Silicosis in Workers Exposed to Artificial Quartz Conglomerates: Does It Differ From Chronic Simple Silicosis?

Abstract

Arch Bronconeumol. 2015;xxx(xx):xxx-xxx w w w . a r c h b r o n c o n e u m o l . o r g a b s t r a c tRecently, a number of reports have been published on silicosis in workers exposed to artificial quartz conglomerates containing high levels of crystalline silica particles (70%-90%) used in the construction of kitchen and bathroom surfaces. Three cases of silicosis in workers exposed to artificial quartz conglomerates are reported. The diagnosis was derived from both the International Labour Office and the International Classification of HRCT for Occupational and Environmental Respiratory Diseases (ICOERD) classifications and cytological analysis of bronchoalveolar lavage fluid. In 2 cases, levels of respirable silica greatly in excess of recommended standards were measured in the workplace, and cytological analysis of bronchoalveolar lavage fluid highlighted a prevalence of lymphocytes, meeting criteria for the diagnosis of accelerated silicosis.The prevention of pneumoconiosis caused by the use of innovative materials such as artificial conglomerates with high crystalline silica content must be addressed. Silicosis en trabajadores expuestos a conglomerados artificiales de cuarzo: ¿es distinta a la silicosis crónica simple?Palabras clave: Silicosis Conglomerados de cuarzo Líquido del lavado broncoalveolar TAC de alta resolución © 2014 SEPAR. Publicado por Elsevier España, S.L.U. Todos los derechos reservados.ଝ Please cite this article as: Paolucci V, Romeo R, Sisinni AG, Bartoli D, Mazzei MA, Sartorelli P. Silicosis en trabajadores expuestos a conglomerados artificiales de cuarzo: ¿es distinta a la silicosis crónica simple? Arch Bronconeumol. 2015.

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

“…Our cases have demonstrated progressive disease consistent with the accelerated form of silicosis 9. The rate of decline in lung function observed has been rapid, with a mean decline in FEV 1 of 386 mL/year (range 171–788 mL) compared with an expected rate of 36 mL/year 12.…”

Artificial stone-associated silicosis in the UK

“…Similar levels of increased lymphocytes (35–41%) on BAL cellular analysis were also noted in two Spanish cases 4. This level of BAL lymphocytosis has not previously been noted in chronic silicosis and is typically found in other lung conditions such as sarcoidosis, a condition that shares many radiological features with silicosis 5.…”

Multiorgan accelerated silicosis misdiagnosed as sarcoidosis in two workers exposed to quartz conglomerate dust

“…These levels of exposure to silica are similar to those measured in the workplace of our workers. In addition, the presentation as accelerated silicosis even in the two cases described by Paolucci  et al 4 suggests that a cumulative exposure to silica, sufficient to induce overt silicosis in <10 years, is reached in these working conditions.…”

“…In addition, freshly fractured silica, generated during abrasive blasting, may exhibit increased toxicity than aged silica, due to the elevated redox potential of silanol groups on crystal surface 8. No data on workplace dust levels were available from most of the previous studies on artificial quartz conglomerates,1–3 except the case report of Paolucci et al 4. Their data in the finishing area showed an average crystalline silica concentration 20 times higher than the threshold limit value proposed by ACGIH.…”