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Gavin J Churchyard - One of the best experts on this subject based on the ideXlab platform.
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predictors of Silicosis and variation in prevalence across mines among employed gold miners in south africa
BMC Public Health, 2020Co-Authors: Dave Knight, Rodney Ehrlich, Annibale Cois, Katherine L Fielding, Alison D Grant, Gavin J ChurchyardAbstract:The stated intention to eliminate Silicosis from the South African goldmining industry as well as current programmes to find and compensate ex-miners with Silicosis require an understanding of variation in Silicosis prevalence across the industry. We aimed to identify the predictors of radiological Silicosis in a large sample of working miners across gold mines in South Africa. Routine surveillance chest radiographs were collected from 15 goldmine “clusters” in a baseline survey undertaken in preparation for a separate tuberculosis isoniazid prophylaxis trial. All images were read for Silicosis by a health professional experienced in using the International Labour Organisation (ILO) classification. Profusion thresholds of > 1/0 and > 1/1 were used. Demographic and occupational information was obtained by questionnaire. Predictors of Silicosis were examined in a multivariable logistic regression model, including age, gender, racial ascription, country of origin, years since starting mine employment, mine shaft, skill category, underground work status and tuberculosis. The crude Silicosis prevalence at ILO > 1/1 was 3.8% [95% confidence interval (CI) 3.5–4.1%]. The range across mine shafts was 0.8–6.9%. After adjustment for covariates, the interquartile range across shafts was reduced from 2.4 to 1.2%. Black miners [adjusted odds ratio (aOR) 2.8; 95% CI 1.1–7.2] and miners in full-time underground work (aOR 2.1; 95% CI 1.3–3.4) had substantially elevated odds of Silicosis, while workers from Mozambique had lower odds (aOR 0.54; 95% CI 0.38–0.77). Silicosis odds rose sharply with both age and years since starting in the industry (p for linear trend 15 years since first exposure and 2.2% < 10 years. In surveillance of Silicosis in working gold miners time since first exposure remains a powerful predictor. Age appears to be an independent predictor, while the detection of radiological Silicosis in short-service miners requires attention. Public risk reporting by mines should include factors bearing on Silicosis prevalence, specifically dust concentrations, with independent verification. Studies of Silicosis and tuberculosis in ex-miners are needed, supported by an accessible electronic database of the relevant medical and dust exposure records of all gold miners.
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Silicosis prevalence and exposure response relations in south african goldminers
Occupational and Environmental Medicine, 2004Co-Authors: Gavin J Churchyard, Rodney Ehrlich, Jim Tewaternaude, L Pemba, K Dekker, M Vermeijs, N W White, J E MyersAbstract:Aims: To measure the prevalence of Silicosis among black migrant contract workers on a South African goldmine and to investigate exposure-response relations with silica dust. Methods: In a cross sectional study, 520 black goldminers (aged >37 years) were interviewed and had chest radiographs taken. Silicosis was defined as International Labour Organisation Classification radiological profusion of 1/1 or greater. Results: Mean length of service was 21.8 years (range 6.3–34.5). The mean intensity of respirable dust exposure was 0.37 mg/m3 (range 0–0.70) and of quartz 0.053 mg/m3 (range 0–0.095). The prevalence of Silicosis was 18.3–19.9% depending on reader. Significant trends were found between the prevalence of Silicosis and length of service, mean intensity of exposure, and cumulative exposure. Conclusion: Results confirm a large burden of Silicosis among older black workers in the South African goldmining industry, which is likely to worsen as such miners spend longer periods in continuous employment in dusty jobs. An urgent need for improved dust control in the industry is indicated. If the assumption of stability of average dust concentrations on this mine over the working life of this group of workers is correct, these workers developed Silicosis while exposed to a quartz concentration below the recommended occupational exposure limit (OEL) of 0.1 mg/m3. This accords with a mounting body of evidence that an OEL of 0.1 mg/m3 is not protective against Silicosis.
David Shitrit - One of the best experts on this subject based on the ideXlab platform.
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ebus tbna is sufficient for successful diagnosis of Silicosis with mediastinal lymphadenopathy
Lung, 2018Co-Authors: Alexander Guber, David Shitrit, Yochai Adir, Avital Avriel, D A King, Gali Epstein Shochet, Sonia Schnaer, Michael KassirerAbstract:Background Silicosis is an occupational lung disease resulting from inhalation of respirable crystalline silica. Recently, an international Silicosis epidemic has been noted among artificial stone workers.
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artificial stone Silicosis disease resurgence among artificial stone workers
Chest, 2012Co-Authors: Mordechai R. Kramer, Elizabeth Fireman, Paul D Blanc, Anat Amital, Alexander Guber, Nader Abdul Rhahman, David ShitritAbstract:Background Silicosis is a progressive, fibrotic, occupational lung disease resulting from inhalation of respirable crystalline silica. This disease is preventable through appropriate workplace practices. We systematically assessed an outbreak of Silicosis among patients referred to our center for lung transplant. Methods This retrospective cohort analysis included all patients with a diagnosis of Silicosis who were referred for evaluation to the National Lung Transplantation Program in Israel from January 1997 through December 2010. We also compared the incidence of lung transplantation (LTX) due to Silicosis in Israel with that of the International Society for Heart and Lung Transplantation (ISHLT) registry. Results During the 14-year study period, 25 patients with Silicosis were referred for evaluation, including 10 patients who went on to undergo LTX. All patients were exposed by dry cutting a relatively new, artificial, decorative stone product with high crystalline silica content used primarily for kitchen countertops and bathroom fixtures. The patients had moderate-to-severe restrictive lung disease. Two patients developed progressive massive fibrosis; none manifested acute Silicosis (silicoproteinosis). Three patients died during follow-up, without LTX. Based on the ISHLT registry incidence, 0.68 Silicosis cases would have been expected instead of the 10 observed (incidence ratio, 14.6; 95% CI, 7.02-26.8). Conclusions This Silicosis outbreak is important because of the worldwide use of this and similar high-silica-content, artificial stone products. Further cases are likely to occur unless effective preventive measures are undertaken and existing safety practices are enforced.
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artificial stone Silicosis corrected disease resurgence among artificial stone workers
Chest, 2012Co-Authors: Mordechai R. Kramer, Elizabeth Fireman, Paul D Blanc, Anat Amital, Alexander Guber, Nader Abdul Rhahman, David ShitritAbstract:Background Silicosis is a progressive, fibrotic, occupational lung disease resulting from inhalation of respirable crystalline silica. This disease is preventable through appropriate workplace practices. We systematically assessed an outbreak of Silicosis among patients referred to our center for lung transplant. Methods This retrospective cohort analysis included all patients with a diagnosis of Silicosis who were referred for evaluation to the National Lung Transplantation Program in Israel from January 1997 through December 2010. We also compared the incidence of lung transplantation (LTX) due to Silicosis in Israel with that of the International Society for Heart and Lung Transplantation (ISHLT) registry. Results During the 14-year study period, 25 patients with Silicosis were referred for evaluation, including 10 patients who went on to undergo LTX. All patients were exposed by dry cutting a relatively new, artificial, decorative stone product with high crystalline silica content used primarily for kitchen countertops and bathroom fixtures. The patients had moderate-to-severe restrictive lung disease. Two patients developed progressive massive fibrosis; none manifested acute Silicosis (silicoproteinosis). Three patients died during follow-up, without LTX. Based on the ISHLT registry incidence, 0.68 Silicosis cases would have been expected instead of the 10 observed (incidence ratio, 14.6; 95% CI, 7.02-26.8). Conclusions This Silicosis outbreak is important because of the worldwide use of this and similar high-silica-content, artificial stone products. Further cases are likely to occur unless effective preventive measures are undertaken and existing safety practices are enforced.
Mordechai R. Kramer - One of the best experts on this subject based on the ideXlab platform.
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outbreak of autoimmune disease in Silicosis linked to artificial stone
Occupational Medicine, 2015Co-Authors: Osnat Shtraichman, Elizabeth Fireman, Paul D Blanc, J E Ollech, Ludmila Fridel, L Fuks, Mordechai R. KramerAbstract:Background There is a well-established association between inhalational exposure to silica and autoimmune disease. We recently observed an outbreak of silica-related autoimmune disease among synthetic stone construction workers with Silicosis referred for lung transplantation assessment. Aims To characterize the rheumatologic complications in Silicosis within these highly exposed, clinically well-characterized patients. Methods We systematically reviewed data from all cases of Silicosis due to synthetic stone dust referred to our pulmonary institute for lung transplant assessment, which represents the national centre for all such referrals. In addition to Silicosis-specific data, we extracted data relevant to the clinical and serological manifestations of autoimmune diseases present in these patients. Results Of 40 patients in our advanced Silicosis national data, we identified nine (23%) with findings consistent with various autoimmune diseases. Among these nine, three also had findings consistent with pulmonary alveolar proteinosis. Based on an expected autoimmune disease prevalence of 3% (based on the upper-end estimate for this group of diseases in European international data), the proportion of disease in our group represents a >7-fold excess (prevalence ratio 7.5; 99% confidence interval 2.6-16.7). Conclusions These cases underscore the strong link between Silicosis and multiple distinct syndromes of autoimmune diseases. Vigilance is warranted for the recognition of autoimmune complications in persons with known Silicosis; so too is consideration of the occupational exposure history in persons presenting with manifestations of autoimmune disease.
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Lung transplantation for Silicosis, report of 17 patients
European Respiratory Journal, 2014Co-Authors: Dror Rosengarten, Viktoria Rusanov, Oren Fruchter, Yael Raviv, Mordechai R. KramerAbstract:Silicosis is a progressive, fibrotic lung disease resulting from inhalation of respirable crystalline silica. Silicosis is one of the most important occupational lung diseases worldwide and is associated with a high morbidity and mortality. Unfortunately, there is no medical treatment available for end-stage Silicosis other than lung transplantation (LT). Nevertheless, Silicosis is a rare indication for LT which has been previously reported to result in poor outcome. Recently, a Silicosis outbreak reported in Israel, which has been attributed to exposure to artificial stone with high-silica-content. During the last 7 years, 60 patients with Silicosis were referred for evaluation, among them, 17 patients underwent LT in the Rabin medical center. All patients were male and average age was 50.3 years. Average FEV1 was 31.6% and average DLCO was 34.8%. Average lung allocation score was 45.9. Single lung transplantation was performed in 82% and 29% were done with extracorporeal membrane oxygenation support. One year survival was 87.5% and two years survival was 75%, which is similar to the outcome of other transplantations in our center. Mean follow-up was 21.6±18.3 months. Silicosis patients represent 5% of all patients transplanted in our center. This rate is extremely high comparing to the rate reported in the United Network of Organ Sharing which was only 0.43%. This tenfold increase in the rate of Silicosis patients transplanted in Israel represents the severity of the artificial stone Silicosis outbreak. Conclusion: Artificial stone Silicosis outbreak in Israel presents a challenge with increased rate of patients with severe Silicosis who required LT. LT offers an effective therapy for patients with end-stage Silicosis.
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artificial stone Silicosis disease resurgence among artificial stone workers
Chest, 2012Co-Authors: Mordechai R. Kramer, Elizabeth Fireman, Paul D Blanc, Anat Amital, Alexander Guber, Nader Abdul Rhahman, David ShitritAbstract:Background Silicosis is a progressive, fibrotic, occupational lung disease resulting from inhalation of respirable crystalline silica. This disease is preventable through appropriate workplace practices. We systematically assessed an outbreak of Silicosis among patients referred to our center for lung transplant. Methods This retrospective cohort analysis included all patients with a diagnosis of Silicosis who were referred for evaluation to the National Lung Transplantation Program in Israel from January 1997 through December 2010. We also compared the incidence of lung transplantation (LTX) due to Silicosis in Israel with that of the International Society for Heart and Lung Transplantation (ISHLT) registry. Results During the 14-year study period, 25 patients with Silicosis were referred for evaluation, including 10 patients who went on to undergo LTX. All patients were exposed by dry cutting a relatively new, artificial, decorative stone product with high crystalline silica content used primarily for kitchen countertops and bathroom fixtures. The patients had moderate-to-severe restrictive lung disease. Two patients developed progressive massive fibrosis; none manifested acute Silicosis (silicoproteinosis). Three patients died during follow-up, without LTX. Based on the ISHLT registry incidence, 0.68 Silicosis cases would have been expected instead of the 10 observed (incidence ratio, 14.6; 95% CI, 7.02-26.8). Conclusions This Silicosis outbreak is important because of the worldwide use of this and similar high-silica-content, artificial stone products. Further cases are likely to occur unless effective preventive measures are undertaken and existing safety practices are enforced.
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artificial stone Silicosis corrected disease resurgence among artificial stone workers
Chest, 2012Co-Authors: Mordechai R. Kramer, Elizabeth Fireman, Paul D Blanc, Anat Amital, Alexander Guber, Nader Abdul Rhahman, David ShitritAbstract:Background Silicosis is a progressive, fibrotic, occupational lung disease resulting from inhalation of respirable crystalline silica. This disease is preventable through appropriate workplace practices. We systematically assessed an outbreak of Silicosis among patients referred to our center for lung transplant. Methods This retrospective cohort analysis included all patients with a diagnosis of Silicosis who were referred for evaluation to the National Lung Transplantation Program in Israel from January 1997 through December 2010. We also compared the incidence of lung transplantation (LTX) due to Silicosis in Israel with that of the International Society for Heart and Lung Transplantation (ISHLT) registry. Results During the 14-year study period, 25 patients with Silicosis were referred for evaluation, including 10 patients who went on to undergo LTX. All patients were exposed by dry cutting a relatively new, artificial, decorative stone product with high crystalline silica content used primarily for kitchen countertops and bathroom fixtures. The patients had moderate-to-severe restrictive lung disease. Two patients developed progressive massive fibrosis; none manifested acute Silicosis (silicoproteinosis). Three patients died during follow-up, without LTX. Based on the ISHLT registry incidence, 0.68 Silicosis cases would have been expected instead of the 10 observed (incidence ratio, 14.6; 95% CI, 7.02-26.8). Conclusions This Silicosis outbreak is important because of the worldwide use of this and similar high-silica-content, artificial stone products. Further cases are likely to occur unless effective preventive measures are undertaken and existing safety practices are enforced.
Alison D Grant - One of the best experts on this subject based on the ideXlab platform.
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predictors of Silicosis and variation in prevalence across mines among employed gold miners in south africa
BMC Public Health, 2020Co-Authors: Dave Knight, Rodney Ehrlich, Annibale Cois, Katherine L Fielding, Alison D Grant, Gavin J ChurchyardAbstract:The stated intention to eliminate Silicosis from the South African goldmining industry as well as current programmes to find and compensate ex-miners with Silicosis require an understanding of variation in Silicosis prevalence across the industry. We aimed to identify the predictors of radiological Silicosis in a large sample of working miners across gold mines in South Africa. Routine surveillance chest radiographs were collected from 15 goldmine “clusters” in a baseline survey undertaken in preparation for a separate tuberculosis isoniazid prophylaxis trial. All images were read for Silicosis by a health professional experienced in using the International Labour Organisation (ILO) classification. Profusion thresholds of > 1/0 and > 1/1 were used. Demographic and occupational information was obtained by questionnaire. Predictors of Silicosis were examined in a multivariable logistic regression model, including age, gender, racial ascription, country of origin, years since starting mine employment, mine shaft, skill category, underground work status and tuberculosis. The crude Silicosis prevalence at ILO > 1/1 was 3.8% [95% confidence interval (CI) 3.5–4.1%]. The range across mine shafts was 0.8–6.9%. After adjustment for covariates, the interquartile range across shafts was reduced from 2.4 to 1.2%. Black miners [adjusted odds ratio (aOR) 2.8; 95% CI 1.1–7.2] and miners in full-time underground work (aOR 2.1; 95% CI 1.3–3.4) had substantially elevated odds of Silicosis, while workers from Mozambique had lower odds (aOR 0.54; 95% CI 0.38–0.77). Silicosis odds rose sharply with both age and years since starting in the industry (p for linear trend 15 years since first exposure and 2.2% < 10 years. In surveillance of Silicosis in working gold miners time since first exposure remains a powerful predictor. Age appears to be an independent predictor, while the detection of radiological Silicosis in short-service miners requires attention. Public risk reporting by mines should include factors bearing on Silicosis prevalence, specifically dust concentrations, with independent verification. Studies of Silicosis and tuberculosis in ex-miners are needed, supported by an accessible electronic database of the relevant medical and dust exposure records of all gold miners.
Alexander Guber - One of the best experts on this subject based on the ideXlab platform.
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ebus tbna is sufficient for successful diagnosis of Silicosis with mediastinal lymphadenopathy
Lung, 2018Co-Authors: Alexander Guber, David Shitrit, Yochai Adir, Avital Avriel, D A King, Gali Epstein Shochet, Sonia Schnaer, Michael KassirerAbstract:Background Silicosis is an occupational lung disease resulting from inhalation of respirable crystalline silica. Recently, an international Silicosis epidemic has been noted among artificial stone workers.
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artificial stone Silicosis disease resurgence among artificial stone workers
Chest, 2012Co-Authors: Mordechai R. Kramer, Elizabeth Fireman, Paul D Blanc, Anat Amital, Alexander Guber, Nader Abdul Rhahman, David ShitritAbstract:Background Silicosis is a progressive, fibrotic, occupational lung disease resulting from inhalation of respirable crystalline silica. This disease is preventable through appropriate workplace practices. We systematically assessed an outbreak of Silicosis among patients referred to our center for lung transplant. Methods This retrospective cohort analysis included all patients with a diagnosis of Silicosis who were referred for evaluation to the National Lung Transplantation Program in Israel from January 1997 through December 2010. We also compared the incidence of lung transplantation (LTX) due to Silicosis in Israel with that of the International Society for Heart and Lung Transplantation (ISHLT) registry. Results During the 14-year study period, 25 patients with Silicosis were referred for evaluation, including 10 patients who went on to undergo LTX. All patients were exposed by dry cutting a relatively new, artificial, decorative stone product with high crystalline silica content used primarily for kitchen countertops and bathroom fixtures. The patients had moderate-to-severe restrictive lung disease. Two patients developed progressive massive fibrosis; none manifested acute Silicosis (silicoproteinosis). Three patients died during follow-up, without LTX. Based on the ISHLT registry incidence, 0.68 Silicosis cases would have been expected instead of the 10 observed (incidence ratio, 14.6; 95% CI, 7.02-26.8). Conclusions This Silicosis outbreak is important because of the worldwide use of this and similar high-silica-content, artificial stone products. Further cases are likely to occur unless effective preventive measures are undertaken and existing safety practices are enforced.
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artificial stone Silicosis corrected disease resurgence among artificial stone workers
Chest, 2012Co-Authors: Mordechai R. Kramer, Elizabeth Fireman, Paul D Blanc, Anat Amital, Alexander Guber, Nader Abdul Rhahman, David ShitritAbstract:Background Silicosis is a progressive, fibrotic, occupational lung disease resulting from inhalation of respirable crystalline silica. This disease is preventable through appropriate workplace practices. We systematically assessed an outbreak of Silicosis among patients referred to our center for lung transplant. Methods This retrospective cohort analysis included all patients with a diagnosis of Silicosis who were referred for evaluation to the National Lung Transplantation Program in Israel from January 1997 through December 2010. We also compared the incidence of lung transplantation (LTX) due to Silicosis in Israel with that of the International Society for Heart and Lung Transplantation (ISHLT) registry. Results During the 14-year study period, 25 patients with Silicosis were referred for evaluation, including 10 patients who went on to undergo LTX. All patients were exposed by dry cutting a relatively new, artificial, decorative stone product with high crystalline silica content used primarily for kitchen countertops and bathroom fixtures. The patients had moderate-to-severe restrictive lung disease. Two patients developed progressive massive fibrosis; none manifested acute Silicosis (silicoproteinosis). Three patients died during follow-up, without LTX. Based on the ISHLT registry incidence, 0.68 Silicosis cases would have been expected instead of the 10 observed (incidence ratio, 14.6; 95% CI, 7.02-26.8). Conclusions This Silicosis outbreak is important because of the worldwide use of this and similar high-silica-content, artificial stone products. Further cases are likely to occur unless effective preventive measures are undertaken and existing safety practices are enforced.
