Silicosis in finishing workers in quartz conglomerates processing.

INTRODUCTION: Outbreaks of silicosis have bene recently reported in artificial stone workers. AIM: To describe the features of silicosis in quartz conglomerate workers in North-Eastern Italy. METHODS: Active search of pneumoconiosis was performed in 11 companies of North-Eastern Italy involved in the fabrication of quartz conglomerate countertops. Occupational history, lung function tests, chest X-ray and high resolution computed tomography (HRCT) were performed. In selected cases, trans-bronchial biopsies were taken for histological evaluation and identification of silica crystals in the tissue. Cumulative exposure to crystalline silica was estimated. RESULTS: We recruited 45 workers and 24 cases of silicosis were diagnosed. Mean age at diagnosis was 43 years and duration of exposure to quartz conglomerate dust was 3.5 to 20 years. The average silica cumulative exposure was 4.3 mg/m3/y. Abnormal findings were detected in 42% of chest X-rays, in 33% of spirometry and 50% of carbon monoxide lung diffusion (DLco). HRCTs were abnormal in all cases showing well-defined rounded opacities, irregular/linear intralobular opacities and bilateral enlarged mediastinal lymph-nodes. Histological findings consistent with silicosis were observed in 24 cases. Numerous silica particles (diameter 0.1-5 µm) were identified in lung tissue. CONCLUSIONS: We reported an unexpected high incidence of silicosis in Italian workers exposed to quartz conglomerate dust. The results suggest that chest HRCT is indicated for screening of workers with high exposure to silica and DLco should be added to spirometry in health surveillance. More rigorous application of safety regulations and more effective preventive interventions at work are necessary.

Feasibility of a screening programme for lung cancer in former asbestos workers.

BACKGROUND: Low-dose computed tomography (CT) has been found to detect more Stage IA lung cancer than chest x-ray. AIMS: To investigate whether lung cancer screening with CT was effective and acceptable in former asbestos workers. METHODS: CT scanning was carried out following the protocol previously described in the literature. A questionnaire was used to assess cumulative asbestos exposure. An economic analysis was also performed. Informed consent was obtained from all patients. RESULTS: A total of 1119 male asbestos workers (58% of invited) were examined, of whom 65% were smokers or ex-smokers. Mean age was 57.1 years with mean cumulative exposure to asbestos of 123 fibres/ml x years. Pleural plaques were found in 375 workers (32%), while 338 workers (29%) were included in the radiological follow-up, which led to 25 biopsies (13 of lung, 9 of pleura, 3 of both) and five screen-detected lung cancers (0.4%), one in Stage I. Incidence rate was 149 per 10(5), equal to that in the male general population of similar age. The expenses for diagnosis were 1014 and 244962 Euro per screened subject and screen-detected lung cancer case, respectively. CONCLUSIONS: Screening adherence and frequency of detection were low, while costs and radiation dose were high. In spite of a high cumulative asbestos exposure, lung cancer risk was not increased relative to the general population. The screening programme was not felt to be cost-effective from the perspective of the government as a third-party funding agency.

Mesotheliomas among Italians, returned to the home country, who worked when migrant at a cement-asbestos factory in Switzerland.

OBJECTIVES: To report the occurrence of mesotheliomas in Italy among subjects who worked, when migrant, at a cement-asbestos factory in Niederurnen, Switzerland, and had resettled to the home country. METHODS: Information about the disease and on the working history of subjects was collected by regional mesothelioma registries. Only cases diagnosed by means of histo-pathological examinations have been considered here. RESULTS: 15 mesotheliomas (13 pleural, 2 perithoneal; 12 among males, 3 among females) have been identified among Italians, who had worked at the factory. None of them had other occupational exposure to asbestos. The majority was living in the Veneto Region (North East of Italy), and in Puglia (Southern Italy). CONCLUSIONS: Exposure to asbestos at this factory has already caused an important number of occupational cancers among the employees, a large fraction being constituted of migrants. In order to avoid under-estimation of risks and to allow compensation, diseases which occur among foreign workers returned to their home country should be evaluated. Migration for work is at the genesis of asbestos-related mesotheliomas now occurring in Italy.