Demographic, exposure and clinical characteristics in a multinational registry of engineered stone workers with silicosis

ObjectivesTo investigate differences in workplace exposure, demographic and clinical findings in engineered stone (ES) workers from a multinational consortium using the Engineered Stone Silicosis Investigators (ESSI) Global Silicosis Registry.MethodsWith ethics board approval in Israel, Spain, Austr...

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Published in:	Occupational and environmental medicine (London, England) Vol. 79; no. 9; pp. 586 - 593
Main Authors:	Hua, Jeremy Tang, Zell-Baran, Lauren, Go, Leonard H T, Kramer, Mordechai R, Van Bree, Johanna B, Chambers, Daniel, Deller, David, Newbigin, Katrina, Matula, Michael, Fireman, Elizabeth, Dahbash, Mor, Martinez-Gonzalez, Cristina, León-Jimenez, Antonio, Sack, Coralynn, Ferrer, Jaume, Villar, Ana, Almberg, Kirsten S, Cohen, Robert A, Rose, Cecile S
Format:	Journal Article
Language:	English
Published:	England BMJ Publishing Group Ltd 01.09.2022 BMJ Publishing Group LTD BMJ Publishing Group
Series:	Original research
Subjects:	Artificial stone Autoimmunity Calcification Comorbidity Composite materials Cross-Sectional Studies Demographics Demography Dust Epidemiology Exposure Fabrication Fibrosis Glass & glassware industry Health surveillance Hospitals Infections Kidney diseases Lung cancer Lung transplants Manufacturing Masonry Occupational exposure Occupational Health Physicians Pneumoconiosis Pulmonary functions Respiratory function Respiratory Function Tests Silica Silicon dioxide Silicosis Smoking Spirometry Surveillance Tuberculosis Variance analysis Workplace Younger workers Queensland Australia United States > US Colorado Israel Australia Tel Aviv Israel Spain Dust Respiratory Function Tests Cross-Sectional Studies Occupational Health Silicosis
ISSN:	1351-0711, 1470-7926, 1470-7926
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Abstract	ObjectivesTo investigate differences in workplace exposure, demographic and clinical findings in engineered stone (ES) workers from a multinational consortium using the Engineered Stone Silicosis Investigators (ESSI) Global Silicosis Registry.MethodsWith ethics board approval in Israel, Spain, Australia and the USA, ES workers ages 18+ with a physician diagnosis of work-related silicosis were enrolled. Demographic, occupational, radiologic, pulmonary function and silica-related comorbidity data were compared cross-sectionally among countries using analysis of variance, Fisher’s exact tests and logistic regression.ResultsAmong 169 ES workers with silicosis, most were men, with mean age 51.7 (±11.4) years. Mean work tenure in stone fabrication or masonry was 19.9 (±9.8) years. Different methods of case ascertainment explained some inter-country differences, for example, workers in Queensland, Australia with a state-based surveillance program were likely to be identified earlier and with shorter work tenure. Overall, 32.5% of workers had progressive massive fibrosis, the most severe form of dust-related pneumoconiosis, of whom 18.5% reported ≤10 years of work tenure. Lung function impairment including restriction, reduced diffusion capacity and hypoxaemia was common, as was autoimmunity.ConclusionsFindings from a multinational registry represent a unique effort to compare demographic, exposure and clinical information from ES workers with silicosis, and suggest a substantial emerging population of workers worldwide with severe and irreversible silica-associated diseases. This younger worker population is at high risk for disease progression, multiple comorbidities and severe disability. The ESSI registry provides an ongoing framework for investigating epidemiological trends and developing prospective studies for prevention and treatment of these workers.
AbstractList	To investigate differences in workplace exposure, demographic and clinical findings in engineered stone (ES) workers from a multinational consortium using the Engineered Stone Silicosis Investigators (ESSI) Global Silicosis Registry. With ethics board approval in Israel, Spain, Australia and the USA, ES workers ages 18+ with a physician diagnosis of work-related silicosis were enrolled. Demographic, occupational, radiologic, pulmonary function and silica-related comorbidity data were compared cross-sectionally among countries using analysis of variance, Fisher's exact tests and logistic regression. Among 169 ES workers with silicosis, most were men, with mean age 51.7 (±11.4) years. Mean work tenure in stone fabrication or masonry was 19.9 (±9.8) years. Different methods of case ascertainment explained some inter-country differences, for example, workers in Queensland, Australia with a state-based surveillance program were likely to be identified earlier and with shorter work tenure. Overall, 32.5% of workers had progressive massive fibrosis, the most severe form of dust-related pneumoconiosis, of whom 18.5% reported ≤10 years of work tenure. Lung function impairment including restriction, reduced diffusion capacity and hypoxaemia was common, as was autoimmunity. Findings from a multinational registry represent a unique effort to compare demographic, exposure and clinical information from ES workers with silicosis, and suggest a substantial emerging population of workers worldwide with severe and irreversible silica-associated diseases. This younger worker population is at high risk for disease progression, multiple comorbidities and severe disability. The ESSI registry provides an ongoing framework for investigating epidemiological trends and developing prospective studies for prevention and treatment of these workers. ObjectivesTo investigate differences in workplace exposure, demographic and clinical findings in engineered stone (ES) workers from a multinational consortium using the Engineered Stone Silicosis Investigators (ESSI) Global Silicosis Registry.MethodsWith ethics board approval in Israel, Spain, Australia and the USA, ES workers ages 18+ with a physician diagnosis of work-related silicosis were enrolled. Demographic, occupational, radiologic, pulmonary function and silica-related comorbidity data were compared cross-sectionally among countries using analysis of variance, Fisher’s exact tests and logistic regression.ResultsAmong 169 ES workers with silicosis, most were men, with mean age 51.7 (±11.4) years. Mean work tenure in stone fabrication or masonry was 19.9 (±9.8) years. Different methods of case ascertainment explained some inter-country differences, for example, workers in Queensland, Australia with a state-based surveillance program were likely to be identified earlier and with shorter work tenure. Overall, 32.5% of workers had progressive massive fibrosis, the most severe form of dust-related pneumoconiosis, of whom 18.5% reported ≤10 years of work tenure. Lung function impairment including restriction, reduced diffusion capacity and hypoxaemia was common, as was autoimmunity.ConclusionsFindings from a multinational registry represent a unique effort to compare demographic, exposure and clinical information from ES workers with silicosis, and suggest a substantial emerging population of workers worldwide with severe and irreversible silica-associated diseases. This younger worker population is at high risk for disease progression, multiple comorbidities and severe disability. The ESSI registry provides an ongoing framework for investigating epidemiological trends and developing prospective studies for prevention and treatment of these workers. To investigate differences in workplace exposure, demographic and clinical findings in engineered stone (ES) workers from a multinational consortium using the Engineered Stone Silicosis Investigators (ESSI) Global Silicosis Registry.OBJECTIVESTo investigate differences in workplace exposure, demographic and clinical findings in engineered stone (ES) workers from a multinational consortium using the Engineered Stone Silicosis Investigators (ESSI) Global Silicosis Registry.With ethics board approval in Israel, Spain, Australia and the USA, ES workers ages 18+ with a physician diagnosis of work-related silicosis were enrolled. Demographic, occupational, radiologic, pulmonary function and silica-related comorbidity data were compared cross-sectionally among countries using analysis of variance, Fisher's exact tests and logistic regression.METHODSWith ethics board approval in Israel, Spain, Australia and the USA, ES workers ages 18+ with a physician diagnosis of work-related silicosis were enrolled. Demographic, occupational, radiologic, pulmonary function and silica-related comorbidity data were compared cross-sectionally among countries using analysis of variance, Fisher's exact tests and logistic regression.Among 169 ES workers with silicosis, most were men, with mean age 51.7 (±11.4) years. Mean work tenure in stone fabrication or masonry was 19.9 (±9.8) years. Different methods of case ascertainment explained some inter-country differences, for example, workers in Queensland, Australia with a state-based surveillance program were likely to be identified earlier and with shorter work tenure. Overall, 32.5% of workers had progressive massive fibrosis, the most severe form of dust-related pneumoconiosis, of whom 18.5% reported ≤10 years of work tenure. Lung function impairment including restriction, reduced diffusion capacity and hypoxaemia was common, as was autoimmunity.RESULTSAmong 169 ES workers with silicosis, most were men, with mean age 51.7 (±11.4) years. Mean work tenure in stone fabrication or masonry was 19.9 (±9.8) years. Different methods of case ascertainment explained some inter-country differences, for example, workers in Queensland, Australia with a state-based surveillance program were likely to be identified earlier and with shorter work tenure. Overall, 32.5% of workers had progressive massive fibrosis, the most severe form of dust-related pneumoconiosis, of whom 18.5% reported ≤10 years of work tenure. Lung function impairment including restriction, reduced diffusion capacity and hypoxaemia was common, as was autoimmunity.Findings from a multinational registry represent a unique effort to compare demographic, exposure and clinical information from ES workers with silicosis, and suggest a substantial emerging population of workers worldwide with severe and irreversible silica-associated diseases. This younger worker population is at high risk for disease progression, multiple comorbidities and severe disability. The ESSI registry provides an ongoing framework for investigating epidemiological trends and developing prospective studies for prevention and treatment of these workers.CONCLUSIONSFindings from a multinational registry represent a unique effort to compare demographic, exposure and clinical information from ES workers with silicosis, and suggest a substantial emerging population of workers worldwide with severe and irreversible silica-associated diseases. This younger worker population is at high risk for disease progression, multiple comorbidities and severe disability. The ESSI registry provides an ongoing framework for investigating epidemiological trends and developing prospective studies for prevention and treatment of these workers.
Author	Martinez-Gonzalez, Cristina Zell-Baran, Lauren Hua, Jeremy Tang Fireman, Elizabeth Chambers, Daniel Deller, David Matula, Michael Rose, Cecile S Sack, Coralynn Villar, Ana Newbigin, Katrina Dahbash, Mor León-Jimenez, Antonio Cohen, Robert A Van Bree, Johanna B Almberg, Kirsten S Kramer, Mordechai R Go, Leonard H T Ferrer, Jaume
AuthorAffiliation	1 Division of Environmental and Occupational Health Sciences , National Jewish Health , Denver , Colorado , USA 11 Pulmonology, Allergy and Thoracic Surgery Department , Puerta del Mar University Hospital , Cádiz , Spain 13 Pulmonology , Hospital Vall d'Hebron , Barcelona , Spain 8 School of Allied Health Sciences , Griffith University , Gold Coast , Queensland , Australia 9 Occupational Environmental Department , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel 7 Department of Radiology , Wesley Hospital , Brisbane , Queensland , Australia 15 School of Public Health, Division of Environmental and Occupational Health Sciences , University of Illinois , Chicago , Illinois , USA 14 Respiratory Medicine Department , Hospital Vall d'Hebron , Barcelona , Spain 6 Gold Coast Respiratory and Sleep Clinic , Pindara Private Hospital , Gold Coast , Queensland , Australia 12 Departments of Medicine & Environmental and Occupational Health Sciences , University of Washington , Seattle , Washington , USA 4
AuthorAffiliation_xml	– name: 14 Respiratory Medicine Department , Hospital Vall d'Hebron , Barcelona , Spain – name: 3 School of Public Health , University of Illinois , Chicago , Illinois , USA – name: 6 Gold Coast Respiratory and Sleep Clinic , Pindara Private Hospital , Gold Coast , Queensland , Australia – name: 9 Occupational Environmental Department , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel – name: 7 Department of Radiology , Wesley Hospital , Brisbane , Queensland , Australia – name: 11 Pulmonology, Allergy and Thoracic Surgery Department , Puerta del Mar University Hospital , Cádiz , Spain – name: 8 School of Allied Health Sciences , Griffith University , Gold Coast , Queensland , Australia – name: 10 Pneumology Service , Central University Hospital , Oviedo , Spain – name: 1 Division of Environmental and Occupational Health Sciences , National Jewish Health , Denver , Colorado , USA – name: 13 Pulmonology , Hospital Vall d'Hebron , Barcelona , Spain – name: 5 School of Clinical Medicine , The University of Queensland , Brisbane , Queensland , Australia – name: 2 Division of Pulmonary Sciences and Critical Care Medicine , University of Colorado - Anschutz Medical Campus , Aurora , Colorado , USA – name: 4 Pulmonary Institute , Rabin Medical Center , Petah Tikva , Israel – name: 15 School of Public Health, Division of Environmental and Occupational Health Sciences , University of Illinois , Chicago , Illinois , USA – name: 12 Departments of Medicine & Environmental and Occupational Health Sciences , University of Washington , Seattle , Washington , USA – name: 16 Environmental and Occupational Health Sciences , University of Illinois , Chicago , Illinois , USA
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Keywords	Dust Respiratory Function Tests Cross-Sectional Studies Occupational Health Silicosis
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PublicationYear	2022
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Occup Environ Med. 2022 Dec;79(12):849-850
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Snippet	ObjectivesTo investigate differences in workplace exposure, demographic and clinical findings in engineered stone (ES) workers from a multinational consortium... To investigate differences in workplace exposure, demographic and clinical findings in engineered stone (ES) workers from a multinational consortium using the...
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SubjectTerms	Artificial stone Autoimmunity Calcification Comorbidity Composite materials Cross-Sectional Studies Demographics Demography Dust Epidemiology Exposure Fabrication Fibrosis Glass & glassware industry Health surveillance Hospitals Infections Kidney diseases Lung cancer Lung transplants Manufacturing Masonry Occupational exposure Occupational Health Physicians Pneumoconiosis Pulmonary functions Respiratory function Respiratory Function Tests Silica Silicon dioxide Silicosis Smoking Spirometry Surveillance Tuberculosis Variance analysis Workplace Younger workers
Title	Demographic, exposure and clinical characteristics in a multinational registry of engineered stone workers with silicosis
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