Silicosis following employment in the manufacture of silica flour and industrial sand.

We describe silicosis in a patient with chronic obstructive pulmonary disease who worked as a maintenance mechanic for less than 5 years in a plant in South Carolina that manufactures silica flour and industrial sand. An open lung biopsy showed an early stage of silicosis manifested by perivascular and peribronchial collections of macrophages as well as early granuloma formation. An antinuclear antibody profile compatible with Sjogren's syndrome or systemic lupus erythematosus occurred with no symptoms of either disease. Excessive occupational exposure levels of respirable free silica were documented.