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Hoy RF, Dimitriadis C, Abramson M, Glass DC, Gwini S, Hore-Lacy F, Jimenez-Martin J, Walker-Bone K, Sim MR. Prevalence and risk factors for silicosis among a large cohort of stone benchtop industry workers. Occup Environ Med 2023; 80:439-446. [PMID: 37328266 PMCID: PMC10423513 DOI: 10.1136/oemed-2023-108892] [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: 02/24/2023] [Accepted: 05/30/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES High silica content artificial stone has been found to be associated with silicosis among stone benchtop industry (SBI) workers. The objectives of this study were to determine the prevalence of and risk factors for silicosis among a large cohort of screened SBI workers, and determine the reliability of respiratory function testing (RFT) and chest x-ray (CXR) as screening tests in this industry. METHODS Subjects were recruited from a health screening programme available to all SBI workers in Victoria, Australia. Workers undertook primary screening, including an International Labour Office (ILO) classified CXR, and subject to prespecified criteria, also underwent secondary screening including high-resolution CT (HRCT) chest and respiratory physician assessment. RESULTS Among 544 SBI workers screened, 95% worked with artificial stone and 86.2% were exposed to dry processing of stone. Seventy-six per cent (414) required secondary screening, among whom 117 (28.2%) were diagnosed with silicosis (median age at diagnosis 42.1 years (IQR 34.8-49.7)), and all were male. In secondary screening, silicosis was associated with longer SBI career duration (12 vs 8 years), older age, lower body mass index and smoking. In those with silicosis, forced vital capacity was below the lower limit of normal in only 14% and diffusion capacity for carbon monoxide in 13%. Thirty-six (39.6%) of those with simple silicosis on chest HRCT had an ILO category 0 CXR. CONCLUSION Screening this large cohort of SBI workers identified exposure to dry processing of stone was common and the prevalence of silicosis was high. Compared with HRCT chest, CXR and RFTs had limited value in screening this high-risk population.
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Affiliation(s)
- 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
| | - Christina Dimitriadis
- 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
| | - Michael Abramson
- School of Public Health & Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Deborah C Glass
- 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
| | - StellaMay Gwini
- 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
| | - Fiona Hore-Lacy
- 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
| | - Javier Jimenez-Martin
- 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
| | - Karen Walker-Bone
- 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
| | - Malcolm R Sim
- 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
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Ronsmans S, Goeminne P, Jerjir N, Nowé V, Vandebroek E, Keirsbilck S, Weynand B, Hoet PH, Vanoirbeek JA, Wuyts WA, Yserbyt J, Nemery B. Outbreak of Silicosis in Workers Producing Artificial Stone Skirting Boards. Chest 2022; 162:406-409. [DOI: 10.1016/j.chest.2022.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 03/02/2022] [Accepted: 03/22/2022] [Indexed: 11/29/2022] Open
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García-Núñez A, Jiménez-Gómez G, Hidalgo-Molina A, Córdoba-Doña JA, León-Jiménez A, Campos-Caro A. Inflammatory indices obtained from routine blood tests show an inflammatory state associated with disease progression in engineered stone silicosis patients. Sci Rep 2022; 12:8211. [PMID: 35581230 PMCID: PMC9114118 DOI: 10.1038/s41598-022-11926-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 04/25/2022] [Indexed: 02/08/2023] Open
Abstract
Patients with silicosis caused by occupational exposure to engineered stone (ES) present a rapid progression from simple silicosis (SS) to progressive massive fibrosis (PMF). Patient classification follows international rules based on radiology and high-resolution computed tomography (HRCT), but limited studies, if any, have explored biomarkers from routine clinical tests that can be used as predictors of disease status. Our objective was thus to investigate circulating biomarker levels and systemic inflammatory indices in ES silicosis patients whose exposure to ES dust ended several years ago. Ninety-one adult men, ex-workers in the manufacturing of ES, 53 diagnosed with SS and 38 with PMF, and 22 healthy male volunteers (HC) as controls not exposed to ES dust, were recruited. The following circulating levels of biomarkers like lactate dehydrogenase (LDH), angiotensin-converting-enzyme (ACE), protein C reactive (PCR), rheumatoid factor, alkaline phosphatase and fibrinogen were obtained from clinical reports after being measured from blood samples. As biochemical markers, only LDH (HC = 262 ± 48.1; SS = 315.4 ± 65.4; PMF = 337.6 ± 79.3 U/L), ACE (HC = 43.1 ± 18.4; SS = 78.2 ± 27.2; PMF = 86.1 ± 23.7 U/L) and fibrinogen (HC = 182.3 ± 49.1; SS = 212.2 ± 43.5; PMF = 256 ± 77.3 U/L) levels showed a significant sequential increase, not been observed for the rest of biomarkers, in the HC → SS → PMF direction. Moreover, several systemic inflammation indices neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), aggregate index of systemic inflammation (AISI) derived from whole blood cell counts showed significant differences between the HC, SS and PMF groups. All these biomarkers were analyzed using receiver operating characteristic (ROC) curves, and the results provided moderately high sensitivity and specificity for discriminating between ES silicosis patient groups and healthy controls. Our study reveals that some inflammatory biomarkers, easily available from routine blood analysis, are present in ES silicosis patients even several years after cessation of exposure to ES silica dust and they could help to know the progression of the disease.
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Affiliation(s)
- Alejandro García-Núñez
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), 11009, Cádiz, Spain.,Research Unit, Puerta del Mar University Hospital, 11009, Cádiz, Spain
| | - Gema Jiménez-Gómez
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), 11009, Cádiz, Spain.,Research Unit, Puerta del Mar University Hospital, 11009, Cádiz, Spain
| | - Antonio Hidalgo-Molina
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), 11009, Cádiz, Spain.,Pulmonology, Allergy and Thoracic Surgery Department, Puerta del Mar University Hospital, 11009, Cádiz, Spain
| | - Juan Antonio Córdoba-Doña
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), 11009, Cádiz, Spain.,Department of Preventive Medicine and Public Health, Jerez University Hospital, 11407, Jerez de la Frontera, Spain
| | - Antonio León-Jiménez
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), 11009, Cádiz, Spain.,Pulmonology, Allergy and Thoracic Surgery Department, Puerta del Mar University Hospital, 11009, Cádiz, Spain
| | - Antonio Campos-Caro
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), 11009, Cádiz, Spain. .,Research Unit, Puerta del Mar University Hospital, 11009, Cádiz, Spain. .,Genetics Area, Biomedicine, Biotechnology and Public Health Department, School of Marine and Environmental Sciences, University of Cadiz, 11510, Cádiz, Spain.
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