Spanish Study: The Long Tail of Silicosis Effects
GLENVIEW, Ill. – Silicosis can continue to worsen for engineered-stone workers for years after being on the job, according to a study released last week.
Artificial Stone Silicosis Rapid Progression Following Exposure Cessation noted worsening diagnoses for engineered-stone workers in Spain examined from 2009-2018.
The research appeared in the June 18 edition of CHEST®, the official publication of the American College of Chest Physicians.
The study from seven Spanish physicians centered on examinations of 106 male engineered-stone workers in southern Spain from 2009-2018. Average age of the workers was 36, with mean duration of about 12 years each in constant exposure to crystalline silica during dry-cutting of the material.
Every one of them showed sign of silicosis on first examination, with seven having progressive massive fibrosis (PMF), a severe complication with large areas of dense fibrosis in the lungs. All of them quit working with the material after diagnosis.
In follow-up examinations, 33 more workers progressed to PMF after (on average) four years. All the workers show significant annual loss in lung capacity after stopping their work with engineered stone.
Approximately two-thirds of the first examinations occurred in 2010-2013, at about the same time as significant action in Spain to decrease dry-cutting. However, new cases continued to appear as late as 2018.
At current rate of the disease’s progression, the study estimated that “in a few years, a significant proportion of patients might develop respiratory failure and will need to undergo lung transplantation, the only effective treatment currently available for this disease.”
The study also emphasized the need to maximize protective measures in active workers, and to find new treatments that may slow or stop disease progression.
An accompanying editorial in CHEST® by two physicians from the University of Illinois at Chicago School of Public Health went further. In Removal from Exposure is Not Enough, Drs Robert A. Cohen and Leonard H.T. Go argued for more-aggressive engineering controls in fabrication and, if needed, a more-radical solution.
“Given the toxicity of this material and the rising human cost of its use,” they wrote, “if engineering controls cannot limit worker exposure to hazardous concentrations of respirable crystalline silicate, a ban on this material needs to be considered.”
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