Abstract
Spectrophotometric techniques provide qualitative but not quantitative data on lung particles. We aimed to quantitate silica content in biopsies of lung-transplanted silicosis patients by applying X-ray fluorescence (XRF) spectrometry. Lung biopsies of 17 lung-transplanted artificial patients were quantitated for silica and other minerals particles by Niton XL3 XRF spectrometry. Occupational and clinical history data were assessed. Lung biopsies of artificial stone-induced silicosis (ASIS) patients contained significantly higher levels of silica compared to those of idiopathic pulmonary fibrosis (IPF) patients (7284.29 ± 4693.75 ppm vs. 898.88 ± 365.66 ppm, p < 0.0001). Silica content correlated negatively with age, body mass index, and pulmonary function test results. A 1128 ppm silica cut-off value yielded 100% sensitivity and 94% specificity for predicting ASIS (AUC = 0.94, p < 0.0001). In conclusion, XRF measurements in lung biopsies can differentiate between silica and mineral particles in ASIS and IPF.
Highlights
Silicosis is a primary pneumoconiosis involving fibronodular lung disease caused by inhalation of silica dust
Overexposure of these marble workers to high concentrations of silica dust in their workplace may lead to silicosis, a chronic granulomatous disease characterized by inflammatory processes followed by fibrosis of lung tissue
The artificial stone-induced silicosis (ASIS) patients were significantly younger (48.7 ± 8.8 years vs. 58.2 ± 6.3 years, p < 0.001), and they had a lower body mass index at diagnosis and at the time of transplantation compared to the idiopathic pulmonary fibrosis (IPF) group (24.9 ± 5.2 vs. 28.4 ± 4.3 and 26.3 ± 4.2 and 29.0 ± 4.4, p < 0.083 and p < 0.044, respectively)
Summary
Silicosis is a primary pneumoconiosis involving fibronodular lung disease caused by inhalation of silica dust. The marble industry in Israel, which manufactures kitchen and bathroom countertops, is based mainly on artificial stone that contains more than 90% silica (SiO2 ) as a substitute for marble or granite Overexposure of these marble workers to high concentrations of silica dust in their workplace may lead to silicosis, a chronic granulomatous disease characterized by inflammatory processes followed by fibrosis of lung tissue. The outbreak of this new type of silicosis was reported in Israel in 2012 [3], and 32 patients with silicosis have since been transplanted in Rabin Medical.
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