Artificial stone-associated silicosis: a rapidly emerging occupational lung disease

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.

Artificial stone-associated silicosis in Belgium

“…Similarly to the cases described by Hoy et al, 1 the first worker developed respiratory symptoms after <10 years of making and processing high-silica content artificial stone. The second worker had silica exposure for nearly 25 years in his current and previous job, possibly both contributing to his lung disease.…”

“…We read with interest the article by Hoy et al reporting silicosis in seven Australian workers fabricating artificial stone countertops,1 and the letter by Barber et al who could not identify cases in the UK 2. We describe two cases of silicosis in workers employed in a two-man company producing and installing artificial stone kitchen countertops.…”

Stonemasons with silicosis: Preliminary findings and a warning message from Australia

“…Due to the high silica content of the material, the potential exposure of respirable crystalline silica (RCS) to stonemasons has increased. The first Australian case of silicosis associated with artificial stone was reported in 2015, followed more recently in 2017 by a case series of eight patients . This case series attributed the identified disease to a failure of the industry regulators to enforce adequate dust control.…”

Artificial stone-associated silicosis in the UK

“…We read with interest the recent article by Hoy et al highlighting the risk of accelerated silicosis in workers installing kitchen and bathroom worktops 1. The Australian paper noted that artificial stone had been available in Australia since the early 2000s, and identified seven cases of silicosis diagnosed between 2011 and 2016.…”