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

Newbigin, Katrina; Parsons, Rex; Deller, David; Edwards, Robert; McBean, Rhiannon

doi:10.1111/resp.13672

Cited by 33 publications

(38 citation statements)

References 7 publications

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“…A study of Chinese miners noted 26.9% had a negative result on chest X‐ray screening despite findings for pneumoconiosis on HRCT 48. A preliminary report of artificial stone workers in Australia noted a normal chest X‐ray in 43% with CT findings of silicosis, suggesting a low sensitivity of the chest X‐ray in that setting 49…”

Section: Clinical Patterns Of Silicosismentioning

confidence: 99%

“…The effectiveness and frequency of these measures, in particular use of chest X‐ray, have not been sufficiently evaluated to screen workers who have been exposed to high levels of RCS from artificial stone and are at risk of accelerated silicosis. Preliminary reports from artificial stone workers noted a significant proportion to have a normal chest X‐ray despite features of silicosis on high‐resolution CT 49…”

Section: Prevention and Managementmentioning

confidence: 99%

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Silica‐related diseases in the modern world

Hoy

Chambers

2020

Allergy

247

174

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Silicosis is an ancient and potentially fatal pneumoconiosis caused by exposure to respirable crystalline silica. Silicosis is historically a disease of miners; however, failure to recognize and control the risk associated with silica exposure in contemporary work practices such as sandblasting denim jeans and manufacturing of artificial stone benchtops has led to re‐emergence of silicosis around the world. This review outlines the mineralogy, epidemiology, clinical and radiological features of the various forms of silicosis and other silica‐associated diseases. Perspective is provided on the most recent studies shedding light on pathogenesis, including the central role of innate immune effector cells and subsequent inflammatory cascades in propagating pulmonary fibrosis and the extrapulmonary manifestations, which uniquely characterize this pneumoconiosis. Clinical conundrums in differential diagnosis, particularly between silicosis and sarcoidosis, are highlighted, as is the importance of obtaining a careful occupational history in the patient presenting with pulmonary infiltrates and/or fibrosis. While silicosis is a completely preventable disease, unfortunately workers around the world continue to be affected and experience progressive or even fatal disease. Although no treatments have been proven, opportunities to intervene to prevent progressive disease, founded in a thorough cellular and molecular understanding of the immunopathology of silicosis, are highlighted.

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Section: Clinical Patterns Of Silicosismentioning

confidence: 99%

Section: Prevention and Managementmentioning

confidence: 99%

Silica‐related diseases in the modern world

Hoy

Chambers

2020

Allergy

247

174

View full text Add to dashboard Cite

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“…17 In a recent retrospective review of 78 AS masons in Queensland who had been given a clinical diagnosis of silicosis following active case finding and using high-resolution CT (HRCT) scanning, 34 (43%) had normal plain chest radiographs. 9 Of these, at least two-thirds had spent >50% of their total work tenure cutting and grinding without appropriate dust controls. Some false-negative findings occurred using chest radiographs alone, and HRCT was a more sensitive diagnostic test.…”

Section: Clinical Aspects Of As Silicosismentioning

confidence: 99%

“…7 Detection of coal mine dust lung diseases (CMDLD) and AS silicosis at an early stage should facilitate more effective management and allow avoidance of further dust exposure to benefit individual workers. Our framework is based on existing literature including the review of the Queensland Coal Mine Worker's Health Scheme, 8 WorkCover Queensland's (WCQ) review of stonemasons with silicosis, 9 targeted literature searches and international guidelines. It also includes opinion from national and international experts in the field.…”

Section: Introductionmentioning

confidence: 99%

Respiratory surveillance for coal mine dust and artificial stone exposed workers in Australia and New Zealand: A position statement from the Thoracic Society of Australia and New Zealand*

et al. 2020

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Coal mine lung dust disease (CMDLD) and artificial stone (AS) silicosis are preventable diseases which have occurred in serious outbreaks in Australia recently. This has prompted a TSANZ review of Australia's approach to respiratory periodic health surveillance. While regulating respirable dust exposure remains the foundation of primary and secondary prevention, identification of workers with early disease assists with control of further exposure, and with the aims of preserving lung function and decreasing respiratory morbidity in those affected. Prompt detection of an abnormality also allows for ongoing respiratory specialist clinical management. This review outlines a medical framework for improvements in respiratory surveillance to detect CMDLD and AS silicosis in Australia. This includes appropriate referral, improved data collection and interpretation, enhanced surveillance, the establishment of a nationwide Occupational Lung Disease Registry and an independent advisory group. These measures are designed to improve health outcomes for workers in the coal mining, AS and other dust-exposed and mining industries.

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“…Although the cohorts were of relatively small size (63 and 18, respectively), and as the authors acknowledge, the results were likely influenced by several unavoidable sources of bias, there are nevertheless clear and chilling messages which come from the data. As has now been described in multiple jurisdictions around the world, artificial stone‐related silicosis is presenting and progressing very differently from natural stone‐associated silicosis. These workers are developing disease with very short latencies of just a few years in some cases and a median of 6 years in the entire cohort.…”

mentioning

confidence: 99%