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Prevalence and risk factors for silicosis among a large cohort of stone benchtop industry workers
  1. Ryan F Hoy1,2,
  2. Christina Dimitriadis1,
  3. Michael Abramson3,
  4. Deborah C Glass1,
  5. StellaMay Gwini1,
  6. Fiona Hore-Lacy1,2,
  7. Javier Jimenez-Martin1,
  8. Karen Walker-Bone1,
  9. Malcolm R Sim1
  1. 1 Monash Centre for Occupational and Environmental Health, School of Public Health & Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
  2. 2 Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia
  3. 3 School of Public Health & Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
  1. Correspondence to Dr Ryan F Hoy, Monash Centre for Occupational and Environmental Health, School of Public Health & Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3004, Australia; ryan.hoy{at}monash.edu

Abstract

Objectives High silica content artificial stone has been found to be associated with silicosis among stone benchtop industry (SBI) workers. The objectives of this study were to determine the prevalence of and risk factors for silicosis among a large cohort of screened SBI workers, and determine the reliability of respiratory function testing (RFT) and chest x-ray (CXR) as screening tests in this industry.

Methods Subjects were recruited from a health screening programme available to all SBI workers in Victoria, Australia. Workers undertook primary screening, including an International Labour Office (ILO) classified CXR, and subject to prespecified criteria, also underwent secondary screening including high-resolution CT (HRCT) chest and respiratory physician assessment.

Results Among 544 SBI workers screened, 95% worked with artificial stone and 86.2% were exposed to dry processing of stone. Seventy-six per cent (414) required secondary screening, among whom 117 (28.2%) were diagnosed with silicosis (median age at diagnosis 42.1 years (IQR 34.8–49.7)), and all were male. In secondary screening, silicosis was associated with longer SBI career duration (12 vs 8 years), older age, lower body mass index and smoking. In those with silicosis, forced vital capacity was below the lower limit of normal in only 14% and diffusion capacity for carbon monoxide in 13%. Thirty-six (39.6%) of those with simple silicosis on chest HRCT had an ILO category 0 CXR.

Conclusion Screening this large cohort of SBI workers identified exposure to dry processing of stone was common and the prevalence of silicosis was high. Compared with HRCT chest, CXR and RFTs had limited value in screening this high-risk population.

  • Silicosis
  • Lung Diseases, Interstitial
  • Respiratory System
  • Occupational Health

Data availability statement

No data are available.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

http://dx.doi.org/10.1136/oemed-2023-108892

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    Data availability statement

    No data are available.

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    • Contributors RFH is the content guarantor. RFH had full access to all of the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. CD, MA, DCG, SMG, FH-L, JJ-M, KW-B and MRS contributed substantially to the study design, data analysis and interpretation, and the writing of the manuscript.

    • Funding This work was supported by WorkSafe Victoria. Award number: not applicable.

    • Competing interests MA holds investigator initiated grants from Pfizer, Boehringer-Ingelheim, Sanofi and GSK for unrelated research. He has also undertaken an unrelated consultancy for Sanofi and received a speaker’s fee from GSK.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.