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Yatera K, Nishida C. Contemporary Concise Review 2023: Environmental and occupational lung diseases. Respirology 2024; 29:574-587. [PMID: 38826078 DOI: 10.1111/resp.14761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 05/16/2024] [Indexed: 06/04/2024]
Abstract
Air pollutants have various effects on human health in environmental and occupational settings. Air pollutants can be a risk factor for incidence, exacerbation/aggravation and death due to various lung diseases, including asthma, chronic obstructive pulmonary disease (COPD), hypersensitivity pneumonitis or pneumonia (HP), pulmonary fibrosis such as pneumoconiosis and malignant respiratory diseases such as lung cancer and malignant pleural mesothelioma. Environmental and occupational respiratory diseases are crucial clinical and social issues worldwide, although the burden of respiratory disease due to environmental and occupational causes varies depending on country/region, demographic variables, geographical location, industrial structure and socioeconomic situation. The correct recognition of environmental and occupational lung diseases and taking appropriate measures are essential to their effective prevention.
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Affiliation(s)
- Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Chinatsu Nishida
- Department of Environmental Health Engineering, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
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Song Y, Yen S, Southam K, Gaskin S, Hoy RF, Zosky GR. The aryl hydrocarbon receptor pathway is a marker of lung cell activation but does not play a central pathologic role in engineered stone-associated silicosis. J Appl Toxicol 2024. [PMID: 38837244 DOI: 10.1002/jat.4653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/29/2024] [Accepted: 05/20/2024] [Indexed: 06/07/2024]
Abstract
Engineered stone-associated silicosis is characterised by a rapid progression of fibrosis linked to a shorter duration of exposure. To date, there is lack of information about molecular pathways that regulates disease development and the aggressiveness of this form of silicosis. Therefore, we compared transcriptome responses to different engineered stone samples and standard silica. We then identified and further tested a stone dust specific pathway (aryl hydrocarbon receptor [AhR]) in relation to mitigation of adverse lung cell responses. Cells (epithelial cells, A549; macrophages, THP-1) were exposed to two different benchtop stone samples, standard silica and vehicle control, followed by RNA sequencing analysis. Bioinformatics analyses were conducted, and the expression of dysregulated AhR pathway genes resulting from engineered stone exposure was then correlated with cytokine responses. Finally, we inhibited AhR pathway in cells pretreated with AhR antagonist and observed how this impacted cell cytotoxicity and inflammation. Through transcriptome analysis, we identified the AhR pathway genes (CYP1A1, CYP1B1 and TIPARP) that showed differential expression that was unique to engineered stones and common between both cell types. The expression of these genes was positively correlated with interleukin-8 production in A549 and THP-1 cells. However, we only observed a mild effect of AhR pathway inhibition on engineered stone dust induced cytokine responses. Given the dual roles of AhR pathway in physiological and pathological processes, our data showed that expression of AhR target genes could be markers for assessing toxicity of engineered stones; however, AhR pathway might not play a significant pathologic role in engineered stone-associated silicosis.
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Affiliation(s)
- Yong Song
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Seiha Yen
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Katherine Southam
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Sharyn Gaskin
- Adelaide Exposure Science and Health, School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Ryan F Hoy
- Monash Centre for Occupational and Environmental Health, School of Public Health & Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia
| | - Graeme R Zosky
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
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Huang X, Liang R, Liu Y, Yu L, Yang M, Shang B, Zhang H, Ma J, Chen W, Wang D. Incidence, mortality, and disability-adjusted life years due to silicosis worldwide, 1990-2019: evidence from the global burden of disease study 2019. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:36910-36924. [PMID: 38758446 DOI: 10.1007/s11356-024-33701-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 05/13/2024] [Indexed: 05/18/2024]
Abstract
Silicosis is an occupational lung disease because of exposure to silica dust in the workplace. Evidence on the spatiotemporal change of silicosis burden worldwide remains limited. This study utilized data extracted from the Global Burden of Disease Study 2019 to examine the numbers and age-standardized rates of incidence (ASIR), mortality (ASMR), and disability-adjusted life years (DALYs) caused by silicosis between 1990 and 2019. Average annual percentage changes (AAPCs) were calculated to evaluate the temporal trends of age-standardized indicators by sex, region, and socio-demographic index (SDI) since 1990. Results indicated an increase in new silicosis cases globally, rising by 64.61% from 84,426 in 1990 to 138,971 in 2019, with a sustained high number of DALYs attributed to this disease. Although the global age-standardized rates of incidence, mortality, and DALYs of silicosis have decreased since 1990, the number of new cases has increased in 168 countries and territories, and the ASIR of silicosis has also risen in 118 countries and territories, primarily in developing countries. Since 1990, the burden of silicosis among the elderly has significantly increased. Countries with higher SDI experienced a more rapid decline in the silicosis burden. Silicosis remains a public health problem that requires significant attention. Programs for prevention and elimination of this public health issue need to be established in more countries and territories. Protecting young workers from silica dust exposure is crucial to prevent the onset of silicosis in their later years and to reduce the disease burden among older workers.
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Affiliation(s)
- Xuezan Huang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ruyi Liang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yang Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Linling Yu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Meng Yang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Bingxin Shang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Haozhe Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jixuan Ma
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Weihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Dongming Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China.
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Chen CH, Tsai PJ, Chang WW, Chen CY, Chen CY, Yates D, Guo YL. Dose-response relationship between lung function and chest imaging response to silica exposures in artificial stone manufacturing workers. Environ Health 2024; 23:25. [PMID: 38429786 PMCID: PMC10908069 DOI: 10.1186/s12940-024-01067-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/26/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Occupational exposure to artificial stone, a popular material used for countertops, can cause accelerated silicosis, but the precise relationship between silica dose and disease development is unclear. OBJECTIVES This study evaluated the impact of silica exposure on lung function and chest imaging in artificial stone manufacturing workers. METHODS Questionnaire and spirometry assessments were administered to workers in two plants. A high-exposure subset underwent further evaluation, including chest CT and DLco. Weighting factors, assigned as proxies for silica exposure, were based on work tasks. Individual cumulative exposures were estimated using area concentration measurements and time spent in specific areas. Exposure-response associations were analyzed using linear and logistic regression models. RESULTS Among 65 participants, the mean cumulative silica exposure was 3.61 mg/m3-year (range 0.0001 to 44.4). Each 1 mg/m3-year increase was associated with a 0.46% reduction in FVC, a 0.45% reduction in FEV1, and increased lung function abnormality risk (aOR = 1.27, 95% CI = 1.03-1.56). Weighting factors correlated with cumulative exposures (Spearman correlation = 0.59, p < 0.0001), and weighted tenure was associated with lung function abnormalities (aOR = 1.04, 95% CI = 1.01-1.09). Of 37 high-exposure workers, 19 underwent chest CT, with 12 (63%) showing abnormal opacities. Combining respiratory symptoms, lung function, and chest X-ray achieved 91.7% sensitivity and 75% specificity for predicting chest CT abnormalities. CONCLUSION Lung function and chest CT abnormalities occur commonly in artificial stone workers. For high-exposure individuals, abnormalities on health screening could prompt further chest CT examination to facilitate early silicosis detection.
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Affiliation(s)
- Chi-Hsien Chen
- Department of Environmental and Occupational Medicine, College of Medicine and NTU Hospital, National Taiwan University (NTU), No. 7, Zhongshan S. Rd., Zhongzheng Dist, Taipei City, Taiwan
| | - Perng-Jy Tsai
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Rd., North District, Tainan, 70403, Taiwan
| | - Wen-Wen Chang
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Rd., North District, Tainan, 70403, Taiwan
| | - Cheng-Yao Chen
- Division of Occupational Hazards Assessment, Institute of Labor, Occupational Safety and Health, Ministry of Labor, No. 99, Ln. 407, Hengke Rd., Xizhi Dist, New Taipei City, 221004, Taiwan
| | - Chih-Yong Chen
- Division of Occupational Hazards Assessment, Institute of Labor, Occupational Safety and Health, Ministry of Labor, No. 99, Ln. 407, Hengke Rd., Xizhi Dist, New Taipei City, 221004, Taiwan
| | - Deborah Yates
- Respiratory Medicine, St Vincent's Public Hospital, Sydney, Australia
- St Vincent's Hospital Clinical School, Sydney, Australia
| | - Yue Leon Guo
- Department of Environmental and Occupational Medicine, College of Medicine and NTU Hospital, National Taiwan University (NTU), No. 7, Zhongshan S. Rd., Zhongzheng Dist, Taipei City, Taiwan.
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, No. 17, Xuzhou Rd., Zhongzheng Dist, Taipei City, Taiwan.
- National Institute of Environmental Health Sciences, National Health Research Institutes, No. 35, Keyan Rd., Zhunan Township, Miaoli County, Taiwan.
- Department of Environmental and Occupational Medicine, College of Medicine and National Taiwan University Hospital, National Taiwan University, Rm 339, 17 Syujhou Road, Taipei, 100, Taiwan.
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González Fernández C, Ros Lucas JA, Molina Molina M, Rigual Bobillo J, García Montenegro RA, Fernández González R, Jaureguiza Oriol A, Abal Arca J. Autoimmune findings in patients with silicosis in Spain. Drugs Context 2024; 13:2023-11-1. [PMID: 38440072 PMCID: PMC10911535 DOI: 10.7573/dic.2023-11-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/30/2024] [Indexed: 03/06/2024] Open
Abstract
Background Occupational exposure to silica is related to autoimmune diseases and features of autoimmunity, mainly autoantibodies. The study objectives were to estimate the prevalence of silicosis with associated autoimmune findings or diagnosed autoimmune diseases in Spain, and to assess the clinical and functional characteristics of affected patients. Methods This is a multicentre prospective study in patients diagnosed with silicosis. Autoantibodies analysed were antinuclear antibodies, isotypes IgA, IgM and IgG, rheumatoid factor, anticyclic citrullinated peptide, anti-Scl70, anti-Ro, and anti-LA. Pulmonary function tests were performed. Results Autoimmunity was assessed in 105 patients. Autoimmune findings were recorded in 29 (27%) patients, including antinuclear antibodies (n=21), anti-Ro (n=7), rheumatoid factor (n=5) and anti-Scl70 (n=3). Autoimmune disease was diagnosed in 16 (15%) patients, mainly rheumatoid arthritis (n=7) and systemic lupus erythematosus (n=4). Patients with silicosis and autoimmune findings had a lower mean time of exposure to silica and showed a trend toward lower values in pulmonary function tests. Conclusions Autoimmune findings and diagnosis of autoimmune diseases were frequent in patients with silicosis in Spain.
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Weller M, Clemence D, Lau A, Rawlings M, Robertson A, Sankaran B. An assessment of worker exposure to respirable dust and crystalline silica in workshops fabricating engineered stone. Ann Work Expo Health 2024; 68:170-179. [PMID: 38096573 DOI: 10.1093/annweh/wxad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/29/2023] [Indexed: 02/21/2024] Open
Abstract
There is a significant silicosis risk for workers fabricating engineered stone (ES) products containing crystalline silica. The aims of this study by SafeWork NSW were to: (i) assess current worker exposure to respirable dust (RD) and respirable crystalline silica (RCS) following a 5-y awareness and compliance program of inspections in ES workshops and (ii) to identify improvements in work practices from the available evidence base to further reduce exposures. One hundred and twenty-three personal full shift samples taken on as many workers and 34 static samples across 27 workshops fabricating ES were included in the final assessment. The exposure assessment was conducted using Casella Higgins-Dewell cyclones (Casella TSI) placed in the breathing zone of workers attached to SKC Air Check XR 5000 or SKC Chek TOUCH sampling pumps. Sample filters were sent to an ISO (2017) 17025:2017 accredited laboratory for gravimetric analysis for RD and X-Ray Diffraction (XRD) analysis to determine the amount of deposited RCS i.e. alpha-quartz and cristobalite. All workshops used wet methods of fabrication. The geometric mean (GM) of the pooled result for respirable dust (RD) was 0.09 mg/m3 TWA-8 h and 0.034 mg/m3 TWA-8 h for RCS. The highest exposed workers with a GM RCS of 0.062 mg/m3 TWA-8 h were those using pneumatic hand tools for cutting or grinding combined with polishing tasks. Workers operating semiautomated routers and edge polishers had the lowest GM RCS exposures of 0.022 mg/m3 TWA-8 h and 0.018 mg/m3 TWA-8 h respectively. Although ES workers remain exposed to RCS above the workplace exposure limit (WEL) of 0.05 mg/m 3 TWA-8 h, these results point to a very substantial reduction in exposures compared to poorly controlled dry methods of fabrication. Therefore, the wearing of respiratory protection by workers remains necessary until further control measures are more widely adopted across the entire industry e.g. reduction in the crystalline silica content of ES.
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Affiliation(s)
- Michael Weller
- Hygiene and Toxicology; (Chemicals, Explosives and Safety Auditing Directorate) SafeWork New South Wales, Parramatta 2150, Australia
| | - Dennis Clemence
- Hygiene and Toxicology; (Chemicals, Explosives and Safety Auditing Directorate) SafeWork New South Wales, Parramatta 2150, Australia
| | - Abe Lau
- Hygiene and Toxicology; (Chemicals, Explosives and Safety Auditing Directorate) SafeWork New South Wales, Parramatta 2150, Australia
| | - Mark Rawlings
- Hygiene and Toxicology; (Chemicals, Explosives and Safety Auditing Directorate) SafeWork New South Wales, Parramatta 2150, Australia
| | - Amy Robertson
- Hygiene and Toxicology; (Chemicals, Explosives and Safety Auditing Directorate) SafeWork New South Wales, Parramatta 2150, Australia
| | - Bhoopathy Sankaran
- Hygiene and Toxicology; (Chemicals, Explosives and Safety Auditing Directorate) SafeWork New South Wales, Parramatta 2150, Australia
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Akira M, Suganuma N. Imaging diagnosis of pneumoconiosis with predominant nodular pattern: HRCT and pathologic findings. Clin Imaging 2023; 97:28-33. [PMID: 36878176 DOI: 10.1016/j.clinimag.2023.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/30/2023] [Accepted: 02/13/2023] [Indexed: 02/19/2023]
Abstract
The radiological patterns of known pneumoconiosis have been changing in recent years. The basic pathology in pneumoconiosis is the presence of dust macules, mixed dust fibrosis, nodules, diffuse interstitial fibrosis, and progressive massive fibrosis. These pathologic changes can coexist in dust-exposed workers. High resolution CT reflects pathological findings in pneumoconiosis and is useful for the diagnosis. Pneumoconiosis such as silicosis, coal workers' pneumoconiosis, graphite pneumoconiosis, and welder's pneumoconiosis, has predominant nodular HRCT pattern. Diffuse interstitial pulmonary fibrosis is sometimes found in the lungs of this pneumoconiosis. In the early stages of metal lung, such as aluminosis and hard metal lung, centrilobular nodules are predominant findings, and in the advanced stages, reticular opacities are predominant findings. The clinician must understand the spectrum of expected imaging patterns related to known dust exposures and novel exposures. In this article, HRCT and pathologic findings of pneumoconiosis with predominant nodular opacities are shown.
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Affiliation(s)
- Masanori Akira
- Department of Radiology, Shin-Aikai Katano Hospital, 39-1 Matsuzuka, Katano City, Osaka 576-0043, Japan.
| | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Okochokohasu, Nankoku, Kochi 783-0043, Japan.
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Xu W, Ma R, Wang J, Sun D, Yu S, Ye Q. Pneumoconiosis combined with connective tissue disease in China: a cross-sectional study. BMJ Open 2023; 13:e068628. [PMID: 37012009 PMCID: PMC10083820 DOI: 10.1136/bmjopen-2022-068628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
OBJECTIVE To describe the prevalence, clinical features and potential risk factors of pneumoconiosis in combination with connective tissue disease (CTD) or positive autoantibodies. DESIGN Cross-sectional study. SETTING A retrospective study of adults recruited in China between December 2016 and November 2021. PARTICIPANTS A total of 931 patients with pneumoconiosis at Beijing Chao-Yang Hospital were enrolled in this study; of these, 580 patients were included in the final analysis. MAIN OUTCOME MEASURES Pneumoconiosis combined with CTD or positive autoantibodies was a major adverse outcome. RESULTS In total, 13.8% (80/580) of the patients had combined pneumoconiosis with CTD, among whom the prevalence of CTD was 18.3% (46/251) in asbestosis and 11.4% (34/298) in silicosis/coal mine workers' pneumoconiosis. In comparison to the general Chinese adult population, the relative risk of various CTD in pneumoconiosis, including rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, primary Sjögren's syndrome, idiopathic inflammatory myopathy and antineutrophil cytoplasmic antibodies-associated vasculitis, were 11.85, 12.12, 127.40, 4.23, 9.94 and 644.66, respectively. Multivariate analysis revealed that female sex (OR 2.55, 95% CI 1.56 to 4.17) and a later stage of pneumoconiosis (OR 2.04, 95% CI 1.24 to 3.34) were the independent risk factors for CTD in patients with pneumoconiosis (all p<0.050). CONCLUSION CTD is highly prevalent in patients with pneumoconiosis, especially in patients of asbestosis, and silicosis/coal mine workers' pneumoconiosis. Female sex and later stages of pneumoconiosis are associated with an increased risk of combined with CTD.
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Affiliation(s)
- Wenjing Xu
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- Department of Pulmonary and Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, China
| | - Ruimin Ma
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jingwei Wang
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Di Sun
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Shiwen Yu
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Qiao Ye
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Surasi K, Ballen B, Weinberg JL, Materna BL, Harrison R, Cummings KJ, Heinzerling A. Elevated exposures to respirable crystalline silica among engineered stone fabrication workers in California, January 2019-February 2020. Am J Ind Med 2022; 65:701-707. [PMID: 35899403 DOI: 10.1002/ajim.23416] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/12/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Workers fabricating engineered stone face high risk for exposure to respirable crystalline silica (RCS) and subsequent development of silicosis. In response, the California Division of Occupational Safety and Health (Cal/OSHA) performed targeted enforcement inspections at engineered stone fabrication worksites. We investigated RCS exposures and employer adherence to Cal/OSHA's RCS and respiratory protection standards from these inspections to assess ongoing risk to stone fabrication workers. METHODS We extracted employee personal air sampling results from Cal/OSHA inspection files and calculated RCS exposures. Standards require that employers continue monitoring employee RCS exposures and perform medical surveillance when exposures are at or above the action level (AL; 25 μg/m3 ); exposures above the permissible exposure limit (PEL; 50 μg/m3 ) are prohibited. We obtained RCS and respiratory protection standard violation citations from a federal database. RESULTS We analyzed RCS exposures for 152 employees at 47 workplaces. Thirty-eight (25%) employees had exposures above the PEL (median = 89.7 μg/m3 ; range = 50.7-670.7 μg/m3 ); 17 (11%) had exposures between the AL and PEL. Twenty-four (51%) workplaces had ≥1 exposure above the PEL; 7 (15%) had ≥1 exposure between the AL and PEL. Thirty-four (72%) workplaces were cited for ≥1 RCS standard violation. Twenty-seven (57%) workplaces were cited for ≥1 respiratory protection standard violation. CONCLUSIONS Our investigation demonstrates widespread RCS overexposure among workers and numerous employer Cal/OSHA standard violation citations. More enforcement and educational efforts could improve employer compliance with Cal/OSHA standards and inform employers and employees of the risks for RCS exposure and strategies for reducing exposure.
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Affiliation(s)
- Krishna Surasi
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA
- Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, Georgia, USA
| | - Brittany Ballen
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA
- University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Justine L Weinberg
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA
- Public Health Institute, Richmond, Richmond, USA
| | - Barbara L Materna
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA
| | - Robert Harrison
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA
- University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Kristin J Cummings
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA
| | - Amy Heinzerling
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA
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Hoy RF, Jeebhay MF, Cavalin C, Chen W, Cohen RA, Fireman E, Go LHT, León-Jiménez A, Menéndez-Navarro A, Ribeiro M, Rosental PA. Current global perspectives on silicosis-Convergence of old and newly emergent hazards. Respirology 2022; 27:387-398. [PMID: 35302259 PMCID: PMC9310854 DOI: 10.1111/resp.14242] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/05/2022] [Indexed: 01/03/2023]
Abstract
Silicosis not a disease of the past. It is an irreversible, fibrotic lung disease specifically caused by exposure to respirable crystalline silica (RCS) dust. Over 20,000 incident cases of silicosis were identified in 2017 and millions of workers continue to be exposed to RCS. Identified case numbers are however a substantial underestimation due to deficiencies in reporting systems and occupational respiratory health surveillance programmes in many countries. Insecure workers, immigrants and workers in small businesses are at particular risk of more intense RCS exposure. Much of the focus of research and prevention activities has been on the mining sector. Hazardous RCS exposure however occurs in a wide range of occupational setting which receive less attention, in particular the construction industry. Recent outbreaks of silicosis associated with the fabrication of domestic kitchen benchtops from high‐silica content artificial stone have been particularly notable because of the young age of affected workers, short duration of RCS exposure and often rapid disease progression. Developments in nanotechnology and hydraulic fracking provide further examples of how rapid changes in technology and industrial processes require governments to maintain constant vigilance to identify and control potential sources of RCS exposure. Despite countries around the world dealing with similar issues related to RCS exposure, there is an absence of sustained global public health response including lack of consensus of an occupational exposure limit that would provide protection to workers. Although there are complex challenges, global elimination of silicosis must remain the goal. See relatedEditorial
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Affiliation(s)
- Ryan F Hoy
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.,Department of Respiratory Medicine, The Alfred Hospital, Prahran, Victoria, Australia
| | - Mohamed F Jeebhay
- Occupational Medicine Division and Centre for Environmental & Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Catherine Cavalin
- CNRS (IRISSO, UMR CNRS-INRAE 7170-1427), Université Paris-Dauphine, PSL, Soutien à la mobilité internationale (SMI) du CNRS, Paris, France.,Madrid Institute for Advanced Study (MIAS), Madrid, Spain.,Interdisciplinary Laboratory for the Evaluation of Public Policies, LIEPP, Sciences Po, Paris, France.,Employment and Labour Research Centre, CNAM, Noisy-le-Grand, France
| | - Weihong Chen
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Robert A Cohen
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Environmental and Occupational Health Sciences Division, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
| | - Elizabeth Fireman
- Institute of Pulmonary and Allergic Diseases, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department Occupational Environmental Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Leonard H T Go
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Environmental and Occupational Health Sciences Division, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
| | - Antonio León-Jiménez
- Pulmonology, Allergy and Thoracic Surgery Department, Puerta del Mar University Hospital, Cádiz, Spain
| | | | - Marcos Ribeiro
- Pulmonary Department, Universidade Estadual de Londrina: Londrina, Paraná, Brazil
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11
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Kumarasamy C, Pisaniello D, Gaskin S, Hall T. OUP accepted manuscript. Ann Work Expo Health 2022; 66:937-945. [PMID: 35411922 PMCID: PMC9357346 DOI: 10.1093/annweh/wxac020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/01/2022] [Accepted: 03/11/2022] [Indexed: 12/02/2022] Open
Abstract
Artificial stone (AS) is a composite material that has seen widespread use in construction, particularly for kitchen benchtops. However, fabrication processes with AS have been associated with serious lung disease. Safety data sheets (SDSs) aim to provide important information pertaining to composition and health risks. In the case of a complex mixture, SDSs may be problematic in terms of specific information on overall health risks. To assess this issue, we compared empirically determined mineral, metallic, and organic resin content of 25 individual AS products across six suppliers, with the corresponding SDS information. X-ray diffraction was used to quantitate the mineralogical components of AS samples, and X-ray fluorescence was used to estimate the metallic components. Organic material (resin content) was estimated using weight loss during calcination. Although the resin content for all AS samples was within the SDS-reported ranges, there was considerable variability in the crystalline silica content when comparing with supplier’s SDS. Potentially toxicologically relevant metallic and mineral constituents were not reported. Some supplier SDSs were found to provide more information than others. Only one of the six suppliers provided crystalline mineral content other than silica, and only two suppliers provided any information about metals. There remains a limited understanding of lung pathogenesis from AS, and this study highlights the need for more comprehensive and standardized SDS information for risk assessment and management.
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Affiliation(s)
| | - Dino Pisaniello
- Author to whom correspondence should be addressed. Tel: +61 8 83133571; e-mail:
| | - Sharyn Gaskin
- Adelaide Exposure Science and Health, School of Public Health, University of Adelaide, Adelaide, SA, Australia
- Curtin Medical School, Curtin University, Perth, WA, Australia
| | - Tony Hall
- Department of Earth Sciences, School of Physical Sciences, University of Adelaide, Adelaide, SA, Australia
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12
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Salamon F, Martinelli A, Vianello L, Bizzotto R, Gottardo O, Guarnieri G, Franceschi A, Porru S, Cena L, Carrieri M. Occupational exposure to crystalline silica in artificial stone processing. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2021; 18:547-554. [PMID: 34643481 DOI: 10.1080/15459624.2021.1990303] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Respirable Crystalline Silica (RCS) is a hazardous substance with known effects that can be well correlated with exposure levels that still persist in many traditional sectors, such as construction or stone processing. In the past decade, exposure scenarios for RCS have been found in the sector of artificial stone processing. The aim of this study is to evaluate the levels of RCS in facilities specialized in the production of artificial stone countertops and other accessories for the furnishing of kitchens, bathrooms, and offices after the introduction of some preventive technical measures such as wet processing or local exhaust ventilation systems. The study involved 51 subjects in four facilities. Personal silica exposure assessment was carried out using GS3 cyclones positioned in the breathing zone during the work shift. Quantitative determination of silica was carried out by X-ray diffraction analysis. Respirable dust levels were in the range 0.046-1.154 mg/m3 with RCS levels within the range <0.003-0.098 mg/m3. The highest exposure was found in dry finishing operations. Although there was a remarkable reduction in RCS exposure levels compared to what was observed in the past before the introduction of preventive measures, the data still showed hazardous exposure levels for some of the monitored activities.
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Affiliation(s)
- Fabiola Salamon
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Andrea Martinelli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Liviano Vianello
- Department of Prevention, ULSS7 Pedemontana, Bassano del Grappa (VI), Italy
| | | | | | - Gabriella Guarnieri
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Antonia Franceschi
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Stefano Porru
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Lorenzo Cena
- Department of Health, West Chester University of Pennsylvania, West Chester, PA
| | - Mariella Carrieri
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
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13
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León-Jiménez A, Mánuel JM, García-Rojo M, Pintado-Herrera MG, López-López JA, Hidalgo-Molina A, García R, Muriel-Cueto P, Maira-González N, Del Castillo-Otero D, Morales FM. Compositional and structural analysis of engineered stones and inorganic particles in silicotic nodules of exposed workers. Part Fibre Toxicol 2021; 18:41. [PMID: 34809667 PMCID: PMC8607701 DOI: 10.1186/s12989-021-00434-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 10/31/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Engineered stone silicosis is an emerging disease in many countries worldwide produced by the inhalation of respirable dust of engineered stone. This silicosis has a high incidence among young workers, with a short latency period and greater aggressiveness than silicosis caused by natural materials. Although the silica content is very high and this is the key factor, it has been postulated that other constituents in engineered stones can influence the aggressiveness of the disease. Different samples of engineered stone countertops (fabricated by workers during the years prior to their diagnoses), as well as seven lung samples from exposed patients, were analyzed by multiple techniques. RESULTS The different countertops were composed of SiO2 in percentages between 87.9 and 99.6%, with variable relationships of quartz and cristobalite depending on the sample. The most abundant metals were Al, Na, Fe, Ca and Ti. The most frequent volatile organic compounds were styrene, toluene and m-xylene, and among the polycyclic aromatic hydrocarbons, phenanthrene and naphthalene were detected in all samples. Patients were all males, between 26 and 46 years-old (average age: 36) at the moment of the diagnosis. They were exposed to the engineered stone an average time of 14 years. At diagnosis, only one patient had progressive massive fibrosis. After a follow-up period of 8 ± 3 years, four patients presented progressive massive fibrosis. Samples obtained from lung biopsies most frequently showed well or ill-defined nodules, composed of histiocytic cells and fibroblasts without central hyalinization. All tissue samples showed high proportion of Si and Al at the center of the nodules, becoming sparser at the periphery. Al to Si content ratios turned out to be higher than 1 in two of the studied cases. Correlation between Si and Al was very high (r = 0.93). CONCLUSION Some of the volatile organic compounds, polycyclic aromatic hydrocarbons and metals detected in the studied countertop samples have been described as causative of lung inflammation and respiratory disease. Among inorganic constituents, aluminum has been a relevant component within the silicotic nodule, reaching atomic concentrations even higher than silicon in some cases. Such concentrations, both for silicon and aluminum showed a decreasing tendency from the center of the nodule towards its frontier.
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Affiliation(s)
- Antonio León-Jiménez
- Pulmonology, Allergy and Thoracic Surgery Department, Puerta del Mar University Hospital, Cádiz, Spain.
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain.
| | - José M Mánuel
- IMEYMAT: University Institute of Research in Electron Microscopy and Materials of the University of Cadiz, Puerto Real, Cádiz, Spain
- Department of Condensed Matter Physics, School of Sciences, University of Cádiz, Puerto Real, Cádiz, Spain
| | - Marcial García-Rojo
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
- Department of Anatomic Pathology, Puerta del Mar University Hospital, Cádiz, Spain
| | - Marina G Pintado-Herrera
- INMAR: University Research Institute of Marine Research, University of Cádiz, Puerto Real, Cádiz, Spain
- Department of Physical Chemistry, CASEM, University of Cádiz, Puerto Real, Cádiz, Spain
| | - José Antonio López-López
- INMAR: University Research Institute of Marine Research, University of Cádiz, Puerto Real, Cádiz, Spain
- Department of Analytical Chemistry, CASEM, University of Cádiz, Puerto Real, Cádiz, Spain
| | - Antonio Hidalgo-Molina
- Pulmonology, Allergy and Thoracic Surgery Department, Puerta del Mar University Hospital, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
| | - Rafael García
- IMEYMAT: University Institute of Research in Electron Microscopy and Materials of the University of Cadiz, Puerto Real, Cádiz, Spain
- Department of Materials Science, Metallurgical Engineering and Inorganic Chemistry, School of Sciences, University of Cádiz, Puerto Real, Cádiz, Spain
| | - Pedro Muriel-Cueto
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
- Department of Anatomic Pathology, Puerta del Mar University Hospital, Cádiz, Spain
| | | | | | - Francisco M Morales
- IMEYMAT: University Institute of Research in Electron Microscopy and Materials of the University of Cadiz, Puerto Real, Cádiz, Spain
- Department of Materials Science, Metallurgical Engineering and Inorganic Chemistry, School of Sciences, University of Cádiz, Puerto Real, Cádiz, Spain
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14
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Pérez-Alonso A, González-Domínguez ME, Novalbos-Ruiz JP, León-Jiménez A, Córdoba-Doña JA. Artificial Stone Silicosis: Accumulation of errors in the resurgence of an occupational disease: A qualitative study. Work 2021; 70:433-442. [PMID: 34633345 DOI: 10.3233/wor-213582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Exposure to artificial stone machining, under the conditions in which marble workers work with this new product, can cause silicosis. OBJECTIVE To examine the experiences of marble workers affected, both in workshop and during home installation of countertops, before diagnosis of silicosis. METHODS Qualitative study in which 10 open-ended semistructured interviews were conducted with marble workers diagnosed with silicosis after machining artificial stone countertops in Cádiz, Spain. Interviews were recorded, transcribed, and coded using a directed content analysis. Codes were organized into themes. RESULTS Interviews up to 120 minutes and transcript analysis revealed three themes: 1) Heavy exposure for piecework: construction boom in an environment of labor deregulation and high demand for the novel product; 2) Poor working conditions: dry machining of artificial stone without proper protection in the workshop and greater exposure during home installation of countertops; 3) Concatenated legal transgressions: deficiencies in prevention and health surveillance without safety conditions for the correct handling of artificial stone. CONCLUSIONS The fight against an emerging occupational disease-artificial stone silicosis-should focus on detecting affected workers and avoiding new cases, forcing joint efforts to achieve rigorous compliance with health surveillance and protecting marble workers to achieve healthy and safe workplaces.
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Affiliation(s)
| | | | - José Pedro Novalbos-Ruiz
- Biomedicine, Biotechnology and Public Health Department, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
| | - Antonio León-Jiménez
- Pulmonology, Alergology and Thoracic Surgery Service, University Hospital of Puerta del Mar, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
| | - Juan Antonio Córdoba-Doña
- Preventive Medicine and Public Health Service, University Hospital of Jerez de la Frontera, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
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15
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d'Alessandro M, Bellisai F, Bergantini L, Cameli P, D'Alessandro R, Mazzei MA, Gentili F, Conticini E, Selvi E, Frediani B, Matucci-Cerinic M, Bargagli E. Prognostic role of KL-6 in SSc-ILD patients with pleuroparenchymal fibroelastosis. Eur J Clin Invest 2021; 51:e13543. [PMID: 33759179 DOI: 10.1111/eci.13543] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Krebs von den Lungen-6 (KL-6) is a high-molecular-weight (200kDa) glycoprotein proposed as a diagnostic biomarker for differentiating interstitial lung disease (ILD). Systemic sclerosis (SSc) is a rare immune-mediated disorder, and ILD is the leading cause of morbidity and mortality. Pleuroparenchymal fibroelastosis (PPFE) has been described to have a poor prognosis in SSc-ILD patients. This study undertook to compare serial changes in KL-6 in SSc-ILD patients with and without PPFE, to verify its prognostic value as a disease biomarker. MATERIALS AND METHODS Twenty-five SSc-ILD patients (median IQR, 62 (56-58); 20% males) were retrospectively enrolled. 12 SSc-ILD patients (48%) had also a radiological diagnosis of PPFE. Serum KL-6 concentrations were measured by KL-6 reagent assay (Fujirebio Europe, Ghent, Belgium). RESULTS Serum KL-6 measurements were increased in SSc-ILD patients with and without PPFE compared with healthy controls (P < .0001). Comparative analysis of the rate of variation of KL-6 over the 6 years of follow-up was performed by serial two-yearly KL-6 measurements: Δ1(t1-t0), Δ2(t2-t1) and Δ3(t3-t2). In SSc-ILD patients with PPFE pattern, Δ3 was significantly different than those without PPFE pattern (P = .0020). Serum KL-6 levels were significantly different (P = .0455) either at Δ2 and Δ3 in the PPFE group. In SSc-ILD patients with PPFE, at t3 serum KL-6 concentrations were inversely correlated with FEV1 (r = -.76; P = .037) and FVC percentages (r = -.79; P = .028). CONCLUSION These results suggest that serial measurements of KL-6 in the follow-up of these patients may help to monitor disease progression. In real life, in SSc-ILD patients PPFE should be always evaluated at CT and when present should suggest a tight follow-up to monitor its evolution.
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Affiliation(s)
- Miriana d'Alessandro
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, Siena, Italy
| | - Francesca Bellisai
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Laura Bergantini
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, Siena, Italy
| | - Paolo Cameli
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, Siena, Italy
| | - Roberto D'Alessandro
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Maria Antonietta Mazzei
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neurosciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Tuscany, Italy
| | - Francesco Gentili
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neurosciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Tuscany, Italy
| | - Edoardo Conticini
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Enrico Selvi
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Bruno Frediani
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Marco Matucci-Cerinic
- Department of Experimental and Clinical Medicine, Division of Rheumatology, University of Florence, Florence, Italy
| | - Elena Bargagli
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, Siena, Italy
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16
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Gentili F, Monteleone I, Mazzei FG, Luzzi L, Del Roscio D, Guerrini S, Volterrani L, Mazzei MA. Advancement in Diagnostic Imaging of Thymic Tumors. Cancers (Basel) 2021; 13:cancers13143599. [PMID: 34298812 PMCID: PMC8303549 DOI: 10.3390/cancers13143599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/13/2021] [Accepted: 07/16/2021] [Indexed: 01/25/2023] Open
Abstract
Simple Summary Diagnostic imaging is pivotal for the diagnosis and staging of thymic tumors. It is important to distinguish thymoma and other tumor histotypes amenable to surgery from lymphoma. Furthermore, in cases of thymoma, it is necessary to differentiate between early and advanced disease before surgery since patients with locally advanced tumors require neoadjuvant chemotherapy for improving survival. This review aims to provide to radiologists a full spectrum of findings of thymic neoplasms using traditional and innovative imaging modalities. Abstract Thymic tumors are rare neoplasms even if they are the most common primary neoplasm of the anterior mediastinum. In the era of advanced imaging modalities, such as functional MRI, dual-energy CT, perfusion CT and radiomics, it is possible to improve characterization of thymic epithelial tumors and other mediastinal tumors, assessment of tumor invasion into adjacent structures and detection of secondary lymph nodes and metastases. This review aims to illustrate the actual state of the art in diagnostic imaging of thymic lesions, describing imaging findings of thymoma and differential diagnosis.
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Affiliation(s)
- Francesco Gentili
- Unit of Diagnostic Imaging, Department of Radiological Sciences, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (F.G.M.); (S.G.)
- Correspondence:
| | - Ilaria Monteleone
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (I.M.); (D.D.R.); (L.V.); (M.A.M.)
| | - Francesco Giuseppe Mazzei
- Unit of Diagnostic Imaging, Department of Radiological Sciences, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (F.G.M.); (S.G.)
| | - Luca Luzzi
- Thoracic Surgery Unit, Department of Medical, Surgical and Neuro Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy;
| | - Davide Del Roscio
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (I.M.); (D.D.R.); (L.V.); (M.A.M.)
| | - Susanna Guerrini
- Unit of Diagnostic Imaging, Department of Radiological Sciences, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (F.G.M.); (S.G.)
| | - Luca Volterrani
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (I.M.); (D.D.R.); (L.V.); (M.A.M.)
| | - Maria Antonietta Mazzei
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy; (I.M.); (D.D.R.); (L.V.); (M.A.M.)
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17
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Metal Ion Release from Engineered Stone Dust in Artificial Lysosomal Fluid-Variation with Time and Stone Type. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126391. [PMID: 34204842 PMCID: PMC8296209 DOI: 10.3390/ijerph18126391] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/05/2021] [Accepted: 06/08/2021] [Indexed: 11/17/2022]
Abstract
Inhalational exposure to dust from engineered stone (ES), also known as artificial or composite stone, is associated with a specific disease profile, namely accelerated silicosis, and scleroderma. The pathogenic mechanisms are poorly understood, particularly the role of resin and metal ions. Metal ions are present in pigments and constituent minerals and may be considered potential contributors to toxicity. The aim of this preliminary study was to understand the solubility of ES-containing metals in artificial lysosomal fluid (ALF) simulating the acidic intracellular environment of the lung macrophage lysosome. Differences with respect to ES types and temporal release were explored. Ten ES products of variable colour and company origin were comminuted and assessed for four different metals, solubilized into ALF solutions at 1,2,4 and 8 weeks at 37 °C. There was significant variability in metal release, particularly with regard to iron and manganese, which could be correlated with the reflected brightness of the stone. A majority of the available Mn, Fe, Al and Ti was solubilized. Time trends for metal release varied with ES type but also with metal ion. The data suggest a high metal ion bioavailability once engulfed by lung macrophages. There is a need to investigate a wider range of ES dust and relate metal content to markers of ES toxicity.
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18
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Shen H, Lai Y, Tsai H, Chang S. Artificial stone-associated silicosis with concurrent Cryptococcus infection. Respirol Case Rep 2021; 9:e00765. [PMID: 33976894 PMCID: PMC8100870 DOI: 10.1002/rcr2.765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 11/11/2022] Open
Abstract
Acute silicoproteinosis is a disease that develops in weeks, and lasting for years, after massive exposure to silica dust in relatively closed spaces. It was rare, but the cases have recently increased worldwide due to the development of artificial stone industry. Compared with traditional silicosis, artificial stone-associated silicosis is more rapidly progressive and lethal. Hence, a correct diagnosis and optimal treatment are crucial. Here, we present the clinical course of a 33-year-old artificial stonemason who suffered from acute silicoproteinosis with concurrent Cryptococcus infection resulting in profound respiratory failure. This patient was treated by bronchoscope-assisted therapeutic segmental lung lavage and antifungal agent, under mechanical ventilator and ECMO support and recovered well. A brief review of acute silicoproteinosis and artificial stone-associated silicosis is also presented and highlights the new form of industry exposure to silica.
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Affiliation(s)
- Hsiang‐Shi Shen
- Department of Chest MedicineTaipei Veterans General HospitalTaipeiTaiwan
| | - Yu‐Ting Lai
- Division of Pulmonology, Department of Internal MedicineKao‐Hsiung Veterans General Hospital Tainan BranchTainanTaiwan
| | - Han‐Chen Tsai
- Department of NursingTaipei Veterans General HospitalTaipeiTaiwan
- Institute of Emergency and Critical Care MedicineNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Shi‐Chuan Chang
- Institute of Emergency and Critical Care MedicineNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
- Division of Pulmonology, Department of Internal MedicineNational Yang Ming Chiao Tung University HospitalYi‐lanTaiwan
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19
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Requena-Mullor M, Alarcón-Rodríguez R, Parrón-Carreño T, Martínez-López JJ, Lozano-Paniagua D, Hernández AF. Association between Crystalline Silica Dust Exposure and Silicosis Development in Artificial Stone Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115625. [PMID: 34070293 PMCID: PMC8197517 DOI: 10.3390/ijerph18115625] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/12/2021] [Accepted: 05/20/2021] [Indexed: 11/24/2022]
Abstract
Occupational exposure to respirable crystalline silica (SiO2) is one of the most common and serious risks because of the health consequences for the workers involved. Silicosis is a progressive, irreversible, and incurable fibrotic lung disease caused by the inhalation of respirable crystalline silica dust. A cross-sectional epidemiological study was carried out to assess the occupational risk factors that may contribute to the onset of silicosis in workers carrying out work activities with the inhalation of silica compact dust. The study population consisted of 311 artificial stone workers from the province of Almeria (southeast of Spain). Among them, 64 were previously diagnosed with silicosis and the rest of the participants (n = 247 workers) were not diagnosed with such a disease. The workers showing a greater risk of developing silicosis were those who installed kitchen worktops at consumers’ homes, as they did not use face-masks or were not provided with personal protective equipment (PPE) by their business. The results of this study provide support for the evidence indicating that silicosis is a major emerging health concern for workers in the artificial stone sector. Exposure to crystalline silica dust thus can influence the development of silicosis in those cases where individual and collective protection measures are not used or adequately applied.
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Affiliation(s)
- Mar Requena-Mullor
- Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (M.R.-M.); (T.P.-C.); (D.L.-P.)
| | - Raquel Alarcón-Rodríguez
- Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (M.R.-M.); (T.P.-C.); (D.L.-P.)
- Correspondence: ; Tel.: +34-950-214-606
| | - Tesifón Parrón-Carreño
- Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (M.R.-M.); (T.P.-C.); (D.L.-P.)
| | | | - David Lozano-Paniagua
- Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain; (M.R.-M.); (T.P.-C.); (D.L.-P.)
| | - Antonio F. Hernández
- Department of Legal Medicine and Toxicology, University of Granada School of Medicine, 18016 Granada, Spain;
- Instituto de Investigación Biosanitaria, Granada (ibs.GRANADA), 18012 Madrid, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 18080 Madrid, Spain
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20
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Gentili F, Guerrini S, Mazzei FG, Monteleone I, Di Meglio N, Sansotta L, Perrella A, Puglisi S, De Filippo M, Gennaro P, Volterrani L, Castagna MG, Dotta F, Mazzei MA. Dual energy CT in gland tumors: a comprehensive narrative review and differential diagnosis. Gland Surg 2020; 9:2269-2282. [PMID: 33447579 DOI: 10.21037/gs-20-543] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Dual energy CT (DECT)with image acquisition at two different photon X-ray levels allows the characterization of a specific tissue or material/elements, the extrapolation of virtual unenhanced and monoenergetic images, and the quantification of iodine uptake; such special capabilities make the DECT the perfect technique to support oncological imaging for tumor detection and characterization and treatment monitoring, while concurrently reducing the dose of radiation and iodine and improving the metal artifact reduction. Even though its potential in the field of oncology has not been fully explored yet, DECT is already widely used today thanks to the availability of different CT technologies, such as dual-source, single-source rapid-switching, single-source sequential, single-source twin-beam and dual-layer technologies. Moreover DECT technology represents the future of the imaging innovation and it is subject to ongoing development that increase according its clinical potentiality, in particular in the field of oncology. This review points out recent state-of-the-art in DECT applications in gland tumors, with special focus on its potential uses in the field of oncological imaging of endocrine and exocrine glands.
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Affiliation(s)
- Francesco Gentili
- Unit of Diagnostic Imaging, Department of Radiological Sciences, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Susanna Guerrini
- Unit of Diagnostic Imaging, Department of Radiological Sciences, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Francesco Giuseppe Mazzei
- Unit of Diagnostic Imaging, Department of Radiological Sciences, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Ilaria Monteleone
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Nunzia Di Meglio
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Letizia Sansotta
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Armando Perrella
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Sara Puglisi
- Unit of Radiology, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Massimo De Filippo
- Unit of Radiology, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Paolo Gennaro
- Department of Maxillofacial Surgery, University of Siena, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Luca Volterrani
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Maria Grazia Castagna
- Unit of Endocrinology, Department of Medical, Surgical and Neuro Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Francesco Dotta
- Unit of Diabetology, Department of Medical, Surgical and Neuro Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Maria Antonietta Mazzei
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
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Hoy RF, Chambers DC. Silica-related diseases in the modern world. Allergy 2020; 75:2805-2817. [PMID: 31989662 DOI: 10.1111/all.14202] [Citation(s) in RCA: 183] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 12/20/2019] [Accepted: 01/08/2020] [Indexed: 11/28/2022]
Abstract
Silicosis is an ancient and potentially fatal pneumoconiosis caused by exposure to respirable crystalline silica. Silicosis is historically a disease of miners; however, failure to recognize and control the risk associated with silica exposure in contemporary work practices such as sandblasting denim jeans and manufacturing of artificial stone benchtops has led to re-emergence of silicosis around the world. This review outlines the mineralogy, epidemiology, clinical and radiological features of the various forms of silicosis and other silica-associated diseases. Perspective is provided on the most recent studies shedding light on pathogenesis, including the central role of innate immune effector cells and subsequent inflammatory cascades in propagating pulmonary fibrosis and the extrapulmonary manifestations, which uniquely characterize this pneumoconiosis. Clinical conundrums in differential diagnosis, particularly between silicosis and sarcoidosis, are highlighted, as is the importance of obtaining a careful occupational history in the patient presenting with pulmonary infiltrates and/or fibrosis. While silicosis is a completely preventable disease, unfortunately workers around the world continue to be affected and experience progressive or even fatal disease. Although no treatments have been proven, opportunities to intervene to prevent progressive disease, founded in a thorough cellular and molecular understanding of the immunopathology of silicosis, are highlighted.
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Affiliation(s)
- Ryan F. Hoy
- Department of Epidemiology and Preventive Medicine School of Public Health and Preventive Medicine Monash University Melbourne VIC. Australia
- Department of Respiratory Medicine Alfred Hospital Melbourne VIC. Australia
| | - Daniel C. Chambers
- School of Clinical Medicine The University of Queensland Brisbane QLD Australia
- Queensland Lung Transplant Program The Prince Charles Hospital Brisbane QLD Australia
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León-Jiménez A, Hidalgo-Molina A, Conde-Sánchez MÁ, Pérez-Alonso A, Morales-Morales JM, García-Gámez EM, Córdoba-Doña JA. Artificial Stone Silicosis. Chest 2020; 158:1060-1068. [DOI: 10.1016/j.chest.2020.03.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 02/26/2020] [Accepted: 03/01/2020] [Indexed: 11/30/2022] Open
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Carrieri M, Guzzardo C, Farcas D, Cena LG. Characterization of Silica Exposure during Manufacturing of Artificial Stone Countertops. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124489. [PMID: 32580452 PMCID: PMC7345731 DOI: 10.3390/ijerph17124489] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/13/2020] [Accepted: 06/21/2020] [Indexed: 11/16/2022]
Abstract
Artificial stone is increasing in popularity in construction applications, including commercial and residential countertops. Eco-friendliness, durability, and resistance to staining, make artificial stone attractive to consumers. Health concerns have arisen during manufacturing of artificial stone due to increased incidence of silicosis after relatively short exposure. Three artificial stone samples (A, B, and C) and one natural granite sample were subjected to cutting and grinding in a controlled environment. Gravimetric analysis, X-Ray diffraction, and scanning electron microscopy with energy dispersive spectroscopy were employed to determine crystalline silica concentrations and particle morphology of bulk and respirable particles. Silica content of bulk dust from artificial samples A and B was 91%, sample C was <10%, while granite was 31%. Silica percent in the respirable fraction for samples A and B was 53% and 54%, respectively, while sample C was <5% and granite was 8%. Number concentrations for samples A and B were mainly in the nano-fraction, indicating potential for translocation of silica particles to other organs outside of the lungs. Respirable dust concentrations inside the chamber were well above Occupational Safety and Health Administration standards for all materials, indicating that confined-space exposures require ventilation to lower risks of acute silicosis regardless of the nature of the stone.
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Affiliation(s)
- Mariella Carrieri
- Department of Cardiologic, Thoracic Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy;
| | - Carly Guzzardo
- Department of Health, West Chester University of Pennsylvania, West Chester, PA 19383, USA;
| | - Daniel Farcas
- Department of Occupational and Environmental Health Sciences, West Virginia University, Morgantown, WV 26505, USA;
- Windjammer Environmental LLC, National Harbor, Washington, DC 20745, USA
| | - Lorenzo G. Cena
- Department of Health, West Chester University of Pennsylvania, West Chester, PA 19383, USA;
- Correspondence:
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24
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Wu N, Xue C, Yu S, Ye Q. Artificial stone-associated silicosis in China: A prospective comparison with natural stone-associated silicosis. Respirology 2020; 25:518-524. [PMID: 31828940 PMCID: PMC7187561 DOI: 10.1111/resp.13744] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 10/23/2019] [Accepted: 10/28/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE We recently noted a dramatic increase in the number of patients with accelerated silicosis associated with exposure to artificial stone dust. Therefore, the natural history of artificial stone-associated silicosis was compared with that of natural stone-associated silicosis. METHODS A total of 18 patients with artificial stone-associated silicosis and 63 with natural stone-associated silicosis were diagnosed sequentially in 2018 and followed up for a period of 6-12 months. Data were collected from clinical charts. RESULTS The median duration of exposure prior to onset of symptoms of silicosis was shorter for patients who had been exposed to artificial stone dust (6.4 vs 29.3 years, P < 0.01). Four of the 18 patients experienced rapid deterioration in lung function over the follow-up period, with declines in pre-bronchodilator FVC of 587 (210-960) mL/year and FEV1 of 625 (360-860) mL/year. GGO, PMF, emphysema and pulmonary artery widening were more frequently observed on computed tomography scans of patients with artificial stone-associated silicosis than of those with natural stone-associated silicosis. Approximately 38.9% of the patients with artificial stone-associated silicosis were lung transplant candidates and 27.8% died, both rates being significantly higher than in patients with natural stone-associated silicosis (3.2% and 0%, both P < 0.01). CONCLUSION Compared to natural stone-associated silicosis, artificial stone-associated silicosis was characterized by short latency, rapid radiological progression, accelerated decline in lung function and high mortality.
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Affiliation(s)
- Na Wu
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung DiseasesBeijing Chao‐Yang Hospital, Capital Medical UniversityBeijingChina
| | - Changjiang Xue
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung DiseasesBeijing Chao‐Yang Hospital, Capital Medical UniversityBeijingChina
| | - Shiwen Yu
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung DiseasesBeijing Chao‐Yang Hospital, Capital Medical UniversityBeijingChina
| | - Qiao Ye
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung DiseasesBeijing Chao‐Yang Hospital, Capital Medical UniversityBeijingChina
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25
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Guarnieri G, Salasnich M, Lucernoni P, Sbaraglia M, Putzu MG, Zuliani P, Rossi F, Vio S, Bianchi L, Martinelli A, Gottardo O, Bizzotto R, Maestrelli P, Mason P, Carrieri M. Silicosis in finishing workers in quartz conglomerates processing. LA MEDICINA DEL LAVORO 2020; 111:99-106. [PMID: 32352423 PMCID: PMC7810008 DOI: 10.23749/mdl.v111i2.9115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/14/2020] [Accepted: 03/19/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Outbreaks of silicosis have bene recently reported in artificial stone workers. AIM To describe the features of silicosis in quartz conglomerate workers in North-Eastern Italy. METHODS Active search of pneumoconiosis was performed in 11 companies of North-Eastern Italy involved in the fabrication of quartz conglomerate countertops. Occupational history, lung function tests, chest X-ray and high resolution computed tomography (HRCT) were performed. In selected cases, trans-bronchial biopsies were taken for histological evaluation and identification of silica crystals in the tissue. Cumulative exposure to crystalline silica was estimated. RESULTS We recruited 45 workers and 24 cases of silicosis were diagnosed. Mean age at diagnosis was 43 years and duration of exposure to quartz conglomerate dust was 3.5 to 20 years. The average silica cumulative exposure was 4.3 mg/m3/y. Abnormal findings were detected in 42% of chest X-rays, in 33% of spirometry and 50% of carbon monoxide lung diffusion (DLco). HRCTs were abnormal in all cases showing well-defined rounded opacities, irregular/linear intralobular opacities and bilateral enlarged mediastinal lymph-nodes. Histological findings consistent with silicosis were observed in 24 cases. Numerous silica particles (diameter 0.1-5 µm) were identified in lung tissue. CONCLUSIONS We reported an unexpected high incidence of silicosis in Italian workers exposed to quartz conglomerate dust. The results suggest that chest HRCT is indicated for screening of workers with high exposure to silica and DLco should be added to spirometry in health surveillance. More rigorous application of safety regulations and more effective preventive interventions at work are necessary.
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Affiliation(s)
- Gabriella Guarnieri
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy.
| | - Mauro Salasnich
- Respiratory Unit, Ca' Foncello Hospital, Azienda ULSS 2 Marca Trevigiana, Treviso, Italy.
| | - Paolo Lucernoni
- Respiratory Unit, Ca' Foncello Hospital, Azienda ULSS 2 Marca Trevigiana, Treviso, Italy.
| | - Marta Sbaraglia
- Pathology Unit, Ca' Foncello Hospital, Azienda ULSS 2 Marca Trevigiana, Treviso, Italy.
| | - Maria Grazia Putzu
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy.
| | - Paolo Zuliani
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy.
| | - Federica Rossi
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy.
| | - Stefania Vio
- Radiology Unit, University Hospital, Padua, Italy.
| | - Leonardo Bianchi
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy.
| | - Andrea Martinelli
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy.
| | | | | | - Piero Maestrelli
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy.
| | - Paola Mason
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy.
| | - Mariella Carrieri
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy.
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Jones CM, Pasricha SS, Heinze SB, MacDonald S. Silicosis in artificial stone workers: Spectrum of radiological high‐resolution CT chest findings. J Med Imaging Radiat Oncol 2020; 64:241-249. [PMID: 32157793 DOI: 10.1111/1754-9485.13015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 02/06/2020] [Indexed: 01/20/2023]
Affiliation(s)
| | | | - Stefan B Heinze
- Department of Radiology Royal Melbourne Hospital Melbourne Victoria Australia
| | - Sharyn MacDonald
- Department of Radiology Canterbury and West Coast Hospitals Christchurch New Zealand
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27
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Levin K, McLean C, Hoy R. Artificial stone-associated silicosis: clinical-pathological-radiological correlates of disease. Respirol Case Rep 2019; 7:e00470. [PMID: 31428428 PMCID: PMC6696906 DOI: 10.1002/rcr2.470] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 06/21/2019] [Accepted: 07/14/2019] [Indexed: 11/29/2022] Open
Abstract
Occupational lung disease secondary to inhalation of silica particles is variable and potentially life-threatening. As the artificial stone industry has grown over the last two decades, the development of silicosis has been seen to accelerate and behave differently to chronic silicosis. In this case report, we present two patients who underwent lung transplantation for silicosis at the Alfred Hospital, both with predominantly artificial stone masonry exposure. We have identified the presence of both fibrotic/nodular silicosis and conspicuous alveolar proteinosis within the same lung parenchyma of both patients. We then demonstrate the radiological and histopathological correlates of disease; the first time this has been shown clearly in the literature.
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Affiliation(s)
- Kovi Levin
- Respiratory MedicineAlfred HealthMelbourneAustralia
| | | | - Ryan Hoy
- Respiratory MedicineAlfred HealthMelbourneAustralia
- Department of Epidemiology and Preventive MedicineSchool of Public Health, Monash UniversityMelbourneAustralia
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Barnes H, Goh NSL, Leong TL, Hoy R. Silica-associated lung disease: An old-world exposure in modern industries. Respirology 2019; 24:1165-1175. [PMID: 31517432 DOI: 10.1111/resp.13695] [Citation(s) in RCA: 164] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 12/31/2022]
Abstract
Despite silica dust exposure being one of the earliest recognized causes of lung disease, Australia, USA, Israel, Turkey and other countries around the world have recently experienced significant outbreaks of silicosis. These outbreaks have occurred in modern industries such as denim jean production, domestic benchtop fabrication and jewellery polishing, where silica has been introduced without recognition and control of the hazard. Much of our understanding of silica-related lung disease is derived from traditional occupations such as mining, whereby workers may develop slowly progressive chronic silicosis. However, workers in modern industries are developing acute and accelerated silicosis over a short period of time, due to high-intensity silica concentrations, oxidative stress from freshly fractured silica and a rapid pro-inflammatory and pro-fibrotic response. Appropriate methods of screening and diagnosis remain unclear in these workers, and a significant proportion may go on to develop respiratory failure and death. There are no current effective treatments for silicosis. For those with near fatal respiratory failure, lung transplantation remains the only option. Strategies to reduce high-intensity silica dust exposure, enforced screening programmes and the identification of new treatments are urgently required.
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Affiliation(s)
- Hayley Barnes
- Department of Respiratory Medicine, Alfred Hospital, Melbourne, VIC, Australia.,Department of Respiratory Medicine, Austin Hospital, Melbourne, VIC, Australia.,Institute for Breathing and Sleep, Melbourne, VIC, Australia
| | - Nicole S L Goh
- Department of Respiratory Medicine, Alfred Hospital, Melbourne, VIC, Australia.,Department of Respiratory Medicine, Austin Hospital, Melbourne, VIC, Australia.,Institute for Breathing and Sleep, Melbourne, VIC, Australia
| | - Tracy L Leong
- Department of Respiratory Medicine, Austin Hospital, Melbourne, VIC, Australia.,Institute for Breathing and Sleep, Melbourne, VIC, Australia
| | - Ryan Hoy
- Department of Medicine, University of Melbourne, Melbourne, VIC, Australia.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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30
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Di Benedetto F, Giaccherini A, Montegrossi G, Pardi LA, Zoleo A, Capolupo F, Innocenti M, Lepore GO, d'Acapito F, Capacci F, Poli C, Iaia TE, Buccianti A, Romanelli M. Chemical variability of artificial stone powders in relation to their health effects. Sci Rep 2019; 9:6531. [PMID: 31024082 PMCID: PMC6484096 DOI: 10.1038/s41598-019-42238-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 03/21/2019] [Indexed: 11/23/2022] Open
Abstract
The occurrence of highly severe silica-related diseases among the resin- and silica-based artificial stone workers was claimed, associated to an extremely short latency. High levels of exposure and intrinsic properties of AS are thought to modulate the development of silicosis and auto-immune diseases. This study compares parent materials and processed dusts, to shed light on changes of AS occurring in the manufacturing process, through an XRF, EPR and XAS investigation. We point out the extremely wide variability of the materials, the occurrence of chemical signatures impressed by the processing techniques, and the unprecedented generation of stable radicals associated to the lysis of the Si-O chemical bond inside the resin coated respirable crystalline silica. These results suggest that the AS processing in industrial stone workshops can create respirable dusts with peculiar physical and chemical properties, to be correlated to the observed clinical evidences.
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Affiliation(s)
- Francesco Di Benedetto
- Dipartimento di Scienze della Terra, Università degli Studi di Firenze, via La Pira 4, Firenze, Italy. .,INSTM Research Unit of Florence, Firenze, Italy.
| | - Andrea Giaccherini
- Dipartimento di Scienze della Terra, Università degli Studi di Firenze, via La Pira 4, Firenze, Italy.,INSTM Research Unit of Florence, Firenze, Italy
| | - Giordano Montegrossi
- INSTM Research Unit of Florence, Firenze, Italy.,CNR - Istituto di Geoscienze e Georisorse, via La Pira 4, Firenze, Italy
| | - Luca A Pardi
- CNR - Istituto dei Processi Chimico Fisici, via Moruzzi 1, Pisa, Italy
| | - Alfonso Zoleo
- Dipartimento di Scienze Chimiche - Università di Padova, Via Marzolo 1, Padova, Italy
| | - Ferdinando Capolupo
- Dipartimento di Chimica, Università degli Studi di Firenze, via della Lastruccia 3, Sesto Fiorentino, Italy
| | - Massimo Innocenti
- INSTM Research Unit of Florence, Firenze, Italy.,Dipartimento di Chimica, Università degli Studi di Firenze, via della Lastruccia 3, Sesto Fiorentino, Italy
| | - Giovanni O Lepore
- CNR - Istituto di Officina dei Materiali - OGG c/o, ESRF, Grenoble, France
| | | | - Fabio Capacci
- Dipartimento di Prevenzione, PISLL, Health Agency of Tuscany (USL Toscana Centro), Tuscany, Italy
| | - Carla Poli
- Dipartimento di Prevenzione, PISLL, Health Agency of Tuscany (USL Toscana Centro), Tuscany, Italy
| | - Tonina Enza Iaia
- Dipartimento di Prevenzione, PISLL, Health Agency of Tuscany (USL Toscana Centro), Tuscany, Italy
| | - Antonella Buccianti
- Dipartimento di Scienze della Terra, Università degli Studi di Firenze, via La Pira 4, Firenze, Italy.,CNR - Istituto di Geoscienze e Georisorse, via La Pira 4, Firenze, Italy
| | - Maurizio Romanelli
- Dipartimento di Scienze della Terra, Università degli Studi di Firenze, via La Pira 4, Firenze, Italy
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Martínez González C, Prieto González A, García Alfonso L, Fernández Fernández L, Moreda Bernardo A, Fernández Álvarez R, Rolle-Sóñora V, Ruano Raviña A, Casan Clarà P. Silicosis in Artificial Quartz Conglomerate Workers. Arch Bronconeumol 2019; 55:459-464. [PMID: 30879876 DOI: 10.1016/j.arbres.2019.01.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/17/2019] [Accepted: 01/20/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Silicosis is a chronic progressive disease caused by inhalation of crystalline silica. Most cases develop in underground mine workers and in subjects involved in the extraction of natural stone (slate and granite). In view of the progressive emergence of new cases of silicosis in artificial quartz conglomerate workers, we performed a study to analyze the characteristics of silicosis produced by this new agent in Spain. METHODS The study consisted of a series of 96 cases of silicosis diagnosed according to international criteria during the period 2010-2017. We analyzed clinical, radiological, pathological and functional characteristics. RESULTS Mean age of participants was 45 years; 55% had simple silicosis and 45% had complicated silicosis. Ten patients were diagnosed with accelerated silicosis, with a mean age of 33 years. Mean time of exposure to conglomerates was 15 years, and 77% had not used appropriate protection measures. Half of the patients were asymptomatic and presented different classic forms on chest X-ray and chest high-resolution computed tomography, along with ground-glass images. No lung function changes were recorded. CONCLUSIONS Silicosis in artificial quartz conglomerate workers occurs in a young, actively employed population, a considerable percentage of whom present an accelerated form. They have few symptoms and no functional limitations. Protection measures are scarce. It is important to characterize these features to provide early diagnosis and implement the necessary preventive measures.
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Affiliation(s)
- Cristina Martínez González
- Área del Pulmón, Hospital Universitario Central de Asturias (HUCA), Facultad de Medicina, Universidad de Oviedo, Oviedo, Asturias, España.
| | - Amador Prieto González
- Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, España
| | - Lucía García Alfonso
- Servicio de Neumología, Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, España
| | - Luis Fernández Fernández
- Servicio de Anatomía Patológica, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, España
| | - Ariel Moreda Bernardo
- Área del Pulmón, Hospital Universitario Central de Asturias (HUCA), Facultad de Medicina, Universidad de Oviedo, Oviedo, Asturias, España
| | - Ramon Fernández Álvarez
- Área del Pulmón, Hospital Universitario Central de Asturias (HUCA), Facultad de Medicina, Universidad de Oviedo, Oviedo, Asturias, España
| | - Valeria Rolle-Sóñora
- Plataforma de Bioestadística y Epidemiología, Fundación para la Investigación y la Innovación Biosanitaria del Principado de Asturias (FINBA), Oviedo, Asturias, España
| | - Alberto Ruano Raviña
- Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, La Coruña, España
| | - Pere Casan Clarà
- Área del Pulmón, Hospital Universitario Central de Asturias (HUCA), Facultad de Medicina, Universidad de Oviedo, Oviedo, Asturias, España
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32
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Artificial Stone Associated Silicosis: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040568. [PMID: 30781462 PMCID: PMC6406954 DOI: 10.3390/ijerph16040568] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 01/30/2019] [Accepted: 02/08/2019] [Indexed: 01/20/2023]
Abstract
Silicosis is a progressive fibrotic lung disease that is caused by the inhalation of respirable crystalline silica. Due to its high silica content, artificial stone (AS) can become a possible source of hazardous dust exposure for workers that are employed in the manufacturing, finishing, and installing of AS countertops. Therefore, the aim of this review was to verify the association between AS derived silica exposure and silicosis development, and also then define the pathological characteristics of the disease in relation to specific work practices and preventive and protective measures that were adopted in the workplace. A systematic review of articles available on Pubmed, Scopus, and Isi Web of Knowledge databases was performed. Although the characteristics of AS-associated silicosis were comparable to those that were reported for the disease in traditional silica exposure settings, some critical issues emerged concerning the general lack of suitable strategies for assessing/managing silica risks in these innovative occupational fields. Further research that is designed to assess the hazardous properties of AS dusts, levels of exposure in workplaces, and the effectiveness of protective equipment appears to be needed to increase awareness concerning AS risks and induce employers, employees, and all factory figures that are engaged in prevention to take action to define/adopt proper measures to protect the health of exposed workers.
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Guarnieri G, Bizzotto R, Gottardo O, Velo E, Cassaro M, Vio S, Putzu MG, Rossi F, Zuliani P, Liviero F, Mason P, Maestrelli P. Multiorgan accelerated silicosis misdiagnosed as sarcoidosis in two workers exposed to quartz conglomerate dust. Occup Environ Med 2018; 76:178-180. [DOI: 10.1136/oemed-2018-105462] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/07/2018] [Accepted: 11/12/2018] [Indexed: 01/07/2023]
Abstract
IntroductionClusters of silicosis cases have been reported in the fabrication of quartz conglomerate, a new high-silica-content artificial stone for kitchen and bathroom benchtops (countertops).AimWe describe two cases of accelerated-type silicosis with hepatic granulomas arising in workers exposed to artificial quartz conglomerates.MethodsA confident diagnosis of multiorgan silicosis was based on high level of respirable silica in the workplace, typical radiological alterations in chest high-resolution CT, histological findings in the lung and liver, and detection of silica crystals in both tissues by phase-contrast polarising light microscopy and scanning electron microscopy and energy dispersive spectroscopy.ResultsThe development of the disease <10 years after the first exposure is consistent with an accelerated-type of silicosis. Compared with other studies related to quartz conglomerate exposure, we determined that the levels of airborne crystalline silica during activity in the finishing area were between 0.260 and 0.744 mg/m3, that is, much higher than the threshold limit value according to American Conference of Governmental Industrial Hygienists (0.025 mg/m3). Moreover, liver granulomas were associated with accumulation of crystalline silica particles in the hepatic tissue.ConclusionsQuartz conglomerate fabrication is a potentially dangerous occupation. General practitioners and physicians should have awareness of this newly described occupational hazard. Accurate occupational history is critical in avoiding misdiagnosis, as silicosis caused by inhalation of dust from artificial quartz conglomerates may exhibit atypical presentation. These features seem to be related to the extremely high level of silica exposure and, possibly, to an increased toxicity of the dust generated in this process.
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Mazzei MA, Sartorelli P, Bagnacci G, Gentili F, Sisinni AG, Fausto A, Mazzei FG, Volterrani L. Occupational Lung Diseases: Underreported Diagnosis in Radiological Practice. Semin Ultrasound CT MR 2018; 40:36-50. [PMID: 30686366 DOI: 10.1053/j.sult.2018.10.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Underreporting of occupational lung diseases is a widespread problem in clinical practice. In Europe there is not a common regulation even for the recognition of occupational cancers. Furthermore epidemiologic data on occupational interstitial lung diseases, in general, is limited by no standardized diagnostic criteria, varied physician awareness and training, limitations inherent to the various data sources, and the long latency period. Therefore, to optimize the management of the patient with occupational pathology, the collaboration and skills of the multidisciplinary at the service of the patient, play a fundamental role. In particular, radiologists should give substance to a clinical suspicion on an anamnestic basis and at the same time should recognize patterns of illness that can lead to the emergence of stories of misunderstood exposures. This article aims to provide an overview of the main occupational lung diseases with attention to diagnostic possibilities of the different imaging techniques. The issue of the radiological error is investigated, providing tools to minimize it in the daily practice.
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Affiliation(s)
- Maria Antonietta Mazzei
- Department of Medical, Surgical and Neuro Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy
| | - Pietro Sartorelli
- Unit of Occupational Medicine, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy; Department of Medical Biotechnology, Unit of Occupational Medicine, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy
| | - Giulio Bagnacci
- Department of Medical, Surgical and Neuro Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy.
| | - Francesco Gentili
- Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy
| | | | - Alfonso Fausto
- Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy
| | | | - Luca Volterrani
- Department of Medical, Surgical and Neuro Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, University of Siena, Italy
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Ronsmans S, Decoster L, Keirsbilck S, Verbeken EK, Nemery B. Artificial stone-associated silicosis in Belgium. Occup Environ Med 2018; 76:133-134. [DOI: 10.1136/oemed-2018-105436] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 09/13/2018] [Accepted: 10/14/2018] [Indexed: 11/03/2022]
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Hoy RF, Yates DH. Response to: 'Artificial stone-associated silicosis in the UK' by Barber et al. Occup Environ Med 2018; 75:541-542. [PMID: 29574403 DOI: 10.1136/oemed-2018-105092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 03/02/2018] [Accepted: 03/14/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Ryan F Hoy
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Deborah H Yates
- Department of Thoracic Medicine, St Vincent's Hospital, Sydney, New South Wales, Australia
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Barber CM, Fishwick D, Seed MJ, Carder M, van Tongeren M. Artificial stone-associated silicosis in the UK. Occup Environ Med 2018; 75:541. [PMID: 29444932 DOI: 10.1136/oemed-2018-105028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 02/05/2018] [Indexed: 11/04/2022]
Affiliation(s)
- Chris M Barber
- Centre for Workplace Health, Health and Safety Executive, Buxton, UK
| | - David Fishwick
- Centre for Workplace Health, Health and Safety Executive, Buxton, UK
| | - Martin J Seed
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, UK
| | - Melanie Carder
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, UK
| | - Martie van Tongeren
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, UK
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Hoy RF, Baird T, Hammerschlag G, Hart D, Johnson AR, King P, Putt M, Yates DH. Artificial stone-associated silicosis: a rapidly emerging occupational lung disease. Occup Environ Med 2017; 75:3-5. [DOI: 10.1136/oemed-2017-104428] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 07/31/2017] [Accepted: 08/13/2017] [Indexed: 11/04/2022]
Abstract
IntroductionArtificial stone is an increasingly popular material used to fabricate kitchen and bathroom benchtops. Cutting and grinding artificial stone is associated with generation of very high levels of respirable crystalline silica, and the frequency of cases of severe silicosis associated with this exposure is rapidly increasing.AimTo report the characteristics of a clinical series of Australian workers with artificial stone-associated silicosis.MethodsRespiratory physicians voluntarily reported cases of artificial stone-associated silicosis identified in their clinical practices. Physicians provided information including occupational histories, respiratory function tests, chest radiology and histopathology reports, when available.ResultsSeven male patients were identified with a median age of 44 years (range 26–61). All were employed in small kitchen and bathroom benchtop fabrication businesses with an average of eight employees (range 2–20). All workplaces primarily used artificial stone, and dust control measures were poor. All patients were involved in dry cutting artificial stone. The median duration of exposure prior to symptoms was 7 years (range 4–10). Six patients demonstrated radiological features of progressive massive fibrosis. These individuals followed up over a median follow-up period of 16 months (IQR 21 months) demonstrated rapid decline in prebronchodilator forced expiratory volume in 1 s of 386 mL/year (SD 204 mL) and forced vital capacity of 448 mL/year (SD 312 mL).ConclusionsThis series of silicosis in Australian workers further demonstrates the risk-associated high-silica content artificial stone. Effective dust control and health surveillance measures need to be stringently implemented and enforced in this industry.
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Incidental and Underreported Pleural Plaques at Chest CT: Do Not Miss Them-Asbestos Exposure Still Exists. BIOMED RESEARCH INTERNATIONAL 2017; 2017:6797826. [PMID: 28656146 PMCID: PMC5474542 DOI: 10.1155/2017/6797826] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/10/2017] [Indexed: 11/22/2022]
Abstract
Pleural plaques (PPs) may be a risk factor for mortality from lung cancer in asbestos-exposed workers and are considered to be a marker of exposure. Diagnosing PPs is also important because asbestos-exposed patients should be offered a health surveillance that is mandatory in many countries. On the other hand PPs are useful for compensation purposes. In this study we aimed to evaluate the prevalence, as incidental findings, and the underreporting rate of PPs in chest CT scans (CTs) performed in a cohort of patients (1512) who underwent chest CT with a slice thickness no more than 1.25 mm. PPs were found in 76 out of 1482 patients (5.1%); in 13 out of 76 (17,1%) CTs were performed because of clinical suspicion of asbestos exposure and 5 of them (38%) were underreported by radiologist. In the remaining 63 cases (82.9%) there was no clinical suspicion of asbestos exposure at the time of CTs (incidental findings) and in 38 of these 63 patients (60.3%) PPs were underreported. Reaching a correct diagnosis of PPs requires a good knowledge of normal locoregional anatomy and rigorous technical approach in chest CT execution. However the job history of the patient should always be kept in mind.
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Bragazzi NL, Dini G, Toletone A, Brigo F, Durando P. Leveraging Big Data for Exploring Occupational Diseases-Related Interest at the Level of Scientific Community, Media Coverage and Novel Data Streams: The Example of Silicosis as a Pilot Study. PLoS One 2016; 11:e0166051. [PMID: 27806115 PMCID: PMC5091866 DOI: 10.1371/journal.pone.0166051] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 10/21/2016] [Indexed: 12/31/2022] Open
Abstract
Objective Silicosis is an untreatable but preventable occupational disease, caused by exposure to silica. It can progressively evolve to lung impairment, respiratory failure and death, even after exposure has ceased. However, little is known about occupational diseases-related interest at the level of scientific community, media coverage and web behavior. This article aims at filling in this gap of knowledge, taking the silicosis as a case study. Methods We investigated silicosis-related web-activities using Google Trends (GT) for capturing the Internet behavior worldwide in the years 2004–2015. GT-generated data were, then, compared with the silicosis-related scientific production (i.e., PubMed and Google Scholar), the media coverage (i.e., Google news), the Wikipedia traffic (i.e, Wikitrends) and the usage of new media (i.e., YouTube and Twitter). Results A peak in silicosis-related web searches was noticed in 2010–2011: interestingly, both scientific articles production and media coverage markedly increased after these years in a statistically significant way. The public interest and the level of the public engagement were witnessed by an increase in likes, comments, hashtags, and re-tweets. However, it was found that only a small fraction of the posted/uploaded material contained accurate scientific information. Conclusions GT could be useful to assess the reaction of the public and the level of public engagement both to novel risk-factors associated to occupational diseases, and possibly related changes in disease natural history, and to the effectiveness of preventive workplace practices and legislative measures adopted to improve occupational health. Further, occupational clinicians should become aware of the topics most frequently searched by patients and proactively address these concerns during the medical examination. Institutional bodies and organisms should be more present and active in digital tools and media to disseminate and communicate scientifically accurate information. This manuscript should be intended as preliminary, exploratory communication, paving the way for further studies.
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Affiliation(s)
- Nicola Luigi Bragazzi
- Department of Health Sciences, Postgraduate School of Public Health, University of Genoa, Genoa, Italy
| | - Guglielmo Dini
- Department of Health Sciences, Postgraduate School in Occupational Medicine, University of Genoa, Genoa, Italy
- * E-mail:
| | - Alessandra Toletone
- Department of Health Sciences, Postgraduate School in Occupational Medicine, University of Genoa, Genoa, Italy
| | - Francesco Brigo
- Department of Neurology, Franz Tappeiner Hospital, Merano, Italy
- Department of Neurological, Biomedical, and Movement Sciences, University of Verona, Verona, Italy
| | - Paolo Durando
- Department of Health Sciences, Postgraduate School in Occupational Medicine, University of Genoa, Genoa, Italy
- Occupational Medicine Unit, IRCCS AOU San Martino-IST, Genoa, Italy
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Pavan C, Polimeni M, Tomatis M, Corazzari I, Turci F, Ghigo D, Fubini B. Editor's Highlight: Abrasion of Artificial Stones as a New Cause of an Ancient Disease. Physicochemical Features and Cellular Responses. Toxicol Sci 2016; 153:4-17. [DOI: 10.1093/toxsci/kfw101] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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