Pulmonology, Allergy and Thoracic Surgery Department, Puerta del Mar University Hospital, Cádiz, Spain.
Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain.
Part Fibre Toxicol. 2021 Nov 22;18(1):41. doi: 10.1186/s12989-021-00434-x.
Engineered stone silicosis is an emerging disease in many countries worldwide produced by the inhalation of respirable dust of engineered stone. This silicosis has a high incidence among young workers, with a short latency period and greater aggressiveness than silicosis caused by natural materials. Although the silica content is very high and this is the key factor, it has been postulated that other constituents in engineered stones can influence the aggressiveness of the disease. Different samples of engineered stone countertops (fabricated by workers during the years prior to their diagnoses), as well as seven lung samples from exposed patients, were analyzed by multiple techniques.
The different countertops were composed of SiO in percentages between 87.9 and 99.6%, with variable relationships of quartz and cristobalite depending on the sample. The most abundant metals were Al, Na, Fe, Ca and Ti. The most frequent volatile organic compounds were styrene, toluene and m-xylene, and among the polycyclic aromatic hydrocarbons, phenanthrene and naphthalene were detected in all samples. Patients were all males, between 26 and 46 years-old (average age: 36) at the moment of the diagnosis. They were exposed to the engineered stone an average time of 14 years. At diagnosis, only one patient had progressive massive fibrosis. After a follow-up period of 8 ± 3 years, four patients presented progressive massive fibrosis. Samples obtained from lung biopsies most frequently showed well or ill-defined nodules, composed of histiocytic cells and fibroblasts without central hyalinization. All tissue samples showed high proportion of Si and Al at the center of the nodules, becoming sparser at the periphery. Al to Si content ratios turned out to be higher than 1 in two of the studied cases. Correlation between Si and Al was very high (r = 0.93).
Some of the volatile organic compounds, polycyclic aromatic hydrocarbons and metals detected in the studied countertop samples have been described as causative of lung inflammation and respiratory disease. Among inorganic constituents, aluminum has been a relevant component within the silicotic nodule, reaching atomic concentrations even higher than silicon in some cases. Such concentrations, both for silicon and aluminum showed a decreasing tendency from the center of the nodule towards its frontier.
工程石矽肺是一种在世界许多国家新兴的疾病，是由可吸入的工程石粉尘引起的。这种矽肺在年轻工人中发病率较高，潜伏期短，比由天然材料引起的矽肺更具侵袭性。尽管二氧化硅含量很高，这是关键因素，但有人假设工程石中的其他成分也会影响疾病的侵袭性。对不同的工程石台面样本（由工人在诊断前几年制作）以及 7 例暴露患者的肺样本进行了多种技术分析。
不同的台面由 87.9%至 99.6%的 SiO 组成，根据样本的不同，石英和方英石的关系也不同。最丰富的金属是 Al、Na、Fe、Ca 和 Ti。最常见的挥发性有机化合物是苯乙烯、甲苯和间二甲苯，在所有样本中都检测到多环芳烃中的菲和萘。患者均为男性，诊断时年龄在 26 至 46 岁之间（平均年龄：36 岁）。他们平均接触工程石 14 年。在诊断时，只有 1 名患者患有进行性大块纤维化。在 8 ± 3 年的随访期后，4 名患者出现进行性大块纤维化。从肺活检中获得的样本最常显示界限清楚或不清楚的结节，由组织细胞和成纤维细胞组成，无中央玻璃样变。所有组织样本在结节中心都显示出高比例的 Si 和 Al，在边缘逐渐减少。在所研究的病例中，有 2 例的 Al 与 Si 含量比高于 1。Si 与 Al 之间的相关性非常高（r=0.93）。
在所研究的台面样本中检测到的一些挥发性有机化合物、多环芳烃和金属已被描述为引起肺部炎症和呼吸道疾病的原因。在无机成分中，铝是矽结节中的一个重要成分，在某些情况下，其原子浓度甚至高于硅。在从结节中心到边界的方向上，硅和铝的浓度都呈现出逐渐降低的趋势。
