Accelerated Silicosis-An Emerging Epidemic Associated with Engineered Stone. Comment on Leso, V. et al. Artificial Stone Associated Silicosis: A Systematic Review. Int. J. Environ. Res. Public Health 2019, 16 (4), 568, doi:10.3390/ijerph16040568.

Graeme Edwards

doi:10.3390/ijerph16071179

Abstract

The systematic review by Leso et al. (16 February 2019) is a timely contribution to the body of knowledge concerning silicosis. It highlights the lack of quality data necessary to inform both occupational health risk management and the clinical management of workers exposed to respirable crystalline silica. This communication highlights current activity being undertaken in Queensland, Australia, that will further inform our knowledge concerning this entirely preventable disease. We are about half-way through a government-funded, case-finding program involving over 800 workers from the engineered stone bench-top fabrication industry. As of 15 February 2019, 99 confirmed cases of silicosis associated with engineered stone work were identified; nearly all were asymptomatic. The empirically observed false negative rate of ILO CXRs in this high-risk group appeared significantly greater than 10%. From pooled data, we hope to develop an appropriate index of exposure to trigger health surveillance using low-dose chest HRCT. Once a worker develops symptoms of silicosis, apart from lung transplantation, there are no treatment options currently available.

Highlights

The systematic review by Leso et al (16 February 2019) [1] is a timely contribution to the body of knowledge concerning silicosis
The emergence of an epidemic of accelerated silicosis associated with engineered or artificial stone in Australia was recently highlighted by The Lancet [2]
Following inspector activity in Queensland, Australia, triggering health monitoring of workers, I advised the health and safety regulator on 5 September 2018 of 12 cases of silicosis out of all 35 workers examined from just two stone bench-top fabricating businesses

Summary

Introduction

The systematic review by Leso et al (16 February 2019) [1] is a timely contribution to the body of knowledge concerning silicosis. Most cases reviewed were identified by their clinical presentation to respiratory physicians, with symptoms being indicative of well-established disease. Leso et al highlighted the lack of quality data to inform both occupational health risk management and the clinical management of workers exposed to respirable crystalline silica years before clinical detection.

Results

Conclusion