Department of Environmental and Occupational Medicine, College of Medicine and NTU Hospital, National Taiwan University (NTU), No. 7, Zhongshan S. Rd., Zhongzheng Dist, Taipei City, Taiwan.
Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Rd., North District, Tainan, 70403, Taiwan.
Environ Health. 2024 Mar 2;23(1):25. doi: 10.1186/s12940-024-01067-1.
Occupational exposure to artificial stone, a popular material used for countertops, can cause accelerated silicosis, but the precise relationship between silica dose and disease development is unclear.
This study evaluated the impact of silica exposure on lung function and chest imaging in artificial stone manufacturing workers.
Questionnaire and spirometry assessments were administered to workers in two plants. A high-exposure subset underwent further evaluation, including chest CT and DLco. Weighting factors, assigned as proxies for silica exposure, were based on work tasks. Individual cumulative exposures were estimated using area concentration measurements and time spent in specific areas. Exposure-response associations were analyzed using linear and logistic regression models.
Among 65 participants, the mean cumulative silica exposure was 3.61 mg/m-year (range 0.0001 to 44.4). Each 1 mg/m-year increase was associated with a 0.46% reduction in FVC, a 0.45% reduction in FEV1, and increased lung function abnormality risk (aOR = 1.27, 95% CI = 1.03-1.56). Weighting factors correlated with cumulative exposures (Spearman correlation = 0.59, p < 0.0001), and weighted tenure was associated with lung function abnormalities (aOR = 1.04, 95% CI = 1.01-1.09). Of 37 high-exposure workers, 19 underwent chest CT, with 12 (63%) showing abnormal opacities. Combining respiratory symptoms, lung function, and chest X-ray achieved 91.7% sensitivity and 75% specificity for predicting chest CT abnormalities.
Lung function and chest CT abnormalities occur commonly in artificial stone workers. For high-exposure individuals, abnormalities on health screening could prompt further chest CT examination to facilitate early silicosis detection.
人造石是一种常用于台面的流行材料，职业性接触人造石可导致矽肺加速进展，但矽尘剂量与疾病发展之间的确切关系尚不清楚。
本研究评估了人造石制造工人的矽尘暴露对肺功能和胸部影像学的影响。
对两家工厂的工人进行问卷调查和肺量计评估。高暴露亚组进一步接受了评估，包括胸部 CT 和 DLco。权重因素被用作矽尘暴露的替代指标，基于工作任务分配。使用面积浓度测量和特定区域的暴露时间估计个体累积暴露量。使用线性和逻辑回归模型分析暴露-反应关系。
在 65 名参与者中，平均累积矽尘暴露量为 3.61mg/m-年（范围 0.0001 至 44.4）。每增加 1mg/m-年，FVC 降低 0.46%，FEV1 降低 0.45%，且肺功能异常风险增加（比值比[aOR] = 1.27，95%置信区间[CI] = 1.03-1.56）。权重因素与累积暴露量相关（Spearman 相关系数 = 0.59，p<0.0001），加权工龄与肺功能异常相关（aOR = 1.04，95%CI = 1.01-1.09）。在 37 名高暴露工人中，19 人进行了胸部 CT 检查，其中 12 人（63%）存在异常不透明。结合呼吸症状、肺功能和胸部 X 线检查，对胸部 CT 异常的预测敏感性为 91.7%，特异性为 75%。
人造石工人中常出现肺功能和胸部 CT 异常。对于高暴露个体，健康筛查中的异常可能提示进一步进行胸部 CT 检查，以促进矽肺的早期发现。
