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Autoimmune diseases, autoantibody status and silicosis in a cohort of 1238 workers from the artificial stone benchtop industry.
Tomic, Dunya; Hoy, Ryan F; Sin, Jesselyn; Jimenez Martin, Javier; Gwini, Stella May; Barnes, Hayley; Nikpour, Mandana; Morrisroe, Kathleen; Lim, Yuan Z; Walker-Bone, Karen.
Affiliation
  • Tomic D; Centre for Occupational and Environmental Health, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia.
  • Hoy RF; Centre for Occupational and Environmental Health, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia.
  • Sin J; Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia.
  • Jimenez Martin J; Centre for Occupational and Environmental Health, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia.
  • Gwini SM; Centre for Occupational and Environmental Health, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia.
  • Barnes H; Centre for Occupational and Environmental Health, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia.
  • Nikpour M; Centre for Occupational and Environmental Health, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia.
  • Morrisroe K; Department of Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia.
  • Lim YZ; Department of Medicine, The University of Melbourne Medicine at St Vincent's Hospital, Fitzroy, Victoria, Australia.
  • Walker-Bone K; Department of Rheumatology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Victoria, Australia.
Occup Environ Med ; 81(8): 388-394, 2024 Aug 29.
Article in En | MEDLINE | ID: mdl-39134395
ABSTRACT

OBJECTIVES:

Autoimmune disorders are multifactorial but occupational exposures have long been implicated, including respirable crystalline silica (RCS). A modern epidemic of silicosis is emerging internationally, associated with dry processing of engineered stone with high (>90%) RCS content. We aimed to investigate the prevalence of clinical autoimmune disease and common autoantibodies in exposed workers.

METHODS:

Stone benchtop industry workers in Victoria, Australia were offered free screening for silicosis and related disorders. Symptoms or diagnoses of autoimmune disease were evaluated by questionnaire and blood tests taken for rheumatoid factor (RF), antinuclear antibodies (ANAs) and extractable nuclear antigens (ENAs).

RESULTS:

Among 1238 workers (93.3% male) screened from 2019 to 2021, 0.9% were confirmed with autoimmune disease. Among those without clinical disease, 24.6% had detectable ANAs (93.5% male), 4.6% detectable ENAs and 2.6% were positive for RF. Silicosis was diagnosed in 253 workers (24.3% of those with diagnostic information available). Of those with ANA readings, 54 (6.6%) had ANA titre >1320. The likelihood of positive autoantibodies increased with age; smoking; higher exposure to RCS and silicosis diagnosis.

CONCLUSION:

The proportion of workers with detectable ANAs or ENAs was considerably higher than the 5%-9% expected in the general population. Some of the antibodies detected (eg, Scl-70, CENPB) have high sensitivity and specificity for systemic sclerosis. Long-term follow-up will be needed to estimate incidence. Rheumatologists should explore occupational history in new cases of autoimmune disease. Screening for autoimmune disease is indicated in workers exposed to RCS as these individuals need specialised management and may be entitled to compensation.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Silicosis / Autoantibodies / Autoimmune Diseases / Occupational Exposure / Silicon Dioxide Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Oceania Language: En Journal: Occup Environ Med Journal subject: MEDICINA OCUPACIONAL / SAUDE AMBIENTAL Year: 2024 Document type: Article Affiliation country: Australia Country of publication: United kingdom

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Silicosis / Autoantibodies / Autoimmune Diseases / Occupational Exposure / Silicon Dioxide Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Oceania Language: En Journal: Occup Environ Med Journal subject: MEDICINA OCUPACIONAL / SAUDE AMBIENTAL Year: 2024 Document type: Article Affiliation country: Australia Country of publication: United kingdom