Case of accelerated silicosis in a sandblaster

Hutyrová, Beáta; Smolková, Petra; Nakládalová, Marie; Tichý, Tomáš; Kolek, Vı́tězslav

doi:10.2486/indhealth.2013-0032

Cited by 20 publications

(14 citation statements)

References 24 publications

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“…Silicotic lesions were also seen in 11 of 13 cases. Notably, two cases showed focal alveolar proteinosis (see Figure E1B), together with interstitial inflammation and silicotic nodules showing varying degrees of maturity, features consistent with accelerated silicosis (17). One of these miners had only 10 years of exposure as a surface worker, while the other had worked for 37 years as a roof bolter.…”

Section: Original Articlementioning

confidence: 87%

Lung Pathology in U.S. Coal Workers with Rapidly Progressive Pneumoconiosis Implicates Silica and Silicates

Cohen

Petsonk²,

Rose

et al. 2016

Am J Respir Crit Care Med

149

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Rationale: Recent reports of progressive massive fibrosis and rapidly progressive pneumoconiosis in U.S. coal miners have raised concerns about excessive exposures to coal mine dust, despite reports of declining dust levels.Objectives: To evaluate the histologic abnormalities and retained dust particles in available coal miner lung pathology specimens, and to compare these findings with those derived from corresponding chest radiographs.Methods: Miners with severe disease and available lung tissue were identified through investigator outreach. Demographic as well as smoking and work history information was obtained. Chest radiographs were interpreted according to the International Labor Organization classification scheme to determine if criteria for rapidly progressive pneumoconiosis were confirmed. Pathology slides were scored by three expert pulmonary pathologists using a standardized nomenclature and scoring system. Measurements and Main Results:Thirteen cases were reviewed, many of which had features of accelerated silicosis and mixed dust lesions. Twelve had progressive massive fibrosis, and 11 had silicosis. Only four had classic lesions of simple coal workers' pneumoconiosis. Four had diffuse interstitial fibrosis with chronic inflammation, and two had focal alveolar proteinosis. Polarized light microscopy revealed large amounts of birefringent mineral dust particles consistent with silica and silicates; carbonaceous coal dust was less prominent. On the basis of chest imaging studies, specimens with features of silicosis were significantly associated (P = 0.047) with rounded (type p, q, or r) opacities, whereas grade 3 interstitial fibrosis was associated (P = 0.02) with the presence of irregular (type s, t, or u) opacities.Conclusions: Our findings suggest that rapidly progressive pneumoconiosis in these miners was associated with exposure to coal mine dust containing high concentrations of respirable silica and silicates.

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Section: Original Articlementioning

confidence: 87%

Lung Pathology in U.S. Coal Workers with Rapidly Progressive Pneumoconiosis Implicates Silica and Silicates

Cohen

Petsonk²,

Rose

et al. 2016

Am J Respir Crit Care Med

149

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“…There is hardly any information in the literature about accelerated and extrapulmonary silicosis. Only some isolated cases but no large series have been reported 12–14. In addition, the coexistence of multiorgan involvement including bone marrow is exceptional in silicosis.…”

Section: Discussionmentioning

confidence: 99%

Accelerated silicosis with bone marrow, hepatic and splenic involvement in a patient with lung transplantation

et al. 2019

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Chronic silicosis is an entity widely described in literature. However, other types such as accelerated, acute, complicated and extrapulmonary silicosis are little documented. We present a case of accelerated extrapulmonary silicosis in a lung transplant patient in whom the diagnosis of systemic silicosis was made incidental to non-respiratory complications that occurred during follow-up. The appearance of cytopenia and liver failure led to diagnostic tests that documented the presence of silicotic granulomas in those locations. Taking into account the intensity, time of exposure, onset and development of the disease, we found a highly atypical case of accelerated extrapulmonary silicosis in which inorganic particles (presumably silica) were documented inside granulomas and macrophages of the bone marrow. With these findings, we reflect on the lack of consideration of these entities within clinical practice, their probable under diagnosis and the need to study other pathophysiological mechanisms of acquisition and dissemination of silicosis.

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“…Although returned lavage fluid from patients with acute silicoproteinosis has classically been reported to be a milky effluent with positive periodic‐acid Schiff stain, cases from more recent outbreaks rarely describe this finding …”

Section: Diagnosis Of Acute and Accelerated Silicosis In Modern Indusmentioning

confidence: 99%

“…All had died by the end of the 3-year follow-up. 56 Thirty-two men screened in a small agate mill in Guangzhou, China, found 15 cases of accelerated silicosis (prevalence of 47%) 27 3 ‡ 40-52 -2 (67%) Iran (2000-2007) 28 23 § 29 (13.7) 2 (0.6) 10 (43%) Italy (2004-2008) 29 1 ¶ 54 4 1 UK (2015) 30 6 ‡ 33.8 (5.9) 13 (5.3) 0 Iran (2017) 31 48 41 46 § 33 (29-37) 11 (9-17) 1 (2%) USA (2014) 42 1 ¶ 37 10 0 USA (1999-2003) 43 35 § --35 (100%) Italy (2015) 44 3 ‡ 48 (3.5) 13 (6) 0 Israel (2016) 45 47 19 § 47 (13.33) 11 (3.58) -Belgium (2018) 48 2 ‡ -<10 0 Australia (2018) 49 7 § 44 (26-61) 7 (4-10) 1 LTx (1%) Sandblaster Spain (2015) 50 1 ¶ 27 5 1 Czech Republic (2015) 51 1 ¶ 38 3.2 1 Turkey (2018) 52 1 ¶ 28 2 0 USA (2018) † † 53 101 § ---Stone crusher India (2015) 54 1 2 8 1 0 India (2015) 55 1 3 5 2 0 Jewellery and semi-precious stone workers India (2015) 56 19 -3.4 (1.7) 12 (63%) Brazil (2017) 57 57 32 12.5 6 (11%) China (2018) 34 15 (47% prevalence) 29 (4.9) 3.5 (1.7)…”

Section: Jewellery Polishersmentioning

confidence: 99%

“…Although returned lavage fluid from patients with acute silicoproteinosis has classically been reported to be a milky effluent with positive periodic-acid Schiff stain, 2 cases from more recent outbreaks rarely describe this finding. 51,78 Histology from lung biopsy or explanted lungs in recent silicosis outbreaks typically demonstrate a combination of acute and accelerated silicosis, with silicotic nodules comprised of histiocytes, fibroblasts and birefringent particles in a peripheral and centrilobular distribution, as well as severe patchy pulmonary fibrosis. 41,46 Respiratory function testing Spirometry may appear normal in the early stages of disease.…”

Section: Bal and Lung Biopsymentioning

confidence: 99%

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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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Case of accelerated silicosis in a sandblaster

Cited by 20 publications

References 24 publications

Lung Pathology in U.S. Coal Workers with Rapidly Progressive Pneumoconiosis Implicates Silica and Silicates

Lung Pathology in U.S. Coal Workers with Rapidly Progressive Pneumoconiosis Implicates Silica and Silicates

Accelerated silicosis with bone marrow, hepatic and splenic involvement in a patient with lung transplantation

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

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