Role of infective, immunological, and chronic irritative factors in the development of silicosis.

The effect of infective, immunological, and irritative factors on the onset and development of silicosis after intratracheal inoculation with 50 mg of tridymite was investigated on 220 specific pathogen free (SPF) female Sprague-Dawley rats. Even after 12 months the rats, always kept in SPF conditions after intratracheal injection of the dust, showed mainly granulomas with little tendency to confluence or to fibrohyalinosis. Chronic infective stimulation was obtained by keeping groups of SPF animals injected with tridymite for three, six, or 12 months in a conventional animal house, where they were exposed to the endemic bacterial flora. In these animal silicosis developed much more rapidly and produced much more severe confluent lesions than in rats always kept in SPF conditions. Horseradish peroxidase and ferritin given by intratracheal injection and by inhalation were histochemically shown mainly in the dust granulomas but did not accelerate the development of silicosis. Exposure to ozone increased the prevalence of lung infections and thus enhanced the silicosis in conventionally kept animals, without modifying the evolution of silicosis in SPF animals. These experiments showed that the presence of bacterial flora, and particularly bronchopulmonary infections, accelerated the development of silicosis and led to the suggestion that individuals subject to frequent bronchopulmonary infections are unfit for occupations necessitating exposure to silica dust.