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*It is only for medical professionals to read and refer to cancer, silicosis, rheumatism, and what else you can't do! Silica (SiO2) is a major element of the earth's crust and is found in soil, sand and rocks, as well as concrete, ceramics, glass and other industrial materials.
In construction, metal industry, agriculture and other industries, these materials are often used in the production of new materials.
Since 1997, SiO2 has been listed as the first type of lung cancer carcinogen by the International Agency for Research on Cancer (IARC).
In addition to silicosis, this type of disease cannot be ignored! However, in addition to carcinogenesis, another disease that SiO2 attracts the most attention is silicosis.
Coal miners need to be exposed to coal dust for a long time at work, causing lung diseases.
Coal miners' pneumoconiosis is the general term for these lung diseases.
Silicosis is a kind of pneumoconiosis disease, and the occurrence of this disease is closely related to the inhalation of large amounts of SiO2 dust [1].
If coal workers' pneumoconiosis and silicosis workers do not deal with it in time, the workers’ condition will be further aggravated and the workers’ risk of complications, such as emphysema, tuberculosis, and chronic bronchitis, will not only affect the workers.
The quality of life is also likely to endanger the life safety of operators [2].
However, SiO2 dust can not only cause pneumoconiosis.
Studies have shown that exposure to SiO2 dust at work, especially in construction and industrial workplaces, may lead to the occurrence of autoimmune rheumatism even at low exposure levels.
The study [3] covered 1,541,505 men and 1,470,769 women in the Danish labor force from 1979 to 2015.
During the follow-up period, a total of 4,673 male workers suffered from autoimmune rheumatism: systemic sclerosis (n=252 cases), rheumatoid arthritis (n=3490 cases), systemic lupus erythematosus (n=255 cases) and small blood vessels Inflammation (n=749 cases).
12,268 cases of female workers suffer from autoimmune rheumatism: systemic sclerosis (n=746 cases), rheumatoid arthritis (n=9190 cases), systemic lupus erythematosus (n=1821) and small vasculitis ( n=869).
17% and 3% of males and females have been exposed to respirable SiO2 dust.
In addition, female exposure is lower than that of males, with an average cumulative exposure of 33 mg/m3/year compared to 60 mg/m3/year for men (see Figure 1).
Figure 1 Distribution of cumulative exposure levels (lg/m3-years) of 266,325 men and 42914 women exposed to respirable silica at the end of follow-up.
Men exposed to high levels of SiO2 dust compared with men who were not exposed to four diseases The incidence rate (IRR) increased by 1.
53 (95% CI 1.
39-1.
69), systemic sclerosis was 1.
62 (95% CI 1.
08-2.
44), and rheumatoid arthritis was 1.
57 (95% CI 1.
41-1.
75).
Female workers are less exposed to respirable SiO2 dust, but the overall risk increases as the cumulative exposure increases.
Table 1 IRR of systemic sclerosis, rheumatoid arthritis, systemic lupus erythematosus and small vasculitis after exposure to respirable SiO2 dust.
This study shows that the level of exposure to SiO2 dust at work is associated with autoimmune rheumatic diseases There is a clear connection, the most obvious being systemic sclerosis and rheumatoid arthritis.
The findings of this study are consistent with extensive evidence.
As far as we know, only a few studies have examined the relationship between autoimmune rheumatism and quantitative exposure to SiO2 dust levels.
Vihlborg[4] et al.
observed that in a group of male foundry workers, when the exposure level was higher than 50mg/m3, the risk of seropositive rheumatoid arthritis doubled, and the exposure-response relationship also increased.
Why does SiO2 dust cause autoimmune rheumatism? Some dust is composed of small particles.
When these small particles are inhaled, SiO2 particles are deposited in the alveoli. Animal models indicate that macrophages can swallow particles, activate the immune system by secreting cytokines, chemokines, and lysosomal enzymes, and activate antigen-presenting and antibody-producing cells.
The apoptosis of macrophages leads to the release of SiO2 particles and the new uptake of antigen presenting cells, which leads to chronic inflammation.
How to prevent the occurrence of silicosis and autoimmune diseases? There are many workers who have been exposed to various types of metals, coal powder, refractory materials, stone powder, cement, glass, ceramics, etc.
for a long time.
How can we better prevent the occurrence of silicosis and autoimmune diseases? 1.
To control or reduce disease, the key is to prevent dust.
Industrial and mining enterprises should focus on comprehensive dust prevention measures such as reforming production processes, wet operations, closed dust sources, ventilation and dust removal, and equipment maintenance and repair.
2.
Strengthen personal protection and comply with dust-proof operating procedures.
Regularly monitor the concentration of dust in the air in the production environment, and strengthen publicity and education.
Do a physical examination before employment, including chest X-rays.
3.
Patients with active internal and external tuberculosis and various respiratory diseases should not participate in silica dust work.
Strengthen the regular physical examinations of silica dust workers, including chest X-rays, and the interval between examinations is determined by the exposure to silica content and air dust concentration.
Reference materials: [1]Guo Wei, Wang Huijuan, Zhao Fengling, et al.
Study on the difference of serum tumor necrosis factor-α content between silicosis and coal worker's pneumoconiosis[J].
Chinese Journal of Health Laboratory Technology,2018,028(014):1665-1667 .
[2]Chen Xiubing,Guan Yuhong.
The epidemiological characteristics of newly reported occupational pneumoconiosis in Changsha from 2006 to 2017[J].
Occupation and Health,2018,34(23):3195-3197.
[3]Signe Hjuler Boudigaard,Vivi Schlunssen,Jesper Medom Vestergaard,etal.
Occupational exposure to respirable crystalline silica and risk ofautoimmune rheumatic diseases: a nationwide cohort study[J].
InternationalJournal of Epidemiology,2021,1-14.
[4]Vihlborg P,Bryngelsson IL, Andersson L, Graff P.
Risk of sar-coidosis and seropositive rheumatoid arthritis from occupational silica exposure in Swedish iron foundries: a retrospective cohort study.
BMJ Open 2017;7:e016839.
In construction, metal industry, agriculture and other industries, these materials are often used in the production of new materials.
Since 1997, SiO2 has been listed as the first type of lung cancer carcinogen by the International Agency for Research on Cancer (IARC).
In addition to silicosis, this type of disease cannot be ignored! However, in addition to carcinogenesis, another disease that SiO2 attracts the most attention is silicosis.
Coal miners need to be exposed to coal dust for a long time at work, causing lung diseases.
Coal miners' pneumoconiosis is the general term for these lung diseases.
Silicosis is a kind of pneumoconiosis disease, and the occurrence of this disease is closely related to the inhalation of large amounts of SiO2 dust [1].
If coal workers' pneumoconiosis and silicosis workers do not deal with it in time, the workers’ condition will be further aggravated and the workers’ risk of complications, such as emphysema, tuberculosis, and chronic bronchitis, will not only affect the workers.
The quality of life is also likely to endanger the life safety of operators [2].
However, SiO2 dust can not only cause pneumoconiosis.
Studies have shown that exposure to SiO2 dust at work, especially in construction and industrial workplaces, may lead to the occurrence of autoimmune rheumatism even at low exposure levels.
The study [3] covered 1,541,505 men and 1,470,769 women in the Danish labor force from 1979 to 2015.
During the follow-up period, a total of 4,673 male workers suffered from autoimmune rheumatism: systemic sclerosis (n=252 cases), rheumatoid arthritis (n=3490 cases), systemic lupus erythematosus (n=255 cases) and small blood vessels Inflammation (n=749 cases).
12,268 cases of female workers suffer from autoimmune rheumatism: systemic sclerosis (n=746 cases), rheumatoid arthritis (n=9190 cases), systemic lupus erythematosus (n=1821) and small vasculitis ( n=869).
17% and 3% of males and females have been exposed to respirable SiO2 dust.
In addition, female exposure is lower than that of males, with an average cumulative exposure of 33 mg/m3/year compared to 60 mg/m3/year for men (see Figure 1).
Figure 1 Distribution of cumulative exposure levels (lg/m3-years) of 266,325 men and 42914 women exposed to respirable silica at the end of follow-up.
Men exposed to high levels of SiO2 dust compared with men who were not exposed to four diseases The incidence rate (IRR) increased by 1.
53 (95% CI 1.
39-1.
69), systemic sclerosis was 1.
62 (95% CI 1.
08-2.
44), and rheumatoid arthritis was 1.
57 (95% CI 1.
41-1.
75).
Female workers are less exposed to respirable SiO2 dust, but the overall risk increases as the cumulative exposure increases.
Table 1 IRR of systemic sclerosis, rheumatoid arthritis, systemic lupus erythematosus and small vasculitis after exposure to respirable SiO2 dust.
This study shows that the level of exposure to SiO2 dust at work is associated with autoimmune rheumatic diseases There is a clear connection, the most obvious being systemic sclerosis and rheumatoid arthritis.
The findings of this study are consistent with extensive evidence.
As far as we know, only a few studies have examined the relationship between autoimmune rheumatism and quantitative exposure to SiO2 dust levels.
Vihlborg[4] et al.
observed that in a group of male foundry workers, when the exposure level was higher than 50mg/m3, the risk of seropositive rheumatoid arthritis doubled, and the exposure-response relationship also increased.
Why does SiO2 dust cause autoimmune rheumatism? Some dust is composed of small particles.
When these small particles are inhaled, SiO2 particles are deposited in the alveoli. Animal models indicate that macrophages can swallow particles, activate the immune system by secreting cytokines, chemokines, and lysosomal enzymes, and activate antigen-presenting and antibody-producing cells.
The apoptosis of macrophages leads to the release of SiO2 particles and the new uptake of antigen presenting cells, which leads to chronic inflammation.
How to prevent the occurrence of silicosis and autoimmune diseases? There are many workers who have been exposed to various types of metals, coal powder, refractory materials, stone powder, cement, glass, ceramics, etc.
for a long time.
How can we better prevent the occurrence of silicosis and autoimmune diseases? 1.
To control or reduce disease, the key is to prevent dust.
Industrial and mining enterprises should focus on comprehensive dust prevention measures such as reforming production processes, wet operations, closed dust sources, ventilation and dust removal, and equipment maintenance and repair.
2.
Strengthen personal protection and comply with dust-proof operating procedures.
Regularly monitor the concentration of dust in the air in the production environment, and strengthen publicity and education.
Do a physical examination before employment, including chest X-rays.
3.
Patients with active internal and external tuberculosis and various respiratory diseases should not participate in silica dust work.
Strengthen the regular physical examinations of silica dust workers, including chest X-rays, and the interval between examinations is determined by the exposure to silica content and air dust concentration.
Reference materials: [1]Guo Wei, Wang Huijuan, Zhao Fengling, et al.
Study on the difference of serum tumor necrosis factor-α content between silicosis and coal worker's pneumoconiosis[J].
Chinese Journal of Health Laboratory Technology,2018,028(014):1665-1667 .
[2]Chen Xiubing,Guan Yuhong.
The epidemiological characteristics of newly reported occupational pneumoconiosis in Changsha from 2006 to 2017[J].
Occupation and Health,2018,34(23):3195-3197.
[3]Signe Hjuler Boudigaard,Vivi Schlunssen,Jesper Medom Vestergaard,etal.
Occupational exposure to respirable crystalline silica and risk ofautoimmune rheumatic diseases: a nationwide cohort study[J].
InternationalJournal of Epidemiology,2021,1-14.
[4]Vihlborg P,Bryngelsson IL, Andersson L, Graff P.
Risk of sar-coidosis and seropositive rheumatoid arthritis from occupational silica exposure in Swedish iron foundries: a retrospective cohort study.
BMJ Open 2017;7:e016839.
