reporting by healthcare providers, Tuberculosis Controllers, or community members to CDPH.
Public health follow-up of mandated medical testing following worksite investigations
Doctor's First Reports of Occupational Injury or Illness (DFR): all physicians are required to complete a DFR form within five days of initial examination for work-related injuries or illnesses statewide.

Reports received from the above sources receive public health follow-up by Occupational Health Branch staff to determine if they meet the case definition specified above; only those considered confirmed ES-Silicosis cases are included in the dashboard.

Countertop fabrication operations where confirmed ES cases have worked are self-reported by identified cases as part of case follow-up, are included in information provided by case reporters, or are recorded in medical records. Countertop fabrication operation information associated with cases is tracked by the silicosis public health surveillance system.

Data Limitation

These data are likely an underestimate of the true burden of ES-Silicosis in California, due to underdiagnosis of silicosis cases, the existence of cases that are not captured by the data sources described above, and lack of information in reports indicating that exposure is associated with engineered stone.

Suggested Citation

California Department of Public Health, Occupational Health Branch, California Engineered Stone Silicosis Dashboard, Access Date: MM/DD/YYYY.

Link

www.cdph.ca.gov/Programs/CCDPHP/DEODC/OHB/Pages/essdashboard.aspx

California Engineered Stone (ES) Silicosis Surveillance

Dashboard Instructions

The dashboard is built in Microsoft Power BI. Below are general instructions on how to use the dashboard. It is recommended to use the dashboard on a desktop for best user experience.

Navigation

This dashboard is organized into a single page with different visual components. The dashboard consists of the following visualizations:

Confirmed ES Silicosis Cases: This displays the number of confirmed Engineered Stone (ES) Silicosis cases identified in California as of the date of the last dashboard update.

Deaths: This displays the number of known deaths due to silicosis among confirmed ES Silicosis cases.

Four data cards that display the median age at diagnosis, the median age at death, the percent male, and percent Latino of all confirmed ES Silicosis cases in California.

Median age at diagnosis: age midpoint for diagnoses. Half of the cases were older than the median age at diagnosis and half of the cases were younger than the median age at diagnosis.

Median age at death: age midpoint for deaths. Half of the silicosis-related deaths were among individuals older than the median age at death and half of the silicosis-related deaths were among individuals younger than the median age at death.

Percent Male: the percentage of all confirmed ES Silicosis cases who are male.

Percent Latino: the percentage of all confirmed ES Silicosis cases who are Latino.

Last known transplant status for confirmed ES Silicosis cases: A bar chart that displays counts of known transplant-related outcomes among ES Silicosis cases identified in California. The categories reflect whether CDPH is aware that a worker with ES Silicosis has undergone or been evaluated for a lung transplant. Availability of follow-up and outcome data once cases are identified is not consistent across data sources, so these counts may be underestimates.

Year confirmed ES Silicosis cases identified by CDPH: A bar chart that displays the number of cases that CDPH has identified over time. The number of cases identified in the current year is only partially complete and is expected to increase over time.

Year of diagnosis for confirmed ES Silicosis cases: A line chart that displays, by year, the number of ES Silicosis cases diagnosed over time. Diagnosis data are only displayed through 2022. Data for more recent years are incomplete due to reporting lags.

Confirmed ES Silicosis cases have been identified in the following counties: A map that displays California counties in color where ES-Silicosis cases have been identified. If you hover the mouse pointer over a county, the number of cases identified in that county will be displayed. In instances where the county has no known cases, it will just display the county name. These reflect the case’s county of residence at the time of case identification.

County and Count: A table that displays the county name and confirmed ES Silicosis case count for all counties in California. These counties reflect the county of residence at the time of case identification.

County of residence drop down list: The drop down displays a list of all counties in the state. When you select a county name, the table below will filter to display the corresponding county’s data.

Tooltips

Move the mouse pointer so that it hovers over a visual on the dashboard. A popup window referred to as “tooltip” will appear. Tooltips contain additional data details, such as the year, number of cases, location, and/or category. In some cases, such as the median age at diagnosis and median age at death, there are additional summary statistics. As you move the mouse pointer over different visuals, the tooltip will automatically update to describe the data it is hovering over. Below are a few examples of tooltips within the dashboard:

	Year of diagnosis tooltip
	Year identified tooltip
	Known transplant status tooltip
	Median age at diagnosis tooltip displays the minimum and maximum age at diagnosis
	Median age at death tooltip displays the minimum and maximum age at death
	Counties with ES Silicosis Cases identified tooltip

Interactive Visualization

Move your mouse pointer and click a county name within the map legend. This will highlight that respective county and fade the colors of the other counties on the map. In addition, it will filter the County Name and Case count table that is located immediately below the map.

Focus Mode

Move your mouse pointer to hover to the top or bottom right corner of a visual to locate “Focus mode.” Select focus mode to enlarge the visual. Return to the dashboard page using “back to report” at the top left corner.