Guo Z Y, Wu N, Wang J W, Ma R M, Ye Q
Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2023 Jul 20;41(7):509-517. doi: 10.3760/cma.j.cn121094-20220408-00185.
To investigate the epidemiology, clinical characteristics, on-site dust monitoring and individual protection of the patients with artificial stone-related silicosis. In March 2022, the literature on artificial stone-related silicosis published from January 1965 to February 2022 was searched in China Journal Full-text Database, Wanfang Database, VIP Database, EMbase and PubMed. Chinese and English search terms include "silica dust""silica dust""silicosis""artificial stone""pneumoconiosis", etc. References were included according to inclusion and exclusion criteria, and data were extracted. The epidemiological characteristics, natural course of disease, workplace dust concentration and individual protection level of patients with artificial stone-related silicosis were analyzed by systematic review. A total of 30 literatures were included, including 7 cohort studies, 14 cross-sectional studies, 3 case-control studies and 6 case reports. A total of 1358 patients with artificial stone-related silicosis were diagnosed from 1997 to 2020, with an average age of 41.5 years old and an average dust exposure time of 11.3 years. Among them, 36.2% (282/778) had progressive mass fibrosis or accelerated progressive silicosis at first diagnosis. Chest imaging showed diffuse small nodule shadow, pulmonary fibrosis, and silico-alveolar proteinosis. Pulmonary function showed restricted or mixed ventilation disorder with or without decreased diffusion volume. The disease progressed rapidly, with progressive mass fibrosis, respiratory failure, and even death. Patients engaged in artificial quartz stone processing, with high concentration of silica including ultra-fine particles, most of which were dry operation, lack of on-site ventilation measures and no effective personal protection. The artificial stone processing workers suffer from artificial stone-related silicosis due to dry cutting, lack of on-site dust removal facilities and personal protective measures, and the disease progresses rapidly, leading to poor prognosis.
探讨人造石相关矽肺患者的流行病学特征、临床特点、作业场所粉尘监测及个体防护情况。2022年3月,在中国知网、万方数据库、维普数据库、EMbase及PubMed中检索1965年1月至2022年2月发表的关于人造石相关矽肺的文献。中英文检索词包括“二氧化硅粉尘”“矽尘”“矽肺”“人造石”“尘肺病”等。按照纳入与排除标准纳入文献并提取数据。采用系统评价方法分析人造石相关矽肺患者的流行病学特征、疾病自然进程、作业场所粉尘浓度及个体防护水平。共纳入30篇文献,其中队列研究7篇、横断面研究14篇、病例对照研究3篇、病例报告6篇。1997年至2020年共诊断出1358例人造石相关矽肺患者,平均年龄41.5岁,平均接尘时间11.3年。其中,36.2%(282/778)初诊时即有进行性块状纤维化或加速性矽肺。胸部影像学表现为弥漫性小结节影、肺纤维化及矽肺合并肺泡蛋白沉积症。肺功能表现为限制性或混合性通气障碍,伴或不伴有弥散量降低。疾病进展迅速,出现进行性块状纤维化、呼吸衰竭,甚至死亡。从事人造石英石加工的患者,二氧化硅浓度高,包括超细颗粒,多为干法作业,作业场所缺乏通风措施,且无有效的个人防护。人造石加工工人因干法切割、缺乏现场除尘设施及个人防护措施而患人造石相关矽肺,且疾病进展迅速,预后较差。