Occupational Silica Exposure and Dose–Response for Related Disorders—Silicosis, Pulmonary TB, AIDs and Renal Diseases: Results of a 15-Year Israeli Surveillance

Abstract

Background: The exposure patterns of respirable crystalline silica based on environmental records, as well as the link to different diseases, are not well described. Aims and objectives: In this study, we evaluated the risk for various diseases in relation to occupational silica exposure, including Silicosis, pulmonary tuberculosis (TB), Autoimmune disorders (AIDs) and Renal diseases. Methods: We assessed the relationship between silica exposure and the rate of various diseases such as silicosis, pulmonary TB, AIDs and renal diseases in a cross-sectional study. We reviewed the medical records and exposure level of workers exposed to silica during the past two decades. Results: 261 workers were included in the study, total duration of exposure 15.6 years (±SD 8.74); 42.15% of them were employed in the artificial marble industry and 29.5% in manufacturing and construction industries. The average yearly silica exposure levels were 0.23 mg/m3 (±0.34). The average cumulative silica concentration was 3.59 mg/m3/y (±4.80). We found 25 (9.58%) incident cases of silicosis, 10 cases of chronic obstructive pulmonary disease (COPD) and emphysema (3.83%), six cases of several AIDs (2.30%), five cases of pulmonary TB (1.92%), three cases of renal diseases (1.15%), two cases of sarcoidosis (0.77%) and no lung cancer cases. When compared to studies with the same endpoint we found excess risk of silicosis (RR = 2.67/0.13 = 20.5, 95% CI 9.85 to 42.86)), pulmonary TB (RR = 30.70, CI 3.43–274.49, p = 0.002) and AIDs (RR = 2.87, 95% CI = 1.27 to 6.48 p = 0.01). Conclusions: Silica exposure was a significant risk factor for silicosis, pulmonary TB and AIDs. Our findings are important given persistent worldwide silica-related epidemics in low and high-income countries.

A cross-national perspective on silicosis: incidence, occupational settings, and trends

“…In epidemiological exposure-response models, the shape of the exposure-response curve arises an issue of concern for risk assessors; in our crossnational model this concern is obvious in the case of Israel after 2012, when silicosis outbreak raised scientific interest [19]. Moreover, silica exposure to 0.1 mg/m3/y is estimated to double the incidence of silicosis in Israel in 20 years [20].…”

Erasmus syndrome: A rare case report of silicosis and systemic sclerosis

“…Silicosis has been associated with TB, immunological disorders, and chronic obstructive pulmonary disease (COPD). 18 The prioritization of prevention strategies for silicosis and Erasmus syndrome is imperative. Occupational health and safety practices are critical for limiting silica exposure and preserving workers' health.…”

“…The occurrence of inflammation can potentially cause lung fibrosis, resulting in a decline in pulmonary function. Silicosis has been associated with TB, immunological disorders, and chronic obstructive pulmonary disease (COPD) 18 …”

“…Silicosis has been associated with TB, immunological disorders, and chronic obstructive pulmonary disease (COPD). 18 …”

Epidemiology: the current burden of tuberculosis and its determinants

“…Other conditions increase the risk of progression from infection to disease. These include silicosis (RR 4-30) [115,116], kidney failure (RR 10-25) [117,118], rheumatoid arthritis (RR 2-16) [111] and cancer (RR 2-40) [119][120][121]. In each of the conditions, the immune system is affected by the required treatment, making the patient less capable of self containing M. tuberculosis infection.…”