Ana Paula S Carneiro1, Nayara F T Braz2, Eduardo Algranti3, Olivia M P A Bezerra4, Natália P S Araujo5, Lênio S Amaral Eng Hyg6, Jean L Edmé7, Annie Sobaszek7, Nathalie Chérot-Kornobis7. 1. State Workers' Health Service, The Clinics Hospital, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. 2. Interdisciplinary Laboratory for Medical Research, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. 3. Division of Medicine, FUNDACENTRO, São Paulo, São Paulo, Brazil. 4. School of Medicine, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil. 5. Department of Biological Sciences, Experimental Pathophysiology Laboratory, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil. 6. Division of Occupational Hygiene, FUNDACENTRO-CRMG, Belo Horizonte, Minas Gerais, Brazil. 7. Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on human health), Lille, France.
Abstract
BACKGROUND: Brazil is an exporter of precious stones and craftsmen often work in poor conditions. We assessed silica-related diseases among crystal craftsmen and the complexity of its control. METHODS: Case-series including 118 subjects evaluated from 2006 to 2015, based on medical interviews, chest X-rays, spirometry, and respirable silica samples. RESULTS: Median age and length of exposure were 32 and 13 years, respectively. Silicosis, with 1/0 as a threshold, was diagnosed radiologically in 57 individuals (48.3%). Respirable silica concentrations were 0.9-29.3 times greater than the Brazilian occupational exposure limit. A Receiver Operating Characteristic (ROC) curve with the same diagnosis threshold showed best discrimination at a cut point of 12.5 years of exposure, corresponding to 4.85 mg-y/m3 of cumulative silica exposure. There was a significant decline in FEV1 across radiological and cumulative silica exposure categories. Eleven individuals (9.3%) had mycobacterial diseases at baseline or follow-up. CONCLUSION: Crystal craftsmen continue to suffer from silicosis, lung function impairment, comorbidity, and death due to silicosis. To date collective protection in some work sheds has not diminished silica levels. Long-term follow-up is needed to evaluate further improvements in preventive measures. Am. J. Ind. Med. 60:239-247, 2017.
BACKGROUND: Brazil is an exporter of precious stones and craftsmen often work in poor conditions. We assessed silica-related diseases among crystal craftsmen and the complexity of its control. METHODS: Case-series including 118 subjects evaluated from 2006 to 2015, based on medical interviews, chest X-rays, spirometry, and respirable silica samples. RESULTS: Median age and length of exposure were 32 and 13 years, respectively. Silicosis, with 1/0 as a threshold, was diagnosed radiologically in 57 individuals (48.3%). Respirable silica concentrations were 0.9-29.3 times greater than the Brazilian occupational exposure limit. A Receiver Operating Characteristic (ROC) curve with the same diagnosis threshold showed best discrimination at a cut point of 12.5 years of exposure, corresponding to 4.85 mg-y/m3 of cumulative silica exposure. There was a significant decline in FEV1 across radiological and cumulative silica exposure categories. Eleven individuals (9.3%) had mycobacterial diseases at baseline or follow-up. CONCLUSION: Crystal craftsmen continue to suffer from silicosis, lung function impairment, comorbidity, and death due to silicosis. To date collective protection in some work sheds has not diminished silica levels. Long-term follow-up is needed to evaluate further improvements in preventive measures. Am. J. Ind. Med. 60:239-247, 2017.
Authors: Ryan F Hoy; Mohamed F Jeebhay; Catherine Cavalin; Weihong Chen; Robert A Cohen; Elizabeth Fireman; Leonard H T Go; Antonio León-Jiménez; Alfredo Menéndez-Navarro; Marcos Ribeiro; Paul-André Rosental Journal: Respirology Date: 2022-03-18 Impact factor: 6.175