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Crawford JA, Sanyal S, Burnett BR, Wiesenfeld SL, Abraham JL. Accelerated silicosis in sandblasters: Pathology, mineralogy, and clinical correlates. Am J Ind Med 2024; 67:179-199. [PMID: 38265196 DOI: 10.1002/ajim.23561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/29/2023] [Accepted: 12/22/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND With increasing reports of accelerated and acute silicosis, PMF, and autoimmune disease among coal miners and silica-exposed countertop workers, we present previously incompletely-described pulmonary pathology of accelerated silicosis and correlations with mineralogy, radiography, and disease progression in 46 Texas oilfield pipe sandblasters who were biopsied between 1988 and 1995. METHODS Worker examinations included pulmonary function tests, chest X-ray (CXR), high-resolution computed tomography (HRCT), and Gallium-67 scans. Quantitative mineralogic analysis of pulmonary parenchymal burden of silica, silicates, and metal particles used scanning electron microscopy with energy dispersive x-ray spectroscopy (SEM EDS). RESULTS Workers had clinical deterioration after <10 years exposure in dusty workplaces. Although initial CXR was normal in 54%, Gallium-67 scans were positive in 68% of those with normal CXR, indicating pulmonary inflammation. The histology of accelerated silicosis is diffuse interstitial infiltration of macrophages filled with weakly birefringent particles with or without silicotic nodules or alveolar proteinosis. Lung silica concentrations were among the highest in our database, showing a dose-response relationship with CXR, HRCT, and pathologic changes (macrophages, fibrosis, and silicotic nodules). Radiographic scores and diffusing capacity worsened during observation. Silica exposure was intensified, patients presented younger, with shorter exposure, more severe clinical abnormalities, higher lung particle burdens, and more rapid progression in a subset of patients exposed to recycled blasting sand. CONCLUSIONS Accelerated silicosis may present with a normal CXR despite significant histopathology. Multivariable analyses showed silica, and not other particles, is the driver of observed radiologic, physiologic, and histologic outcomes. Eliminating this preventable disease requires higher physician, public health, and societal awareness.
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Affiliation(s)
- Judith A Crawford
- Department of Pathology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Soma Sanyal
- Department of Pathology, SUNY Upstate Medical University, Syracuse, New York, USA
| | | | - Stephen L Wiesenfeld
- Department of Medicine, Texas Tech University Health Sciences Center, Odessa, Texas, USA
| | - Jerrold L Abraham
- Department of Pathology, SUNY Upstate Medical University, Syracuse, New York, USA
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2
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Ding M, Zhang C, Wang W, Wang P, Pei Y, Wang N, Huang S, Hao C, Yao W. Silica-exposed macrophages-secreted exosomal miR125a-5p induces Th1/Th2 and Treg/Th17 cell imbalance and promotes fibroblast transdifferentiation. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 267:115647. [PMID: 37918332 DOI: 10.1016/j.ecoenv.2023.115647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/22/2023] [Accepted: 10/27/2023] [Indexed: 11/04/2023]
Abstract
Until now, the specific pathogenesis of silicosis is not clear. Exosomal miRNAs, as a newly discovered intercellular communication medium, play an important role in many diseases. Our previous research found that serum exosomal miR125a-5p was increased in silicosis patients by miRNAs high-throughput sequencing. TRAF6, is a target gene of miR125a-5p, which is involved in T-cell differentiation. Furthermore, results from animal study indicate that knockdown of miR-125a-5p can regulate T lymphocyte subsets and significantly reduce pulmonary fibrosis by targeting TRAF6. However, the level of serum exosomal miR125a-5p in silicosis patients has not been reported, the role of macrophages-secreted exosomal miR-125a-5p in regulating T cell differentiation to promote fibroblast transdifferentiation (FMT) remains unknown. In this study, the levels of serum exosomal miR125a-5p and serum TGF-β1, IL-17A, IL-4 cytokines in silicosis patients were elevated, with the progression of silicosis, the level of serum exosomal miR125a-5p and serum IL-4 were increased; thus, the serum level of IFN-γ was negatively correlated with the progression of silicosis. In vitro, the levels of miR125a-5p in macrophages, exosomes, and T cells stimulated by silica were significantly increased. When the mimic was transfected into T cells, which directly suppressed TRAF6 and caused the imbalance of T cells differentiation, induced FMT. To sum up, these results indicate that exosomal miR-125a-5p may by targeting TRAF6 of T cells, induces the activation and apoptosis of T cells and the remodeling of Th1/Th2 and Th17/Tregs distribution, ultimately promotes FMT. Suggesting that exosomal miR-125a-5p may be a potential therapeutic target for silicosis.
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Affiliation(s)
- Mingcui Ding
- Department of Nosocomial Infection Control, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, Henan, China
| | - Chengpeng Zhang
- Department of Occupational Health and Occupational Disease, School of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Wei Wang
- Department of Occupational Health and Occupational Disease, School of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Pengpeng Wang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yangqing Pei
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Na Wang
- Department of Occupational Health and Occupational Disease, School of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Shan Huang
- Henan Institute of Food and Salt Industry Inspection Technology, Zhengzhou 450001, Henan, China
| | - Changfu Hao
- Department of child and Adolecence health, School of public health, Zhengzhou University, Zhengzhou 450001, Henan, China.
| | - Wu Yao
- Department of Occupational Health and Occupational Disease, School of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China.
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RenChen X, Wang W, Lu Y. Emerging trends in silicosis research: a scientometric review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:113280-113296. [PMID: 37864705 DOI: 10.1007/s11356-023-30418-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/08/2023] [Indexed: 10/23/2023]
Abstract
Silicosis is a global disease whose prevention efforts cannot be ignored today. Although numerous silicosis-related data have been published recently, emphasizing the characteristics and nature of silicosis, a summary of the developmental laws of research is lacking, especially in the visual analysis of the literature. We aim to address this issue through a scientometric review. The Web of Science Core Collection and the All Databases were searched with "silicosis" as the topic, excluding unrelated publications, and obtained data from 9802 and 1613 publications, respectively. The data was then analyzed using the Web of Science's online scientometric analysis function and CiteSpace's visual analysis functionality, including publication volume analysis, co-occurrence analysis, co-citation analysis, cluster analysis, and explosive detection. The results identify the "respiratory system" as the most influential area over a century. Furthermore, the publication's number was correlated with the gross domestic product. We ranked countries and institutions based on the frequency of publications and discovered that Europe, the USA, and China are the leading regions for silicosis research, with the USA and Europe having a stronger influence. Many reports related to artificial stone and denim jean production have been studied through citation analysis, indicating new epidemic trends in silicosis. Besides, silicosis-related diseases and the pathogenesis of silicosis were the research hotspots of silicosis through co-occurrence keyword analysis and outbreak detection. Furthermore, related diseases include coal workers' pneumoconiosis and tuberculosis, while the mechanism of silicosis includes studies on inflammation and fibrosis, oxidative stress, alveolar macrophages, apoptosis, and pathways.
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Affiliation(s)
- Xiaotian RenChen
- School of Medicine, Department of Medical Frontier Experimental Center, Anhui University of Science and Technology, Anhui, China
| | - Wenyang Wang
- Center for Clinical Laboratory, The Affiliated Taian City Central Hospital of Qingdao University, Taian, 271000, Shandong, China.
| | - Yuting Lu
- School of Medicine, Department of Medical Frontier Experimental Center, Anhui University of Science and Technology, Anhui, China
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Tan S, Yang S, Kang H, Zhou K, Wang H, Zhang Y, Chen S. Atractylenolide III Ameliorated Autophagy Dysfunction via Epidermal Growth Factor Receptor-Mammalian Target of Rapamycin Signals and Alleviated Silicosis Fibrosis in Mice. J Transl Med 2023; 103:100024. [PMID: 37039148 DOI: 10.1016/j.labinv.2022.100024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 01/11/2023] Open
Abstract
Atractylenolide III (ATL-III) is a major active constituent of the natural plant Atractylodes rhizome. Our previous study has shown that ATL-III may alleviate alveolar macrophage apoptosis via the inhibition of the mammalian target of rapamycin (mTOR)-mediated autophagy of human silicosis. Therefore, we aimed to further explore the function of ATL-III in autophagy, apoptosis, and pulmonary fibrosis by establishing the ATL-III-intervened silicosis mouse model in this study. Meanwhile, we sought and then verified potential autophagy-related signaling pathways by matching differentially expressed genes (attained by RNA sequencing) and the autophagy database. In this study, RNA-sequencing results implied that the epidermal growth factor receptor, the crucial upstream activator of mTOR, was seen as a potential autophagy-regulatory molecule in the ATL-III-intervened silicosis mouse model. The finding of this study was that ATL-III might improve the disorder of autophagic degradation via the activation of epidermal growth factor receptor-mTOR signals in the pulmonary tissue of the silicosis mouse model. ATL-III also alleviated cell apoptosis and silicotic fibrosis. Overall, we supposed that ATL-III might be a potential protective medicine, which had a regulatory effect on autophagy, for the intervention of silicotic fibrosis. In the future, the therapeutic drugs for silicosis should be further focused on the development and application of such natural autophagy agents.
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Lee CT, Feary J, Johannson KA. Environmental and occupational exposures in interstitial lung disease. Curr Opin Pulm Med 2022; 28:414-420. [PMID: 35838370 DOI: 10.1097/mcp.0000000000000894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW We highlight recent advances in the understanding of how environmental and occupational exposures increase the risk of developing interstitial lung disease (ILD), and how to evaluate a patient for potential exposures. RECENT FINDINGS A review of emerging literature suggests that environmental and occupational exposures can be directly causal, as in the case of the pneumoconioses and smoking-related ILDs, or one of many contributors to disease, as in the case of idiopathic pulmonary fibrosis (IPF). Regardless of the level of association, exposures are clearly prevalent across all ILD subtypes studied. SUMMARY Inhalational exposures are increasingly recognized as an important component in the development of ILDs, and novel exposure-disease associations continue to be discovered. These exposures represent potential opportunities for further understanding the pathobiology of disease and for the prevention of these often progressive and debilitating disorders. Prospective, comprehensive data collection regarding occupational and environmental exposures are needed in ILD patients to fully elucidate specific antigens and their relationships to disease incidence and outcomes. Systematically collected exposure information will also inform potential interventions to remediate exposures and thus mitigate the course of frequently progressive and fatal diseases.
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Affiliation(s)
- Cathryn T Lee
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Johanna Feary
- Department of Occupational and Environmental Medicine, Royal Brompton Hospital
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Kerri A Johannson
- Department of Medicine
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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Akgün M, Ozmen I, Ozari Yildirim E, Tuzun B, Nur Toreyin Z, Kayinova A, Arbak P, Akkurt I. Pitfalls of using the ILO classification for silicosis compensation claims. Occup Med (Lond) 2022; 72:372-377. [PMID: 35304606 DOI: 10.1093/occmed/kqac010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND The International Labour Organization (ILO) Classification of Radiographs of Pneumoconioses is used as the primary tool to determine compensation for pneumoconiosis in Turkey. AIMS We aimed to evaluate how the ILO classification applied, but obtaining chest radiographs in the workplace for screening until the completion of compensation claim files by the referral centres, based on the ILO reading. METHODS The study included 320 digital chest radiographs previously taken for screening from eight different ceramic factories and having finalised claim files by referral centres. We used an expert reference panel consisting of five ILO readers to re-evaluate all the radiographs independently using ILO standard films and reached a conclusion based on the agreement among at least three readers. The evaluation primarily included technical quality and silicosis diagnosis with an ILO 1/0 or above small profusion. The results were compared with previous findings. RESULTS Sixty-three (20%) chest radiographs were unacceptable for classification purposes according to the ILO technical quality grades. Among the remaining 257 chest radiographs, we diagnosed 103 with silicosis (40%), while the referral centres diagnosed 182 (71%). A discrepancy was found between our results and previous evaluations. We diagnosed silicosis in 50% and 17% of the previous silicosis and normal evaluations, respectively. CONCLUSIONS Our findings suggest that the use of the ILO classification for compensation claims may be problematic due to the way of its implementation in Turkey in addition to its subjectivity.
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Affiliation(s)
- Metin Akgün
- Department of Pulmonary Diseases, Ataturk University, School of Medicine, Erzurum, Turkey
| | - Ipek Ozmen
- Health Science University, Süreyyapasa Chest Diseases, and Chest Surgery Education and Research Hospital, Istanbul, Turkey
| | - Elif Ozari Yildirim
- Health Science University, Süreyyapasa Chest Diseases, and Chest Surgery Education and Research Hospital, Istanbul, Turkey
| | - Bahar Tuzun
- Occupational Disease Hospital, Chest Diseases Clinic, Istanbul, Turkey
| | - Zehra Nur Toreyin
- Department of Public Health, Ege University, School of Medicine, Division of Occupational Health and Occupational Diseases, Izmir, Turkey
| | - Atinc Kayinova
- ODAS Mining Company, Occupational Safety and Health Unit, Istanbul, Turkey
| | - Peri Arbak
- Department of Pulmonary Diseases, Düzce University, School of Medicine, Düzce, Turkey
| | - Ibrahim Akkurt
- Retired Pulmonary Physician and Occupational Diseases Specialist, Ankara, Turkey
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7
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Masoudi G, Montazer M, Ezazshahabi N, Mianehro A, Mahmoudirad M. Biocompatible antibacterial denim fabric prepared via green synthesis of the copper oxide nanoparticles using raw sugar molasses. STARCH-STARKE 2022. [DOI: 10.1002/star.202200105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Ghazaleh Masoudi
- Textile Department, Center of Excellence in Textile Amirkabir University of Technology Tehran Iran
| | - Majid Montazer
- Textile Department, Center of Excellence in Textile Amirkabir University of Technology Tehran Iran
- Functional Fibrous Structures & Environmental Enhancement (FFSEE), Department of Textile Engineering Amirkabir University of Technology Tehran Iran
| | - Nazanin Ezazshahabi
- Textile Department, Center of Excellence in Textile Amirkabir University of Technology Tehran Iran
| | - Ali Mianehro
- Textile Department, Center of Excellence in Textile Amirkabir University of Technology Tehran Iran
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8
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Albez FS, Araz Ö, Yılmazel Uçar E, Alper F, Karaman A, Sağlam L, Akgün M. Long-term follow-up of young denim sandblasters in Turkey. Occup Med (Lond) 2022; 72:403-410. [PMID: 35762845 DOI: 10.1093/occmed/kqac043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Denim sandblasting-induced silicosis is a recently identified occupational disease. AIMS In this study, we aimed to evaluate pulmonary and radiological changes in the long-term follow-up of former denim sandblasters. METHODS Ninety former denim sandblasters were followed from 2007 to 2018. Chest X-rays were evaluated according to the International Labour Organization (ILO) classification. Baseline and final data were compared. Silicosis prevalence, radiological progression and pulmonary dysfunction were evaluated. RESULTS All of the sandblasters were men. Their mean age was 34 ± 5 years, mean follow-up time was 9 ± 2 years (mean time since initial exposure: 17 ± 2 years) and mean duration of exposure was 34 ± 25 months. Rates of radiological progression and decline in pulmonary during follow-up were 63% and 39%, respectively. During follow-up, all patients were diagnosed with silicosis. All workers who were ILO category 0 at baseline (n = 26, 29%) progressed to higher categories. The number of patients in Category 2 doubled and the number of patients in Category 3 increased by 2.5-fold. Eleven patients developed new large opacities and the number of patients with category C opacity increased from 4 to 13. Exposure time was an independent determinant of radiological progression (OR: 1.0, P = 0.036) and decline in pulmonary function (OR: 1.3, P = 0.019). CONCLUSION The prevalence of silicosis in denim sandblasters increases steadily even after exposure is discontinued. Radiological progression was observed in a higher proportion of workers than a decline in lung function. Duration of exposure was the major determinant of disease progression in our study.
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Affiliation(s)
- F S Albez
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
| | - Ö Araz
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
| | - E Yılmazel Uçar
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
| | - F Alper
- Department of Radiology, Atatürk University School of Medicine, Erzurum, Turkey
| | - A Karaman
- Department of Radiology, Atatürk University School of Medicine, Erzurum, Turkey
| | - L Sağlam
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
| | - M Akgün
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
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Murgia N, Gambelunghe A. Occupational COPD-The most under-recognized occupational lung disease? Respirology 2022; 27:399-410. [PMID: 35513770 PMCID: PMC9321745 DOI: 10.1111/resp.14272] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 03/16/2022] [Accepted: 04/19/2022] [Indexed: 11/29/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is caused by exposure to noxious particles and gases. Smoking is the main risk factor, but other factors are also associated with COPD. Occupational exposure to vapours, gases, dusts and fumes contributes to the development and progression of COPD, accounting for a population attributable fraction of 14%. Workplace pollutants, in particular inorganic dust, can initiate airway damage and inflammation, which are the hallmarks of COPD pathogenesis. Occupational COPD is still underdiagnosed, mainly due to the challenges of assessing the occupational component of the disease in clinical settings, especially if other risk factors are present. There is a need for specific education and training for clinicians, and research with a focus on evaluating the role of occupational exposure in causing COPD. Early diagnosis and identification of occupational causes is very important to prevent further decline in lung function and to reduce the health and socio-economic burden of COPD. Establishing details of the occupational history by general practitioners or respiratory physicians could help to define the occupational burden of COPD for individual patients, providing the first useful interventions (smoking cessation, best therapeutic management, etc.). Once patients are diagnosed with occupational COPD, there is a wide international variation in access to specialist occupational medicine and public health services, along with limitations in workplace and income support. Therefore, a strong collaboration between primary care physicians, respiratory physicians and occupational medicine specialists is desirable to help manage COPD patients' health and social issues.
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Affiliation(s)
- Nicola Murgia
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, Perugia, Italy
| | - Angela Gambelunghe
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, Perugia, Italy
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Abstract
PURPOSE OF REVIEW This review details recent findings related to the health effects of occupational exposure to artificial stone dust and the rapid increase in cases of artificial stone associated silicosis around the world. RECENT FINDINGS High crystalline silica content artificial stone is now commonly used for the production of kitchen benchtops. Reports of artificial stone silicosis from many countries have noted that workers were typically employed at small workplaces and were often diagnosed in their 30s or 40s. Poor exposure control measures were common, including the practice of 'dry processing'. Dust generated from artificial stone has been noted to have properties that influence toxicity, including high silica content, generation of nanosized particles and presence of metals and resins. Artificial stone silicosis differs from silicosis associated with other occupational settings including shorter latency and rapid disease progression. High-resolution computed tomography (CT) chest imaging of artificial stone silicosis has often noted the presence of ground glass opacities, which may not be detected in chest x-ray screening. Increased prevalence of autoimmune disease, such as scleroderma, has also been reported in this industry. SUMMARY Further evaluation of the safety of work with artificial stone is required, including the effectiveness of dust control measures. Current reports of artificial stone silicosis indicate the potential for widespread undiagnosed respiratory disease in this industry. Provision of more sensitive health screening methods for all at-risk workers and the development of new treatment options particularly for this form of silicosis is urgently required.
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Affiliation(s)
- Ryan F Hoy
- School of Public Health & Preventive Medicine Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
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11
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Çankaya BY, Polat G, Tezcan A, Yalçın A, Sade R, Pirimoğlu RB, Karaman A, Kızıloğlu HA, Alper F, Akgün M. Evaluation of lung densitometric and volumetric changes in silicosis patients using three-dimensional software for multidetector CT and the relationship with profusion scores. Clin Radiol 2021; 76:393.e19-393.e24. [PMID: 33509607 DOI: 10.1016/j.crad.2020.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 12/24/2020] [Indexed: 11/25/2022]
Abstract
AIM To evaluate the density and volume changes in the lungs of silicosis patients and their relationship with the disease severity classification of the International Labor Organization (ILO). MATERIALS AND METHODS The multidetector computed tomography (CT) images of 44 patients diagnosed with silicosis and 32 controls that underwent thoracic CT due to trauma were evaluated. Patients with silicosis were divided into three categories according to the ILO classification. Data related to the total lung volume, total lung mean density, lung opacity score, percentage of lung high opacity, and mean density in the lower and upper lobes were obtained using three-dimensional (3D) software. RESULTS There was no significant difference between the total lung mean densities of the silicosis and control groups (p=0.213); however, a significant difference was observed between the two groups in terms of the total lung volume (p<0.0001). According to the ILO classification, there was a significant difference between the disease severity categories in relation to the percentage of lung high opacity (p=0.000005). A strong correlation was detected between disease severity and high opacity percentage (p<0.0001, r=0.804). According to the ILO classification, there was also a significant difference between disease severity categories in terms of the lung opacity score (p=0.000144), as well as a moderate correlation between disease severity and opacity score (p<0.0001, r=0.580). CONCLUSION Total lung volume is a CT finding that shows variation in exposure to crystalline silica. The percentage of high opacity determined using multidetector CT is an effective parameter in evaluating disease severity.
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Affiliation(s)
- B Y Çankaya
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey.
| | - G Polat
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - A Tezcan
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - A Yalçın
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - R Sade
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - R B Pirimoğlu
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - A Karaman
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - H A Kızıloğlu
- Ömer Halisdemir Training and Research Hospital, Niğde, Turkey
| | - F Alper
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - M Akgün
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
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12
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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: 171] [Impact Index Per Article: 42.8] [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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13
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Santana PT, Luna-Gomes T, Rangel-Ferreira MV, Tamura AS, Da Graça CLAL, Machado MN, Zin WA, Takiya CM, Faffe DS, Coutinho-Silva R. P2Y 12 Receptor Antagonist Clopidogrel Attenuates Lung Inflammation Triggered by Silica Particles. Front Pharmacol 2020; 11:301. [PMID: 32256366 PMCID: PMC7093325 DOI: 10.3389/fphar.2020.00301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 02/28/2020] [Indexed: 11/15/2022] Open
Abstract
Silicosis is an occupational lung disease caused by inhalation of silica particles. It is characterized by intense lung inflammation, with progressive and irreversible fibrosis, leading to impaired lung function. Purinergic signaling modulates silica-induced lung inflammation and fibrosis through P2X7 receptor. In the present study, we investigate the role of P2Y12, the G-protein-coupled subfamily prototype of P2 receptor class in silicosis. To that end, BALB/c mice received an intratracheal injection of PBS or silica particles (20 mg), without or with P2Y12 receptor blockade by clopidogrel (20 mg/kg body weight by gavage every 48 h) - groups CTRL, SIL, and SIL + Clopi, respectively. After 14 days, lung mechanics were determined by the end-inflation occlusion method. Lung histology was analyzed, and lung parenchyma production of nitric oxide and cytokines (IL-1β, IL-6, TNF-α, and TGF-β) were determined. Silica injection reduced animal survival and increased all lung mechanical parameters in relation to CTRL, followed by diffuse lung parenchyma inflammation, increased neutrophil infiltration, collagen deposition and increased pro-inflammatory and pro-fibrogenic cytokine secretion, as well as increased nitrite production. Clopidogrel treatment prevented silica-induced changes in lung function, and significantly reduced lung inflammation, fibrosis, as well as cytokine and nitrite production. These data suggest that inhibition of P2Y12 signaling improves silica-induced lung inflammation, preventing lung functional changes and mortality. Our results corroborate previous observations of silica-induced lung changes and expand the understanding of purinergic signaling in this process.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Robson Coutinho-Silva
- Institute of Biophysics Carlos Chagas Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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14
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Ferreira TPT, Lima JGME, Farias-Filho FA, Jannini de Sá YAP, de Arantes ACS, Guimarães FV, Carvalho VDF, Hogaboam C, Wallace J, Martins MA, Silva PMRE. Intranasal Flunisolide Suppresses Pathological Alterations Caused by Silica Particles in the Lungs of Mice. Front Endocrinol (Lausanne) 2020; 11:388. [PMID: 32625168 PMCID: PMC7311565 DOI: 10.3389/fendo.2020.00388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/15/2020] [Indexed: 12/19/2022] Open
Abstract
Silicosis is an occupational disease triggered by the inhalation of fine particles of crystalline silica and characterized by inflammation and scarring in the form of nodular lesions in the lungs. In spite of the therapeutic arsenal currently available, there is no specific treatment for the disease. Flunisolide is a potent corticosteroid shown to be effective for controlling chronic lung inflammatory diseases. In this study, the effect of flunisolide on silica-induced lung pathological changes in mice was investigated. Swiss-Webster mice were injected intranasally with silica particles and further treated with flunisolide from day 21 to 27 post-silica challenge. Lung function was assessed by whole body invasive plethysmography. Granuloma formation was evaluated morphometrically, collagen deposition by Picrus sirius staining and quantitated by Sircol. Chemokines and cytokines were evaluated using enzyme-linked immunosorbent assay. The sensitivity of lung fibroblasts was also examined in in vitro assays. Silica challenge led to increased leukocyte numbers (mononuclear cells and neutrophils) as well as production of the chemokine KC/CXCL-1 and the cytokines TNF-α and TGF-β in the bronchoalveolar lavage. These alterations paralleled to progressive granuloma formation, collagen deposition and impairment of lung function. Therapeutic administration of intranasal flunisolide inhibited granuloma and fibrotic responses, noted 28 days after silica challenge. The upregulation of MIP-1α/CCL-3 and MIP-2/CXCL-2 and the cytokines TNF-α and TGF-β, as well as deposition of collagen and airway hyper-reactivity to methacholine were shown to be clearly sensitive to flunisolide, as compared to silica-challenge untreated mice. Additionally, flunisolide effectively suppressed the responses of proliferation and MCP-1/CCL-2 production from IL-13 stimulated lung fibroblasts from silica- or saline-challenged mice. In conclusion, we report that intranasal treatment with the corticosteroid flunisolide showed protective properties on pathological features triggered by silica particles in mice, suggesting that the compound may constitute a promising strategy for the treatment of silicosis.
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Affiliation(s)
| | | | | | | | | | | | | | - Cory Hogaboam
- Department of Medicine, Cedars-Sinai Medical Center, Women's Guild Lung Institute, Los Angeles, CA, United States
| | - John Wallace
- Departments of Physiology and Pharmacology, and Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Marco Aurélio Martins
- Laboratory of Inflammation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Patrícia Machado Rodrigues e Silva
- Laboratory of Inflammation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- *Correspondence: Patrícia Machado Rodrigues e Silva
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15
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Akgün M. Reporting an Index Case: "Mighty Oaks from Little Acorns Grow". Turk Thorac J 2019; 20:267-268. [PMID: 31584391 DOI: 10.5152/turkthoracj.2019.191909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 08/26/2019] [Indexed: 11/22/2022]
Affiliation(s)
- Metin Akgün
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
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16
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Benmerzoug S, Ryffel B, Togbe D, Quesniaux VF. Self-DNA Sensing in Lung Inflammatory Diseases. Trends Immunol 2019; 40:719-734. [DOI: 10.1016/j.it.2019.06.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/31/2019] [Accepted: 06/04/2019] [Indexed: 02/07/2023]
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17
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A wide scope of new developments in occupational allergy and clinical immunology. Curr Opin Allergy Clin Immunol 2019; 17:61-63. [PMID: 28141629 DOI: 10.1097/aci.0000000000000354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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STING-dependent sensing of self-DNA drives silica-induced lung inflammation. Nat Commun 2018; 9:5226. [PMID: 30523277 PMCID: PMC6283886 DOI: 10.1038/s41467-018-07425-1] [Citation(s) in RCA: 167] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 10/28/2018] [Indexed: 12/11/2022] Open
Abstract
Silica particles induce lung inflammation and fibrosis. Here we show that stimulator of interferon genes (STING) is essential for silica-induced lung inflammation. In mice, silica induces lung cell death and self-dsDNA release in the bronchoalveolar space that activates STING pathway. Degradation of extracellular self-dsDNA by DNase I inhibits silica-induced STING activation and the downstream type I IFN response. Patients with silicosis have increased circulating dsDNA and CXCL10 in sputum, and patients with fibrotic interstitial lung disease display STING activation and CXCL10 in the lung. In vitro, while mitochondrial dsDNA is sensed by cGAS-STING in dendritic cells, in macrophages extracellular dsDNA activates STING independent of cGAS after silica exposure. These results reveal an essential function of STING-mediated self-dsDNA sensing after silica exposure, and identify DNase I as a potential therapy for silica-induced lung inflammation. Silica particles induce intereukin-1 (IL-1) response to contribute to lung inflammation, but the underlying mechanism is unclear. Here the authors show that silica induces cell death and release of mitochondria and genomic DNA, which are sensed by STING with or without involving cGAS, respectively, for IL-1 induction and lung inflammation.
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19
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Silica Exposure, Silicosis, and the New Occupational Safety and Health Administration Silica Standard. What Pulmonologists Need to Know. Ann Am Thorac Soc 2018; 15:1391-1392. [DOI: 10.1513/annalsats.201809-589ed] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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20
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Huaux F. Emerging Role of Immunosuppression in Diseases Induced by Micro- and Nano-Particles: Time to Revisit the Exclusive Inflammatory Scenario. Front Immunol 2018; 9:2364. [PMID: 30510551 PMCID: PMC6252316 DOI: 10.3389/fimmu.2018.02364] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 09/24/2018] [Indexed: 12/21/2022] Open
Abstract
Fibrosis, cancer, and autoimmunity developing upon particle exposure have been exclusively linked with uncontrolled inflammatory processes. The critical role of inflammation is now challenged by several contradictory observations indicating that the emergence of these chronic disorders may result from non-inflammatory events. A growing number of studies reveals that micro- and nano-particles can cause exaggerated and persistent immunosuppression characterized by the release of potent anti-inflammatory cytokines (IL-10 and TGF-β), and the recruitment of major regulatory immune cells (M2 macrophages, T and B regs, and MDSC). This persistent immunosuppressive environment is initially established to limit early inflammation but contributes later to fibrosis, cancer, and infection. Immunosuppression promotes fibroblast proliferation and matrix element synthesis and subverts innate and adaptive immune surveillance against tumor cells and microorganisms. This review details the contribution of immunosuppressive cells and their derived immunoregulatory mediators and delineates the mutual role of inflammatory vs. immunosuppressive mechanisms in the pathogenesis of chronic diseases induced by particles. The consideration of these new results explains how particle-related diseases can develop independently of chronic inflammation, enriches current bioassays predicting particle toxicity and suggests new clinical strategies for treating patients affected by particle-associated diseases.
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Affiliation(s)
- François Huaux
- Louvain Centre for Toxicology and Applied Pharmacology, Institut de Recherche Experimentale et Clinique, Université catholique de Louvain, Brussels, Belgium
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21
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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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22
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Akgün M, Ergan B. Silicosis in Turkey: Is it an Endless Nightmare or is There Still Hope? Turk Thorac J 2018; 19:89-93. [PMID: 29755813 DOI: 10.5152/turkthoracj.2018.040189] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 03/28/2018] [Indexed: 11/22/2022]
Abstract
Silicosis is an ancient but still life-threatening occupational lung disease because of its incurable nature. Although its risks are known in many occupational settings and effective control strategies are well established, new cases, even epidemics, continue to occur in different sectors of Turkey. Before taking action, defining the magnitude of the problem is essential. In this concise review, we aimed to present the current situation of silicosis in Turkey. According to the data available to date, silicosis continues to be a major health problem in different sectors. Sandblasting seems to have the highest risk for the development of silicosis. Disease onset at early age and history of short exposure duration may indicate intense silica exposure. After denim sandblasters, dental technicians seem to be the new and recently recognized high-risk occupation group as per the increasing reports. Because of the lack of a definite treatment of silicosis, prevention of the disease should be the main target. Better occupational disease registry systems would be useful to assess the magnitude of the problem. In addition to implementing the necessary regulations, a close inspection of the workplaces for potential risks is essential. Other social and economic factors related with the occurrence of disease, such as unregistered employment rate and unlicensed and uninsured work, should also be considered. Finally, optimal healthcare and better living conditions for patients with silicosis should be ensured.
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Affiliation(s)
- Metin Akgün
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
| | - Begüm Ergan
- Department of Pulmonary and Critical Care, Dokuz Eylül University School of Medicine, İzmir, Turkey
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23
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De Matteis S, Heederik D, Burdorf A, Colosio C, Cullinan P, Henneberger PK, Olsson A, Raynal A, Rooijackers J, Santonen T, Sastre J, Schlünssen V, van Tongeren M, Sigsgaard T. Current and new challenges in occupational lung diseases. Eur Respir Rev 2017; 26:170080. [PMID: 29141963 PMCID: PMC6033059 DOI: 10.1183/16000617.0080-2017] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 09/02/2017] [Indexed: 01/13/2023] Open
Abstract
Occupational lung diseases are an important public health issue and are avoidable through preventive interventions in the workplace. Up-to-date knowledge about changes in exposure to occupational hazards as a result of technological and industrial developments is essential to the design and implementation of efficient and effective workplace preventive measures. New occupational agents with unknown respiratory health effects are constantly introduced to the market and require periodic health surveillance among exposed workers to detect early signs of adverse respiratory effects. In addition, the ageing workforce, many of whom have pre-existing respiratory conditions, poses new challenges in terms of the diagnosis and management of occupational lung diseases. Primary preventive interventions aimed to reduce exposure levels in the workplace remain pivotal for elimination of the occupational lung disease burden. To achieve this goal there is still a clear need for setting standard occupational exposure limits based on transparent evidence-based methodology, in particular for carcinogens and sensitising agents that expose large working populations to risk. The present overview, focused on the occupational lung disease burden in Europe, proposes directions for all parties involved in the prevention of occupational lung disease, from researchers and occupational and respiratory health professionals to workers and employers.
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Affiliation(s)
- Sara De Matteis
- Respiratory Epidemiology, Occupational Medicine and Public Health, Imperial College London, London, UK
| | - Dick Heederik
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Alex Burdorf
- Dept of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Claudio Colosio
- Dept of Health Sciences of the University of Milan and International Centre for Rural Health of the S. Paolo Hospital, Milan, Italy
| | - Paul Cullinan
- Respiratory Epidemiology, Occupational Medicine and Public Health, Imperial College London, London, UK
| | - Paul K Henneberger
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Ann Olsson
- International Agency for Research on Cancer, Lyon, France
| | - Anne Raynal
- Occupational Medicine Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Jos Rooijackers
- Netherlands Expertise Center for Occupational Respiratory Disorders, Utrecht, The Netherlands
| | - Tiina Santonen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Joaquin Sastre
- Allergy Service, Fundacion Jimenez Diaz, Faculty of Medicine Universidad Autonoma de Madrid, CIBER of Respiratory Diseases, Ministry of Economy, Madrid, Spain
| | - Vivi Schlünssen
- Dept of Public Health, Section of Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
- National Research Center for the Working Environment, Copenhagen, Denmark
| | - Martie van Tongeren
- Centre for Occupational and Environmental Health; Centre for Epidemiology; Division of Population Health, Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Torben Sigsgaard
- Dept of Public Health, Section of Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
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