Granite Workers Research Articles

Barre, Vermont Granite Workers and the Struggle Against Silicosis, 1890–1960

Barre, Vermont Granite Workers and the Struggle Against Silicosis, 1890–1960

Barre, Vermont Granite Workers and the Struggle Against Silicosis, 1890–1960

Barre, Vermont Granite Workers and the Struggle Against Silicosis, 1890–1960

Barre, Vermont Granite Workers and the Struggle Against Silicosis, 1890-1960

Barre, Vermont Granite Workers and the Struggle Against Silicosis, 1890-1960

Crystalline Silica and Lung Cancer: The Problem of Conflicting Evidence

The IARC Working Group, in 1997, had considerable difficulty in reaching a decision and might well not have done so had it not been made clear that it was concerned with hazard identification, not risk. Other authors have explained the complexity of the mechanistic findings; we do so with the epidemiological. Of the many studies reviewed by the Working Group, excluding those of registered silicotics, nine were identified as providing the least confounded evidence. Four studies which we considered positive included two of refractory brick workers, one in the diatomite industry and our own in pottery workers; the five which seemed negative or equivocal included studies of South Dakota gold miners, Danish stone workers, US stone workers and US granite workers. This further example that the truth is seldom pure and never simple underlines the difficulty of establishing a rational control policy for some carcinogenic materials.

Crystalline Silica and Lung Cancer: The Problem of Conflicting Evidence

The IARC Working Group, in 1997, had considerable diffi culty in reaching a decision and might well not have done so had it not been made clear that it was concerned with hazard identification, not risk. Other authors have explained the complexity of the mechanistic findings; we do so with the epidemiological. Of the many studies reviewed by the Working Group, excluding those of registered silicotics, nine were identified as providing the least confounded evidence. Four studies which we con sidered positive included two of refractory brick workers, one in the diatomite industry and our own in pottery workers; the five which seemed negative or equivocal included studies of South Dakota gold miners, Danish stone workers, US stone workers and US granite work ers. This further example that the truth is seldom pure and never simple underlines the difficulty of establishing a rational control policy for some carcinogenic materi als.

Radiographic Evidence of Silicosis in Relation to Silica Exposure

Abstract Although the risk of silicosis has long been recognized as a consequence of exposure to crystalline silica, there are only limited data available for quantitatively estimating risk in relation to modern concentrations. Reports on three large groups of workers (Vermont granite workers, South African gold miners, and Ontario hardrock miners) form the basis for estimating silicosis risk; two other smaller studies, of British gypsum miners and North Carolina dusty trades workers, provide additional but less quantitative information. For 40 years of exposure to a respirable silica concentration of 0.1 mg/m3, the estimated cumulative risk of radiographic evidence of silicosis is approximately 1 to 3 percent based on the Ontario miners (depending on whether diagnosis requires a positive reading by a majority of five readers or by only one reader) and is 60 percent based on South African miners. Findings from Vermont granite workers and North Carolina dusty trades workers are more consistent with the low...

Mortality of a cohort of U.S. workers employed in the crushed stone industry, 1940-1980.

The mortality of 3,246 males who had been employed 1 or more years during 1940-1980 at 20 crushed stone operations was evaluated for possible association between employment and death from lung cancer, pneumoconiosis, and other respiratory diseases. Four deaths were attributed to pneumoconiosis. Based on available work histories, at least two of these deaths were probably due to dust exposures in the crushed stone industry. Mortality attributed to pneumoconiosis and other nonmalignant respiratory diseases, including chronic obstructive lung disease, was significantly increased overall (SMR: 1.98; 95% CI: 1.21-3.05), and especially so for a subcohort of crushed stone workers that processed granite (SMR: 7.26; 95% CI: 1.97-18.59). With regard to lung cancer, overall SMRs were elevated (although not statistically significant). Analyzed by rock type, there was a significantly elevated lung cancer SMR among granite workers with at least 20 years latency (SMR: 3.35; 95% CI: 1.34-6.90). Although not definitive, results of this study are consistent with the hypothesis that exposure to respirable silica dust is a risk factor for lung cancer.

Does occupational exposure to dust prevent colorectal cancer?

To explore the impression that occupational epidemiologists tend to focus on associations suggestive of increased risk and tend to ignore those associations in which risk is not increased. To examine the risk of colorectal cancer in cohorts exposed to dust, cohorts in which it has been suggested that occupational exposure is a cause of increased risk of stomach cancer. A review of the publications in the English language on mortality among hard rock miners, granite, and quarry workers identified from a MEDLINE search and the index of the library of the Ontario Ministry of Labour. When all of the studies were combined, there were significant excesses of lung and stomach cancers, but a significant deficit of colorectal cancer (standardised mortality ratio (SMR) = 83.9; 95% confidence interval (95% CI) 76-91). Overall mortality from gastrointestinal cancer was close to expectation (SMR = 105; 95% CI 99-111). Among those cohorts with increased risk of stomach cancer, rates of colorectal cancer were significantly decreased (SMR = 80; 95% CI 72-88). Among cohorts without increased risk of stomach cancer, the SMR for colorectal cancer was not significantly different from 100 (SMR = 98; 95% CI 81-115). This review supports the impression that occupational epidemiologists tend to focus on associations suggestive of increased risk and tend to ignore those associations in which risk is not increased. The explanation for the inverse association between risk of stomach and colorectal cancer is uncertain and deserves further study.

Silica dust exposure and lung cancer.

The study evaluated the possibility of a direct association between silica dust exposure and lung cancer. Mortality and morbidity among 1026 granite workers was followed in 1940-1989. Regional census data for 1970-1985 and lung cancer incidence data were also linked. The cytotoxicity of different granite fractions and their capacity to induce reactive oxygen species (ROS) in human leukocytes was studied in vitro. Excess lung cancer mortality was found during several follow-up periods. The rate ratios were 1.6-3.8 for different latency periods. Lung cancer risk increased with the length of exposure and latency. Lung cancer morbidity in 1953-1987 showed an excess for the red and grey granite areas, the rate ratio being 2.5 for > or = 20-year latency. Only one lung cancer case came from the black granite area. The cancer cases from the grey area had a shorter latency than those from the red area. The mineral composition differed for each area. The strongest ROS-inducing activity of grey and red granite was seen in the quartz-containing fractions. In the cytotoxicity tests the quartz-containing fractions of the grey and red granite also caused the strongest lactic dehydrogenase (LDH) release. However, plagioclase, the main constituent of black granite (60%), had approximately the same ability to induce ROS as the quartz-containing fractions of red and grey granite. The cancer morbidity and mortality figures of the three different granite areas, combined with the found differences in biological activity of granite dusts and a hypothesis that there is a cancer-inducing mechanism for ROS, point to a direct role for quartz in cancer induction.

Longitudinal Pulmonary Function Losses in Vermont Granite Workers: A Reevaluation

Previous studies have suggested that excessive losses of FVC and FEV1 were occurring in Vermont granite workers despite the fact that mean quartz levels existing in the industry were below the current OSHA standard of 100 micrograms/m3. We reexamined these losses in granite workers over an 8-year period, testing the workforce biennially from 1979 to 1987. All workers, including stone shed, quarry, and office, were offered forced spirometry using a 10-L water-sealed spirometer (Collins). In the peak year of participation (1983), 887 workers out of a total of approximately 1,400 were tested. Estimates of longitudinal loss were based on 711 workers who participated in at least three of the surveys. The mean age of this group was 42.9 years, and the mean years employed was 19.3 years; 21.4 percent were non-smokers (NS), 34.2 percent were ex-smokers (ES), and 44.4 percent were current smokers (CS). Average annual losses of FVC were 0.018 (SD = 0.056) L (CS, 0.025 L; NS, 0.006 L: and ES, 0.016 L). Average annual losses of FEV1 were 0.030 (SD = 0.041) L (CS, 0.038 L; NS, 0.020 L; and ES, 0.027 L). Analysis of covariance indicated that losses were related to the initial values for FVC or FEV1, height, age, and smoking status. After adjusting for these variables, the losses of both FVC and FEV1 were not correlated with years employed in the granite industry. No significant differences existed in the loss of FVC or FEV1 in categories of workers exposed to different levels of granite dust, eg, office, quarry, and stone shed workers. The annual losses of pulmonary function were significantly smaller than those estimated previously, which were 0.070 to .080 L in FVC, and 0.050-0.070 L in FEV1. We conclude that dust levels in the Vermont granite industry, which have been in conformance with OSHA permissible exposure limits, do not accelerate pulmonary function loss.

Quantitative Relations Between Silica Exposure and Development of Radiological Small Opacities in Granite Workers

Quantitative Relations Between Silica Exposure and Development of Radiological Small Opacities in Granite Workers

Further evidence of human silica nephrotoxicity in occupationally exposed workers.

It has previously been shown that granite workers with heavy exposure to silica had glomerular and proximal tubular dysfunction evidenced by increased urinary excretions of albumin, alpha-1-microglobulin (AMG), and beta-N-acetyl-glucosaminidase (NAG). The investigation was replicated in another group of granite workers to further elucidate the exposure effect relation. The urinary excretion of albumin, alpha-1-microglobulin (AMG), beta-2-microglobulin (BMG), and beta-N-acetyl-glucosaminidase (NAG) was determined in two groups of granite workers with low and high exposure to silica. Low molecular weight proteinuria and enzymuria were significantly correlated with duration of exposure in the high but not the low exposure group. These increases were most pronounced in those with 10 or more years of heavy exposure, and in those with radiological evidence of pulmonary fibrosis, particularly those with rounded small opacities denoting classical silicosis. These results provide further evidence that prolonged and heavy exposure to silica is associated with nephrotoxic effects in granite workers.

Phospholipid content of bronchoalveolar lavage fluid in granite workers with silicosis in Quebec.

Some of the prominent features of silicosis are hyperplasia and hypertrophy of epithelial type II cells, which in experimental animals are often accompanied by accumulation of phospholipids in the lung. The total phospholipid content of lung lavage fluid and its composition in 28 granite stone cutters with long term exposure to silica dust (23 with radiological silicosis) was compared with that of lavage fluid in 15 normal volunteers, 15 patients with untreated idiopathic pulmonary fibrosis, and 19 patients with untreated stage 2 or 3 sarcoidosis. All lavage fluid was obtained at the time of first pulmonary investigation, which also included lung function tests. In the normal subjects total phospholipid content was 1.13 (0.16) micrograms phosphorus/ml of lung lavage, in the patients with idiopathic pulmonary fibrosis 0.52 (0.07) microgram/ml (p < 0.05), and in the patients with sarcoidosis 1.02 (0.20) microgram/ml composition being in the range reported in humans. In the patients with silicosis total phospholipid content was significantly decreased to an average of 0.46 (0.08) microgram/ml compared with the findings in normal subjects and patients with sarcoidosis. Within the group exposed to silica changes in total phospholipid content did not correlate with the severity of the radiographic disease, changes in lung function, the cellularity of lung lavage fluid, or hyaluronate concentrations. The secretory capacity of rat epithelial type II cells was not significantly different when cultured with bronchoalveolar lavage fluid from all four groups of subjects. Total phospholipid content in lung lavage fluid was significantly reduced in granite workers with radiological evidence of lung disease, but showed no correlation with radiological or functional markers of disease severity.

Fiberglass or silica exposure and increased nephritis or ESRD (end-stage renal disease).

The U.S. multiplant cohort mortality study of workers producing manufactured mineral fibers is finding increasing mortality from nephritis and/or nephrosis. We examine other data sets to see if similar effects can be identified. In a case-referent study among Michigan patients with end-stage renal disease (ESRD), men with exposures to silica have elevated odds ratio for ESRD. In a California occupational mortality study based on 1979-81 data, a number of the construction trades, farmers, and farm laborers show excess mortality for renal disease. The highest mortality ratio is found in the category including insulation workers. This ratio remains significantly elevated when adjusted for estimated exposures to smoking, alcohol, and for socio-economic status. California mortality data from 20 years earlier (1959-61) fail to show much excess renal disease in construction workers, but do for farmers. In Singapore, granite workers with a long-term exposure to silica have excess excretion of albumin and similar compounds compared to less exposed controls, leading to the presumption that silica exposure can lead to silica nephrotoxicity. Balkan nephropathy has been associated with consumption of well water high in silica. In the Negev of Israel, dust storms are a vehicle for increasing respiratory uptake of silica. The Beduin, thought to be a population with maximal exposures, have higher rates of ESRD than do Jews in the age groups over 60 years. Although high blood concentrations of silica are found in persons with renal failure, the close association with elevated creatinine has been interpreted as evidence that the buildup of silica is due to renal failure, rather than vice-versa.(ABSTRACT TRUNCATED AT 250 WORDS)

New Technology, Old Hazard: The 1909 Granite Workers' Strike

New Technology, Old Hazard: The 1909 Granite Workers' Strike

Lung function in relation to silicosis and silica exposure in granite workers

Lung function tests (forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC %) were related to silica exposure and the extent of radiological opacities in a study of 206 active and 132 previously employed granite workers from two quarries. The investigations included detailed personal interviews, spirometric testing and radiographic examination of the chest. The chest X-ray films were read randomly and independently by three readers, using International Labour Office (ILO) standard films. Cumulative exposure to respirable silica (mg.m-3-yr) and total granite dust (million particles per cubic foot (mppcf-yr)) were estimated for each subject based on his years of employment at various jobs and historical and current measurements of quarry-, period- and job-specific exposures. The results suggest that chronic simple silicosis, especially for profusion category 2 and 3, was associated with significant lung function loss. As expected, mixed dust fibrosis was associated with little or no functional disturbance. Massive fibrosis was associated with significant obstructive and restrictive impairment. No additional effect of exposure to respirable silica on lung function loss was found after allowing for the presence of "silicosis". However, exposure to total dust (mppcf-yr) appeared to be associated with some lung function loss independent of silicosis. Our results indicate that chronic simple silicosis is not a benign disease; silica exposure is the primary cause, but the lung function loss in silicotics is directly attributable to the fibrotic lung disease. However, exposure to total granite dust beyond the respirable size range may separately produce additional lung function loss.

Small airways function of silica-exposed workers.

Small airways obstruction may be present for many years before chronic airway obstruction becomes evident. Several spirometric indices, especially flow rates at low lung volumes, may reflect the status of small airways. Time domain indices, by using moments analysis of the volume time spirogram, have also been shown to be sensitive indicators of small airways obstruction. In this study, we have applied the various spirometric indices as well as time domain indices to a group of granite quarry workers without radiographic evidence of silicosis or physiological evidence of obstruction to the larger airways. The aim was to evaluate small airways function in relation to dust exposure in subjects with normal ratio of the forced expiratory volume in one second to the forced vital capacity (FEV1/FVC) and normal FVC. The volume-time spirograms of 140 quarry workers were digitized using an electronic digitizer connected to a microcomputer where flow and time domain indices were computed. The workers were divided into three exposure groups based on their occupational history. With adjustment for age, height, and smoking status, all the time domain indices showed significant small airways obstruction with increasing dust exposure. Smokers had greater degree of airways obstruction than the non-smokers, with a similar trend of increase in small airways obstruction in relation to higher exposure. Our present study suggests that small airways obstruction is present among silica exposed workers in the absence of radiological evidence of silicosis and large airways obstruction. There was also evidence of increasing small airways obstruction in higher dust exposure group. Our study also suggests that time domain indices are more sensitive to small airways obstruction.

Effects of work exposure, retirement, and smoking on bronchoalveolar lavage measurements of lung dust in Vermont granite workers.

Estimation of the exposure to respirable dust in the workplace is an important aspect of industrial hygiene. We performed bronchoalveolar lavage (BAL) on 42 healthy nonindustrial control subjects and 44 workers in the Barre, Vermont granite industry to determine whether BAL materials reflected occupational exposure. The granite workers held jobs with a range of dust exposure intensities and had employment histories from 1 to 43 yr; 12 workers were retired. None of the workers had radiologic evidence of silicosis. The granite dust content of BAL materials was measured by enumerating the percentage of cells positive for particulates by polarized light microscopy, by analysis for silicon by scanning electron microscopy with energy-dispersive X-ray spectrometry, and by chemical analysis. Minerals were present in greater quantity in the BAL cells from granite workers than from nonindustrial control subjects. Polarized light microscopy was comparable in sensitivity, specificity, and overall accuracy to electron microscopy; chemical analysis was less accurate than either microscopic technique. Tobacco smoking did not interfere with the detection of the occupationally related minerals or influence the quantity of dust present. The mineral in BAL cells was partially related to the intensity of exposure within the granite industry and to the duration of employment, but there was great individual variation among subjects. Retirement led to a decrease in BAL mineral content, but substantial dust remained for many years.

Radiographic Abnormalities in Vermont Granite Workers Exposed to Low Levels of Granite Dust

The issue of whether low levels of granite dust exposure lead to radiographic abnormalities after a lifetime of exposure has not been settled. In 1983, we carried out a radiographic survey of the Vermont granite industry, consisting of quarry and stone shed workers who had been exposed to the low dust levels prevailing in the industry since 1938 to 1940. Films were read by three "B" readers, using the ILO classification system, which requires the identification of both rounded and irregular opacities, as well as combinations of both. X-ray films were taken of 972 workers, out of a total work force of approximately 1,400. Of these films, 28 (3 percent) were interpreted by either two or three of the three readers as showing abnormalities consistent with pneumoconiosis. Only seven films (or 0.7 percent of the entire cohort) showed nodular or rounded opacities of the type typically seen in uncomplicated silicosis. The remainder of the abnormal x-ray films showed irregular opacities, largely in the lower lung zones, which are of uncertain significance, but may be related to heavy cigarette smoking and aging, and possibly dust inhalation. In addition, total gravimetric dust concentrations in the workplace were measured; 417 respirable-size mass samples showed concentrations of 601 micrograms/cu m +/- 368 micrograms/cu m. Using previously published estimates of 10 percent quartz in granite dust, the average quartz concentration was 60 micrograms/cu m. Twelve percent of the samples exceeded 100 micrograms/cu m, the current OSHA standard for quartz. We conclude that control of quartz exposure in the Vermont granite industry to levels which are on average less than the current OSHA standard has essentially eliminated definite radiographic changes of silicosis. The significance of the irregular opacities in the lower lung zones seen on a majority of the 28 x-ray films judged to be abnormal is not clear.

Silicosis and lung cancer among Chinese granite workers : Chia S-E, Chia K-S, Phoon W-H, Lee H-P. Department of Community, Occupational and Family Medicine, National University of Singapore, National University Hospital, Lower Kent Ridge Road, Singapore 0511. Scand J Work Environ Health 1991;17:170-4

Silicosis and lung cancer among Chinese granite workers : Chia S-E, Chia K-S, Phoon W-H, Lee H-P. Department of Community, Occupational and Family Medicine, National University of Singapore, National University Hospital, Lower Kent Ridge Road, Singapore 0511. Scand J Work Environ Health 1991;17:170-4