“…Nevertheless, in this group of exposed patients, because asbestos was concurrent with crystalline silica exposure (contaminated vermiculite), it is difficult to assess the role of each material separately. Moreover, based on examination of US death certificates of SSc patients (n=5642), Gold et al [40] have also observed an Table 1 Occupations associated with exposure to crystalline silica -Work of drilling, demolition, extraction, and transport of ores or rocks containing free silica -Crushing, grinding, sifting, and handling carried-out dry ores or rocks containing free silica -Cutting and polishing of rocks containing free silica -Manufacture and handling of grittings, scouring powders, or other products containing free silica -Work of sanding and dry sawing of materials containing free silica -Work in the coal mines -Extraction, splitting, cutting, smoothing, and polishing of slates -Use of crushed slate dust in rubber factory or in the preparation of cement or sinter -Extraction, crushing, and conditioning of talc -Use of talc like lubricant or like charges in paper sizing, certain paintings, preparation of cosmetic powders, and mixtures of rubbers -Manufacture of carborundum, glass, porcelain, earthenware, and other products such as ceramics and refractory products -Work of foundry exposing to dust of sand, stripping, trimming, and desanding -Work of grinding, polishing, and dry grinding by means of grinding wheels containing free silica -Work of scouring or polishing to the sand blast -Building work and demolition exposing to the inhalation of dust containing free silica association between occupational asbestos exposure and SSc (OR 1.2, 95 % CI 1.1-1.3).…”