Outbreak of autoimmune disease in silicosis linked to artificial stone

Shtraichman, Osnat; Blanc, Paul D.; Ollech, Jacob; Fridel, Ludmila; Fuks, Leonardo; Fireman, Elizabeth; Kramer, Mordechai R

doi:10.1093/occmed/kqv073

Cited by 73 publications

(62 citation statements)

References 26 publications

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“…Occupations traditionally associated with increased risk of silicosis include glass and pottery making, mining and quarrying, sandblasting and construction trades that generate silica dust through stone or concrete work . Silicosis in workers exposed to artificial quartz conglomerates containing high proportions of crystalline silica particles has been a topic of investigation in recent years …”

Section: Introductionmentioning

confidence: 99%

“…Artificial stone became commercially available in 1986, and the first report of artificial stone‐associated silicosis caused by stonemasonry was published in Italy in 2010 . Since then, increasing numbers of cases have been reported from Spain, Israel, Australia, Turkey and the USA . Artificial stone has been available in China since the early 2000s, but no reports of artificial stone‐associated silicosis in China have been published.…”

Section: Introductionmentioning

confidence: 99%

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Artificial stone‐associated silicosis in China: A prospective comparison with natural stone‐associated silicosis

Xue

et al. 2019

Respirology

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Background and objective:We recently noted a dramatic increase in the number of patients with accelerated silicosis associated with exposure to artificial stone dust. Therefore, the natural history of artificial stoneassociated silicosis was compared with that of natural stone-associated silicosis. Methods: A total of 18 patients with artificial stoneassociated silicosis and 63 with natural stone-associated silicosis were diagnosed sequentially in 2018 and followed up for a period of 6-12 months. Data were collected from clinical charts. Results: The median duration of exposure prior to onset of symptoms of silicosis was shorter for patients who had been exposed to artificial stone dust (6.4 vs 29.3 years, P < 0.01). Four of the 18 patients experienced rapid deterioration in lung function over the follow-up period, with declines in pre-bronchodilator FVC of 587 (210-960) mL/year and FEV 1 of 625 (360-860) mL/year. GGO, PMF, emphysema and pulmonary artery widening were more frequently observed on computed tomography scans of patients with artificial stone-associated silicosis than of those with natural stone-associated silicosis. Approximately 38.9% of the patients with artificial stone-associated silicosis were lung transplant candidates and 27.8% died, both rates being significantly higher than in patients with natural stone-associated silicosis (3.2% and 0%, both P < 0.01). Conclusion: Compared to natural stone-associated silicosis, artificial stone-associated silicosis was characterized by short latency, rapid radiological progression, accelerated decline in lung function and high mortality. SUMMARY AT A GLANCEHigh silica content of artificial stone and uncontrolled dry cutting and grinding presents as a high risk of developing accelerated silicosis. Compared to natural stone-associated silicosis, artificial stoneassociated silicosis was characterized by short latency, rapid radiological progression, accelerated decline in lung function and high mortality in this study.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Artificial stone‐associated silicosis in China: A prospective comparison with natural stone‐associated silicosis

Xue

et al. 2019

Respirology

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“…Such associations have been reported in cases series (especially in heavily exposed groups). 10,11 In Scandinavia in particular, population-based case referent studies and linkage of census-defined occupation and hospitalization records have provided valuable insights into the potential relationships among occupational exposures, including to silica containing and other mineral dusts, and selected rheumatologic conditions, especially rheumatoid arthritis. [12][13][14][15][16][17][18][19] Sample size considerations, however, generally preclude occupationally-defined cohort investigations of rheumatologic diseases, especially conditions other than rheumatoid arthritis.…”

Section: Introductionmentioning

confidence: 99%

“…Also, we did not include in this analysis certain other even less common autoimmune diseases also associated with silica, for example, ANCA-associated vasculitis, Sjögren syndrome, "overlap" syndromes, and even pemphigus. 10,11,[25][26][27][28] There are other study limitations that should also be noted as well. The job exposure matrix subcategory of other inorganic dusts captures a heterogeneous group of exposures.…”

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confidence: 99%

Prospective Risk of Rheumatologic Disease Associated with Occupational Exposure in a Cohort of Male Construction Workers

Blanc

Järvholm

Torén

2015

The American Journal of Medicine

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“…Postulated mechanisms include increased levels of autoantibody production, immune complexes and excess production of immunoglobulin. The incidence of autoimmune diseases has increased in artificial stone benchtop fabricators, especially in those with silicoproteinosis . As part of the diagnostic workup for those with suspected accelerated silicosis, it is important to assess for these associated conditions, as treatment for these may alter the disease trajectory …”

Section: Associated Conditionsmentioning

confidence: 99%

Silica‐associated lung disease: An old‐world exposure in modern industries

et al. 2019

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Despite silica dust exposure being one of the earliest recognized causes of lung disease, Australia, USA, Israel, Turkey and other countries around the world have recently experienced significant outbreaks of silicosis. These outbreaks have occurred in modern industries such as denim jean production, domestic benchtop fabrication and jewellery polishing, where silica has been introduced without recognition and control of the hazard. Much of our understanding of silica‐related lung disease is derived from traditional occupations such as mining, whereby workers may develop slowly progressive chronic silicosis. However, workers in modern industries are developing acute and accelerated silicosis over a short period of time, due to high‐intensity silica concentrations, oxidative stress from freshly fractured silica and a rapid pro‐inflammatory and pro‐fibrotic response. Appropriate methods of screening and diagnosis remain unclear in these workers, and a significant proportion may go on to develop respiratory failure and death. There are no current effective treatments for silicosis. For those with near fatal respiratory failure, lung transplantation remains the only option. Strategies to reduce high‐intensity silica dust exposure, enforced screening programmes and the identification of new treatments are urgently required.

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Outbreak of autoimmune disease in silicosis linked to artificial stone

Cited by 73 publications

References 26 publications

Artificial stone‐associated silicosis in China: A prospective comparison with natural stone‐associated silicosis

Artificial stone‐associated silicosis in China: A prospective comparison with natural stone‐associated silicosis

Prospective Risk of Rheumatologic Disease Associated with Occupational Exposure in a Cohort of Male Construction Workers

Silica‐associated lung disease: An old‐world exposure in modern industries

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