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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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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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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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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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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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