Silicosis and Granite

Pub Med search 2 July 2011 Silicosis AND granite
J Occup Environ Hyg. 2011 Feb;8(2):71-9.
Silica exposure assessment in a mortality study of Vermont granite workers.

Verma DK, Vacek PM, des Tombe K, Finkelstein M, Branch B, Gibbs GW, Graham WG.
Source
Program in Occupational Health and Environmental Medicine, McMaster University, Hamilton, Ontario, Canada.
Abstract
A study of past silica and respirable dust exposures in the Vermont granite industry was conducted to develop a job exposure matrix (JEM) that used 5204 industrial hygiene measurements made from 1924-2004. The construction of the JEM involved data entry from several original sources into an Excel database that was reviewed later to ensure accuracy. Exposure measurements by job or location were grouped in two broad categories of quarry or shed and then into 22 job classes. Missing exposure data by time period were computed, taking into account improvements in dust control and periods of significant reduction in dustiness. Percent free silica (-quartz) in respirable dust was estimated to be 11.0% based on previous published studies in Vermont and on data in the current database. About 60% of all measurement data (primarily from years prior to 1972) were obtained using the impinger and expressed in millions of particles per cubic foot (mppcf), which were converted to equivalent respirable free silica concentrations using the conversion of 10 mppcf = 0.1 mg/m(3) of respirable silica. For impinger data, respirable dust was calculated by multiplying respirable silica by a factor of 9.091 to reflect that the respirable silica was 11.0% respirable dust. This JEM has been used in a recent epidemiologic study to assess mortality in Vermont granite workers and to examine the relationships among mortality from silicosis, lung cancer, and other nonmalignant respiratory diseases.
PMID: 21229455 [PubMed - indexed for MEDLINE]
Related citations
Publication Types, MeSH Terms, Substances

Publication Types Research Support, Non-U.S. Gov't MeSH Terms Air Pollutants, Occupational/analysis* Dust/analysis* Extraction and Processing Industry/statistics & numerical data* Humans Job Description Occupational Diseases/epidemiology* Occupational Exposure/analysis* Occupational Exposure/statistics & numerical data Silicon Dioxide/analysis* Vermont/epidemiology Substances Air Pollutants, Occupational Dust granite Silicon Dioxide
2. Occup Environ Med. 2011 May;68(5):312-8. Epub 2010 Sep 19.
Mortality in Vermont granite workers and its association with silica exposure.
Vacek PM, Verma DK, Graham WG, Callas PW, Gibbs GW.
Source
Department of Medical Biostatistics, University of Vermont, Burlington, Vermont 05405, USA. Pamela.Vacek@uvm.edu
Abstract
OBJECTIVES: To assess mortality in Vermont granite workers and examine relationships between silica exposure and mortality from lung cancer, kidney cancer, non-malignant kidney disease, silicosis and other non-malignant respiratory disease. Methods Workers employed between 1947 and 1998 were identified. Exposures were estimated using a job-exposure matrix. Mortality was assessed through 2004 and standardised mortality ratios (SMRs) were computed. Associations between mortality and exposure to silica were assessed by nested case-control analyses using conditional logistic regression. Results 7052 workers had sufficient data for statistical analysis. SMRs were significantly elevated for lung cancer (SMR 1.37, 95% CI 1.23 to 1.52), silicosis (SMR 59.13, 95% CI 44.55 to 76.97), tuberculosis (SMR 21.74, 95% CI 18.37 to 25.56) and other non-malignant respiratory disease (SMR 1.74, 95% CI 1.50 to 2.02) but not for kidney cancer or non-malignant kidney disease. In nested case-control analyses, significant associations with cumulative exposure to respirable free silica were observed for silicosis (OR 1.13, 95% CI 1.05 to 1.21 for each 1 mg/m(3)-year increase in cumulative exposure) and other non-malignant respiratory disease (OR 1.10, 95% CI 1.03 to 1.16) but not for lung cancer (OR 0.99, 95% CI 0.94 to 1.03), kidney cancer (OR 0.96, 95% CI 0.84 to 1.09) or non-malignant kidney disease (OR 0.95, 95% CI 0.84 to 1.08). Conclusions Exposure to crystalline silica in Vermont granite workers was associated with increased mortality from silicosis and other nonmalignant respiratory disease, but there was no evidence that increased lung cancer mortality in the cohort was due to exposure. Mortality from malignant and non-malignant kidney disease was not significantly increased or associated with exposure.
PMID: 20855299 [PubMed - in process] PMCID: PMC3088478 Free PMC Article Related citations
Publication Types
Publication Types
Research Support, Non-U.S. Gov't
J Occup Environ Med. 2008 Jul;50(7):827-33.
High prevalence and advanced silicosis in active granite workers: a dose-response analysis including FEV1.
Rego G, Pichel A, Quero A, Dubois A, Martnez C, Isidro I, Gil M, Cuervo V, Gonzlez A.
Source
National Institute of Silicosis, Oviedo, Spain. Gumersino.rego@sespa.princast.es
Abstract
OBJECTIVE:
To evaluate silica exposure and respiratory disease in granite workers.
METHODS:
A cross-sectional study of 440 active granite workers.
RESULTS:
Seventy-seven (17.5%) have silicosis, complicated in 15 of them; 18 have an obstructive ventilatory defect and 73 had exceeded 3.5 mg/m-year of cumulative silica exposure. Percent predicted FEV1 have a significant negative relation with mg/m(3)-year (P < 0.001) with a trend toward dose-response excluding silicotics and controlling for tobacco. The odds ratio (95% confidence interval) of having a percent predicted FEV1 below 50th percentile is 1.18 (0.66 to 2.11) for nonexposed smokers, 1.47 (0.76 to 2.84) for exposed nonsmokers, and 2.07 (1.12 to 3.85) for exposed smokers, in comparison with the control group.
CONCLUSIONS:
This study suggests that silica induces functional alteration regardless of silicosis and, in all likelihood, synergistically with tobacco. Exposure levels must be controlled better in these workers and those with silicosis must be relocated to risk-free jobs or retired.
PMID: 18617839 [PubMed - indexed for MEDLINE] Related citations

Publication Types Research Support, Non-U.S. Gov't MeSH Terms Adolescent Adult Cross-Sectional Studies Dose-Response Relationship, Drug Environmental Pollutants/toxicity Forced Expiratory Volume/drug effects* Humans Male Middle Aged Occupational Exposure* Odds Ratio Respiratory Tract Infections/chemically induced* Silicon Dioxide/toxicity Silicosis/classification Silicosis/epidemiology* Spain Young Adult Substances Environmental Pollutants granite Silicon Dioxide
Rev Environ Health. 2007 Oct-Dec;22(4):255-72.
Chronic obstructive pulmonary disease and occupational exposure to silica.

Rushton L.
Source
Imperial College London, Department of Epidemiology and Public Health Faculty of Medicine, St Mary's Campus, Norfolk Place, London W2 1PG, UK. l.rushton@imperial.ac.uk
Abstract
Prolonged exposure to high levels of silica has long been known to cause silicosis This paper evaluates the evidence for an increased risk of chronic obstructive pulmonary disease (COPD) in occupations and industries in which exposure to crystalline silica is the primary exposure, with a focus on the magnitude of risks and levels of exposure causing disabling health effects. The literature suggests consistently elevated risks of developing COPD associated with silica exposure in several occupations, including the construction industry; tunneling; cement industry; brick manufacturing; pottery and ceramic work; silica sand, granite and diatomaceous earth industries; gold mining; and iron and steel founding, with risk estimates being high in some, even after taking into account the effect of confounders like smoking. Average dust levels vary from about 0.5 mg.m3 to over 10 mg.m3 and average silica levels from 0.04 to over 5 mg.m3, often well above occupational standards. Factors influencing the variation from industry to industry in risks associated with exposure to silica-containing dusts include (a) the presence of other minerals in the dust, particularly when associated with clay minerals; (b) the size of the particles and percentage of quartz; (c) the physicochemical characteristics, such as whether the dust is freshly fractured. Longitudinal studies suggest that loss of lung function occurs with exposure to silica dust at concentrations of between 0.1 and 0.2 mg.m3, and that the effect of cumulative silica dust exposure on airflow obstruction is independent of silicosis. Nevertheless, a disabling loss of lung function in the absence of silicosis would not occur until between 30 and 40 years exposure.

Publication Types Review MeSH Terms Dose-Response Relationship, Drug Dust Humans Inhalation Exposure/adverse effects* Occupational Diseases/etiology* Occupational Exposure/adverse effects* Particle Size Pulmonary Disease, Chronic Obstructive/etiology* Risk Factors Silicon Dioxide/poisoning* Silicosis/etiology Spirometry Substances Dust Silicon Dioxide
Occup Environ Med. 2007 Oct;64(10):681-7. Epub 2007 Apr 20.
Reducing healthy worker survivor bias by restricting date of hire in a cohort study of Vermont granite workers.
Applebaum KM, Malloy EJ, Eisen EA.
Source
Harvard School of Public Health, Department of Environmental Health, Boston, Massachusetts 02115, USA.
Abstract
OBJECTIVE:
To explore the healthy worker survivor effect (HWSE) in a study of Vermont granite workers by distinguishing "prevalent" from "incident" hires based on date of hire before or after the start of follow-up.
METHODS:
Records of workers between 1950 and 1982 were obtained from a medical surveillance programme. Proportional hazards models were used to model the association between silica exposure and lung cancer mortality, with penalised splines used to smooth the exposure-response relationship. A sensitivity analysis compared results between the original cohort and subcohorts defined by restricting date of hire to include varying proportions of prevalent hires.
RESULTS:
Restricting to incident hires reduced the 213 cases by 74% and decreased the exposure range. The maximum mortality rate ratio (MRR) was close to twofold in all subcohorts. However, the exposure at which the maximum MRR was achieved decreased from 4.0 to 0.6 mg-year/m3 as the proportion of prevalent hires decreased from 50% in the original cohort to 0% in the subcohort of incident hires.
CONCLUSION:
Despite loss in power and restricted exposure range, decreasing the relative proportion of prevalent to incident hires reduced HWSE bias, resulting in stronger evidence for a dose-response between silica exposure and lung cancer mortality.
PMID: 17449560 [PubMed - indexed for MEDLINE] PMCID: PMC2078404 Free PMC Article
Publication Types, MeSH Terms, Substances, Grant Support

Publication Types Comparative Study Research Support, N.I.H., Extramural MeSH Terms
Aged Bias (Epidemiology) Cohort Studies Employment/statistics & numerical data* Follow-Up Studies Healthy Worker Effect Humans Incidence Industry/statistics & numerical data* Lung Neoplasms/mortality* Middle Aged Prevalence Proportional Hazards Models Silicon Dioxide* Silicosis/mortality* Survival Analysis Time Factors Vermont/epidemiology Substances granite Silicon Dioxide Grant Support CA81345/CA/NCI NIH HHS/United States T32 ES07155/ES/NIEHS NIH HHS/United States
J Public Health Policy. 2005 Jul;26(2):192-202; discussion 203-5.
Change in the world of occupational health: silica control, then and now.
Rosenberg B, Levenstein C, Spangler E.
Source
Department of Public Health and Family Medicine, Tufts University School of Medicine, Boston, MA 02111, USA.
Abstract
To control silicosis, we need to understand how change happens in occupational health. Science alone does not drive policy, because we have known the causes of silicosis, and how to prevent it for decades, yet the disease persists. To control occupational disease, we need to enter the social realm of work. To investigate the determinants of a successful silicosis control program, we wrote a social history of the Vermont Granite Industry from 1938 to
1960, examining union journals, newspapers, industry journals, scientific literature and government documents, and interviewing key informants. The crucial factor of the successful program was a strong public health movement to control tuberculosis, rather than pressure to control the occupational disease. Using this lesson, to protect workers from silica exposure now, we chose to regulate silica under an environmental law, the Massachusetts Toxics Use Reduction Act. Science is but one small factor, necessary but insufficient, in policy change. We in occupational health need to hitch onto a stronger movement, currently the environmental movement. Where unions are too weak to demand safe technologies, we need to learn to speak the language of employers, because they may have little idea of the costs of interventions. We need to gather more economic information about the costs of interventions.

Publication Types Research Support, N.I.H., Extramural Research Support, U.S. Gov't, P.H.S. MeSH Terms Dust/prevention & control Humans Industry* Massachusetts/epidemiology Occupational Exposure/prevention & control* Occupational Health Silicosis/epidemiology Silicosis/prevention & control* Vermont/epidemiology Substances Dust Grant Support U60/CCU112232-01/CC/CDC HHS/United States
Am J Ind Med. 2004 Jul;46(1):89; author reply 90.
Re: Attfield M, Costello J. Quantitative exposure-response for silica dust and lung cancer in Vermont granite workers. Am J Ind Med 45:129-138, 2004.
Graham WG.
Comment on
Am J Ind Med. 2004 Feb;45(2):129-38.

Publication Types Comment Letter MeSH Terms Adult Causality Humans Lung Neoplasms/etiology* Lung Neoplasms/mortality Middle Aged Occupational Diseases/etiology* Occupational Diseases/mortality Occupational Exposure/adverse effects* Silicon Dioxide/toxicity* Silicosis/etiology Silicosis/mortality Vermont/epidemiology Substances Silicon Dioxide
J Occup Environ Med. 2004 May;46(5):459-66.
Vermont granite mortality study: an update with an emphasis on lung cancer.

Graham WG, Costello J, Vacek PM.
Source
Pulmonary Unit, University of Vermont College of Medicine, Burlington, Vermont, USA. wgraham@uvm.edu
Erratum in
J Occup Environ Med. 2004 Aug;46(8):876.
Abstract
This mortality study extends the period of observation of an article published in 1988 of 5414 workers in Vermont granite sheds and quarries to assess whether previously reported reductions in silicosis and tuberculosis mortality were maintained. The relationship between lung cancer and quartz exposure is also examined by comparing mortality in workers hired before and after 1940, when dust controls were introduced and exposures were reduced by 80% to 90%. Before 1940, general stone shed air contained 20 million particles/cubic foot (mppcf) (approximately equivalent to 0.2 mg/m of quartz), and pneumatic chisel workers were exposed on average to 60 mppcf (approximately equivalent to 0.6 mg/m of quartz). Other workers had variable exposures. After 1940, a period of decline occurred in dust levels and then stabilized in approximately 1955, when average dust levels were 5 to 6 mppcf (equivalent to 0.05-.06 mg/m of quartz). Dust exposures in the Vermont industry is considered to be free of confounding occupational substances such as arsenic, although cigarette smoking was common. By the end of 1996, 2539 workers, or 46.9% of the cohort, had died. There were no silicosis deaths in workers hired after 1940 who were exposed only in the Vermont granite industry, illustrating the effect of lowering quartz exposures. Tuberculosis caused 2 deaths in those hired after 1940 (standardized mortality ratio [SMR] = 0.52; not significant). Overall lung cancer mortality was elevated in shed workers who had been exposed both to high levels of quartz before 1940 and to the lower levels prevailing after 1940 (SMR = 1.32; P < 0.01). Quarry workers did not show an excess of lung cancer (SMR = 0.73; not significant). When shed workers with high and low exposure histories (before and after 1940) but with comparable latency and tenure were contrasted, lung cancer mortality was similar. Differing levels of quartz exposure, which resulted in large differences in the mortality experience from silicosis, did not result in
differences in lung cancer mortality. The results do not support the hypothesis that granite dust exposure has a causal association with lung cancer.
MeSH Terms, Substances

MeSH Terms Cause of Death Cohort Studies Environmental Exposure Extraction and Processing Industry* Humans Lung Neoplasms/mortality* Male Occupational Diseases/mortality* Quartz Silicon Dioxide Silicosis/mortality Tuberculosis, Pulmonary/mortality Vermont/epidemiology Substances granite Quartz Silicon Dioxide
Am J Ind Med. 2004 Feb;45(2):129-38.
Quantitative exposure-response for silica dust and lung cancer in Vermont granite workers.
Attfield MD, Costello J.
Source
Division of Respiratory Disease Studies, NIOSH, Morgantown, West Virginia 26505, USA.
Abstract
BACKGROUND:
Excess lung cancer mortality among the exposed Vermont granite workers has been reported. These studies were based on job and tenure surrogates, with the potential for misclassification and inability to evaluate quantitative exposure-response.
METHODS:
Industrial hygiene data collected from 1924 to 1977 was analyzed in conjunction with mortality data to examine quantitative exposure-response for silica, lung cancer, and other lung diseases. A person-years analysis was undertaken by cumulative exposure group, including lagged and unlagged tabulations. Poisson models were fitted to untransformed and log transformed exposure.
RESULTS:
The results indicated a clear relationship of lung cancer, tuberculosis, pneumoconiosis, non-malignant lung disease, and kidney cancer with cumulative exposure. An exposure to 0.05 mg/m(3) from age 20 to 64 was associated with a lifetime excess risk of lung cancer for white males of 27/1,000.
CONCLUSIONS:
The results of this study of workers exposed almost exclusively to silica and no other major occupational confounding exposures indicate a clear exposure-response for lung cancer.
Comment in
Am J Ind Med. 2004 Jul;46(1):89; author reply 90.

MeSH Terms Adult Causality Confounding Factors (Epidemiology) Follow-Up Studies Humans Life Tables Lung Neoplasms/etiology Lung Neoplasms/mortality* Middle Aged Occupational Diseases/etiology Occupational Diseases/mortality* Occupational Exposure/adverse effects* Poisson Distribution Risk Factors Silicon Dioxide/toxicity* Silicosis/etiology Silicosis/mortality Vermont/epidemiology Substances Silicon Dioxide
Appl Occup Environ Hyg. 2002 Jun;17(6):424-9.
An evaluation of compliance with occupational exposure limits for crystalline silica (quartz) in ten Georgia granite sheds.
Wickman AR, Middendorf PJ.
Source
Electro-Optics, Environmental, and Materials Laboratory, Georgia Tech Research Institute, Atlanta, USA.
Abstract
Since the 1920s, industrial hygiene studies have documented granite shed workers' exposures to crystalline silica, and the data from these studies have contributed to a better understanding of the relationship between silica exposures and adverse health effects, such as silicosis. The majority of these studies were conducted in the Barre,
Vermont, granite sheds. However, a second major granite processing region is located in Elberton, Georgia, where approximately 1800 workers are employed in 150 granite sheds and 45 quarries. The current study reports the exposures of 40 workers in 10 granite sheds in Elberton, Georgia. The arithmetic mean exposure to silica for all monitored employees was 0.052 mg/m3. Employees were classified into one of seven job task groups. The job task group with the greatest exposure was the top polish group, which had a mean exposure of 0.085 mg/m3. Among the top polish workers, the greatest percentage of exposures above the Occupational Safety and Health Administration's permissible exposure limit (OSHA PEL) occurred among the workers who used dry grinders. Wet methods were effective in reducing these exposures to below the OSHA PEL. The mean exposure of Elberton granite shed workers was less than the OSHA PEL, but was not below the threshold limit value of the American Conference of Industrial Hygienists (ACGIH TLV), which was lowered in the year 2000 to 0.05 mg/m3. The Elberton granite shed workers provide a valuable cohort for research on the effects of exposure to crystalline silica at levels between the ACGIH TLV and the OSHA PEL. They are a relatively permanent worker population, are concentrated geographically, and have a quantitatively documented exposure to crystalline silica over the past twenty years.

Publication Types Research Support, U.S. Gov't, Non-P.H.S. MeSH Terms Environmental Monitoring* Georgia Guideline Adherence* Humans Job Description Occupational Exposure* Public Policy* Reference Values Silicon Dioxide*/analysis* United States United States Occupational Safety and Health Administration Substances
granite Silicon Dioxide
Cancer Causes Control. 2001 Nov;12(9):773-84.
Pooled exposure-response analyses and risk assessment for lung cancer in 10 cohorts of silica-exposed workers: an IARC multicentre study.
Steenland K, Mannetje A, Boffetta P, Stayner L, Attfield M, Chen J, Dosemeci M, DeKlerk N, Hnizdo E, Koskela R, Checkoway H; International Agency for Research on Cancer.
Source
National Institute for Occupational Safety and Health, Cincinnati, USA. nsteenland@cdc.gov
Erratum in
Cancer Causes Control 2002 Oct;13(8):777.
Abstract
OBJECTIVES:
Silica is one of the most common occupational exposures worldwide. In 1997 the International Agency for Research on Cancer (IARC) classified inhaled crystalline silica as a human carcinogen (group 1), but acknowledged limitations in the epidemiologic data, including inconsistencies across studies and the lack of extensive exposure-response data. We have conducted a pooled exposure-response analysis of 10 silica-exposed cohorts to investigate lung cancer.
METHODS:
The pooled cohort included 65,980 workers (44,160 miners, 21,820 nominees), and 1,072 lung cancer deaths (663 miners, 409 nonminers). Follow-up has been extended for five of these cohorts beyond published data. Quantitative exposure estimates by job and calendar time were adopted, modified, or developed to permit common analyses by respirable silica (mg/m3) across cohorts.
RESULTS:
The log of cumulative exposure, with a 15-year lag, was a strong predictor of lung cancer (p = 0.0001), with consistency across studies (test for heterogeneity, p = 0.34). Results for the log of cumulative exposure were consistent between underground mines and other facilities. Categorical analyses by quintile of cumulative exposure resulted in a monotonic trend with odds ratios of 1.0. 1.0, 1.3, 1.5, 1.6. Analyses using a spline curve also showed a monotonic increase in risk with increasing exposure. The estimated excess lifetime risk (through age 75) of lung cancer for a worker exposed from age 20 to 65 at 0.1 mg/m3 respirable crystalline silica (the permissible level in many countries) was 1.1-1.7%, above background risks of 3-6%.
CONCLUSIONS:
Our results support the decision by the IARC to classify inhaled silica in occupational settings as a carcinogen, and suggest that the current exposure limits in many countries may be inadequate. These data represent the first quantitative exposure-response analysis and risk assessment for silica using data from multiple studies.
Comment in
Cancer Causes Control. 2001 Nov;12(9):785-7. Cancer Causes Control. 2002 Oct;13(8):779-80; author reply 781-2. Cancer Causes Control. 2002 Oct;13(8):783-4; author reply 785.

Publication Types Multicenter Study Research Support, U.S. Gov't, P.H.S. Review MeSH Terms
Air Pollutants, Occupational/adverse effects* Air Pollutants, Occupational/standards Carcinogens, Environmental/adverse effects* Cohort Studies Diatomaceous Earth/adverse effects Follow-Up Studies Gold/adverse effects Humans Linear Models Lung Neoplasms/epidemiology Lung Neoplasms/etiology* Lung Neoplasms/mortality Maximum Allowable Concentration Mining Occupational Diseases/epidemiology Occupational Diseases/etiology* Occupational Diseases/mortality Risk Assessment Silicon Dioxide/adverse effects* Silicon Dioxide/standards Silicosis/complications Substances Air Pollutants, Occupational Carcinogens, Environmental granite Diatomaceous Earth Gold Silicon Dioxide
Occup Environ Med. 2001 Jul;58(7):467-71.
Radiological progression and its predictive risk factors in silicosis.

Lee HS, Phoon WH, Ng TP.
Source
Department of Occupational Health, Ministry of Manpower, 18 Havelock Road, 05-01, Singapore 059764. lee_hock_siang@mom.gov.sg
Abstract
OBJECTIVES:
To investigate the risk factors predicting radiological progression in silicosis in a prospective cohort study of patients with silicosis who were previously exposed to silica from granite dust.
METHODS:
From among a total of 260 patients with silicosis contracted from granite work, 141 with available serial chest x ray films of acceptable quality taken over a period of 2 to 17 (mean 7.5) years, were selected for study. Ninety four (66.7%) had ended exposure 5 or more years previously (mean 10.1 years, maximum 28 years). Radiological progression was assessed by paired comparison of the initial and most recent radiographs, with two or more steps of increase in profusion of small opacities according to the 12 point scale of the International Labour Organisation (ILO) classification of radiographs of pneumoconiosis, taken from the majority reading by a panel of three independent readers.
RESULTS:
Overall, 37% of patients with silicosis had radiological evidence of progression. From the initial radiographs, 24 (31.6%) of those with radiological profusion category 1, 15 (37.5%) of those with radiological profusion category 2, and 13 (52%) of those with complicated silicosis (including all seven with category 3 profusion of small opacities) showed radiological progression. As expected, progression was more likely to be found after longer periods of follow up (the interval between the two chest x ray films) with a 20% increased odds of progression for every additional year of follow up. After adjustment for varying intervals of follow up, the probability of radiological progression was found to be significant if large opacities were present in the initial chest x ray film. Progression was also less likely to be found among those who had ended exposure to silica longer ago, although the result was of borderline significance (p=0.07). Tuberculosis was also associated with increased likelihood of progression (borderline significance).
CONCLUSIONS:
There is a high probability of radiological progression in silicosis after high levels of exposure to granite dust among workers who were followed up for up to 17 years. A significant risk factor is the extent of radiological opacities in the initial chest x ray film. The probability of progression is also likely to be reduced with longer periods after the end of exposure.
PMID: 11404452 [PubMed - indexed for MEDLINE] PMCID: PMC1740153

MeSH Terms Adolescent Adult Aged Aged, 80 and over Disease Progression Dust/adverse effects* Humans Middle Aged Occupational Exposure/adverse effects* Occupational Exposure/statistics & numerical data Predictive Value of Tests Prospective Studies Risk Factors Silicosis/pathology Silicosis/radiography* Singapore/epidemiology Substances Dust
J Occup Environ Med. 2001 Apr;43(4):412-7.
Radiographic abnormalities in long-tenure Vermont granite workers and the permissible exposure limit for crystalline silica.
Graham WG, Vacek PM, Morgan WK, Muir DC, Sisco-Cheng B.
Source
Pulmonary Division, Department of Medicine, University of Vermont College of Medicine, 420 Lake Road, Charlotte, VT 05445, USA.
Abstract
This study was undertaken to assess the prevalence of radiographic abnormalities consistent with silicosis in a group of 600 retired granite workers who were receiving pensions. Files of regional clinics and hospitals were searched for chest radiographs taken on these men, and 470 x-ray films suitable for interpretation were located. After exclusions (women, and men who had worked in the granite industry elsewhere), 408 x-ray films were independently read by three experienced readers using the 1980 International Labour Office scheme. Dust exposures were estimated for workers hired after 1940, when the dust-control standard of 10 million particles per cubic foot (mppcf) (equivalent to 0.1 mg/m3) was put in place and monitored by the Vermont Division of Industrial Hygiene. Dust levels were initially high but were gradually reduced from 1940 to 1954, after which average quartz exposures stabilized to a mean of approximately 0.05 to 0.06 mg/m3; however, about 10% to 15% of samples after 1954 exceeded 0.1 mg/m3. Of the 408 x-ray films, 58 were taken on workers hired before dust controls were instituted in 1940, and 25.9% showed abnormalities (a profusion score of 1/0 or greater). A total of 350 x-ray films were taken on workers hired in 1940 or after, and the prevalence in this group was 5.7%. The radiographic changes in workers hired after 1940 are likely due to excessive exposures during the first 15 years of dust control. We conclude that if the exposure standard of 0.1 mg/m3 is rigorously observed in the workplace, radiographic abnormalities caused by quartz dust in long-term workers will be rare.
Comment in
J Occup Environ Med. 2002 Apr;44(4):308; author reply 308-9.

Publication Types Research Support, Non-U.S. Gov't MeSH Terms Aged Aged, 80 and over
Cross-Sectional Studies Dust/adverse effects Humans Male Middle Aged Silicon Dioxide/adverse effects* Silicosis/epidemiology* Silicosis/radiography Threshold Limit Values Vermont/epidemiology Substances Dust granite Silicon Dioxide
Appl Occup Environ Hyg. 1999 Sep;14(9):577-82.
Silica exposure during granite countertop fabrication.

Simcox NJ, Lofgren D, Leons J, Camp J.
Source
University of Washington, Field Research and Consultation Group, Seattle 98195-4695, USA.

Publication Types Multicenter Study MeSH Terms Air Pollutants, Occupational/adverse effects Air Pollutants, Occupational/analysis* Dust/adverse effects
Dust/analysis* Equipment Design Humans Silicon Dioxide/adverse effects Silicon Dioxide/analysis* Silicosis/etiology Silicosis/prevention & control* Ventilation Washington Substances Air Pollutants, Occupational Dust Silicon Dioxide
Singapore Med J. 1996 Apr;37(2):160-4.
Occupational respiratory diseases in Singapore.

Lee HS, Phoon WH, Wang SY, Tan KP.
Source
Department of Industrial Health Ministry of Labour, Singapore.
Abstract
Occupational respiratory disease statistics in Singapore from 1970 to 1993 were reviewed. Silicosis was the most common occupational respiratory disease in the 1970s and 1980s. About 78% of the cases were from granite quarries. With progressive reduction in dust levels and the closure of some quarries, there has been a decline in cases. From 1990 to 1993, occupational asthma was the most common occupational respiratory disease and more cases are expected with increasing awareness of the condition. The most common causative agent was isocyanates accounting for about 34% of cases. Of the asbestosis and malignant mesothelioma cases, about 70%-80% were from the one and only asbestos cement factory. With the closure of this factory and the increasing restrictions on the use of asbestos, cases of asbestosis are expected to decline in the long term. However, malignant mesothelioma cases may continue to surface because of the long latent period and the potential risk with low and brief exposures to asbestos. It is important to probe for possible occupational exposures (both present and past) in a patient with respiratory symptoms or disease.
MeSH Terms
MeSH Terms Data Collection Humans Incidence Occupational Diseases/diagnosis Occupational Diseases/epidemiology* Respiratory Tract Diseases/epidemiology* Respiratory Tract Diseases/etiology Risk Factors Singapore/epidemiology
Int J Epidemiol. 1995 Dec;24(6):1154-61.
Healthy worker effect in a longitudinal study of one-second forced expiratory volume (FEV1) and chronic exposure to granite dust.
Eisen EA, Wegman DH, Louis TA, Smith TJ, Peters JM.
Source
Department of Work Environment, University of Massachusetts, Lowell 01854, USA.
Abstract
BACKGROUND:
Low level effects of granite dust on one-second forced expiratory volume (FEV1) are estimated in 618 Vermont granite workers followed for 5 years with annual pulmonary function tests. Reduced pulmonary function has already been reported for the subset of subjects lost to follow-up (dropouts) suggesting possible bias in analyses based only on survivors.
METHOD:
Healthy worker selection bias is directly assessed by comparing the dose-response associations between survivors who remained in the study for the full 5-year observation period and the dropouts.
RESULTS:
The 353 survivors had an FEV1 of 96% of predicted at baseline and were losing FEV1 at an average rate of 44 ml/yr. No association was found in this group between the rate of FEV1 decline and lifetime dust exposure. However, the 265 workers with incomplete follow-up, 'dropouts', had a lower FEV1 at baseline (94%) and were losing FEV1 at an average rate of 69 ml/yr. The dose-response parameter in this group was estimated to be 4 ml/yr loss per mg/m3year and was statistically significant.
CONCLUSIONS:
These results provide an illustration of bias due to the healthy worker effect and an example of the failure to detect a true work-related health effect in a study based only on a 'survivor' population.

Publication Types Comparative Study Research Support, U.S. Gov't, P.H.S. MeSH Terms Adult Forced Expiratory Volume Healthy Worker Effect Humans Longitudinal Studies Male Middle Aged Mining
Population Surveillance* Regression Analysis Silicon Dioxide/adverse effects* Silicosis/epidemiology* Silicosis/etiology* Vermont/epidemiology Substances granite Silicon Dioxide Grant Support 5 P30 ES0002/ES/NIEHS NIH HHS/United States OH-070-6/OH/NIOSH CDC HHS/United States
Chest. 1994 Jul;106(1):125-30.
Longitudinal pulmonary function losses in Vermont granite workers. A reevaluation.

Graham WG, Weaver S, Ashikaga T, O'Grady RV.
Source
Department of Medicine, University of Vermont, Burlington.
Abstract
Previous studies have suggested that excessive losses of FVC and FEV1 were occurring in Vermont granite workers despite the fact that mean quartz levels existing in the industry were below the current OSHA standard of 100 micrograms/m3. We reexamined these losses in granite workers over an 8-year period, testing the workforce biennially from 1979 to 1987. All workers, including stone shed, quarry, and office, were offered forced spirometry using a 10-L water-sealed spirometer (Collins). In the peak year of participation (1983), 887 workers out of a total of approximately 1,400 were tested. Estimates of longitudinal loss were based on 711 workers who participated in at least three of the surveys. The mean age of this group was 42.9 years, and the mean years employed was 19.3 years; 21.4 percent were non-smokers (NS), 34.2 percent were ex-smokers (ES), and 44.4 percent were current smokers (CS). Average annual losses of FVC were 0.018 (SD = 0.056) L (CS, 0.025 L; NS, 0.006 L: and ES, 0.016
L). Average annual losses of FEV1 were 0.030 (SD = 0.041) L (CS, 0.038 L; NS, 0.020 L; and ES, 0.027 L). Analysis of covariance indicated that losses were related to the initial values for FVC or FEV1, height, age, and smoking status. After adjusting for these variables, the losses of both FVC and FEV1 were not correlated with years employed in the granite industry. No significant differences existed in the loss of FVC or FEV1 in categories of workers exposed to different levels of granite dust, eg, office, quarry, and stone shed workers. The annual losses of pulmonary function were significantly smaller than those estimated previously, which were 0.070 to .080 L in FVC, and 0.050-0.070 L in FEV1. We conclude that dust levels in the Vermont granite industry, which have been in conformance with OSHA permissible exposure limits, do not accelerate pulmonary function loss.

Publication Types Research Support, U.S. Gov't, P.H.S. MeSH Terms Adult Air Pollutants, Occupational/adverse effects* Air Pollutants, Occupational/analysis Dust/adverse effects Dust/analysis Forced Expiratory Volume Humans Longitudinal Studies Male Quartz/analysis Respiratory Mechanics* Silicon Dioxide/adverse effects* Silicosis/diagnosis* Silicosis/physiopathology Vital Capacity Substances Air Pollutants, Occupational Dust granite Quartz
Silicon Dioxide Grant Support NIOSH 5 R01 OH0135-04/OH/NIOSH CDC HHS/United States
[Silicosis in the granite industry].

[Article in Spanish] Ubeda E, Sibn JM, Valle M. PMID: 8149079 [PubMed - indexed for MEDLINE] Related citations

Publication Types Letter MeSH Terms Humans Incidence Mining* Prevalence Silicon Dioxide* Silicosis/epidemiology* Spain/epidemiology Substances granite Silicon Dioxide
Br J Ind Med. 1993 Oct;50(10):907-12.
Further evidence of human silica nephrotoxicity in occupationally exposed workers.

Ng TP, Lee HS, Phoon WH.
Source
Department of Community, Occupational, and Family Medicine, National University of Singapore.
Abstract
It has previously been shown that granite workers with heavy exposure to silica had glomerular and proximal tubular dysfunction evidenced by increased urinary excretions of albumin, alpha-1-microglobulin (AMG), and beta-N-acetylglucosaminidase (NAG). The investigation was replicated in another group of granite workers to further elucidate the exposure effect relation. The urinary excretion of albumin, alpha-1-microglobulin (AMG), beta-2-microglobulin (BMG), and beta-N-acetyl-glucosaminidase (NAG) was determined in two groups of granite workers with low and high exposure to silica. Low molecular weight proteinuria and enzymuria were significantly correlated with duration of exposure in the high but not the low exposure group. These increases were most pronounced in those with 10 or more years of heavy exposure, and in those with radiological evidence of pulmonary fibrosis, particularly those with rounded small opacities denoting classical silicosis. These results provide further evidence that prolonged and heavy exposure to silica is associated with nephrotoxic effects in granite workers.
PMID: 8217850 [PubMed - indexed for MEDLINE] PMCID: PMC1035520 Free PMC Article Related citations

MeSH Terms Acetylglucosaminidase/urine Adult Albuminuria/etiology Humans Kidney/physiopathology Kidney Diseases/etiology* Kidney Diseases/physiopathology
Kidney Diseases/urine Male Occupational Diseases/etiology* Occupational Diseases/physiopathology Occupational Diseases/urine Occupational Exposure/adverse effects* Silicon Dioxide/adverse effects* Substances Silicon Dioxide Acetylglucosaminidase
20. Br J Ind Med. 1993 Aug;50(8):726-31.
Changes in lung function of granite crushers exposed to moderately high silica concentrations: a 12 year follow up.
Malmberg P, Hedenstrm H, Sundblad BM.
Source
National Institute of Occupational Health, Solna, Sweden.
Abstract
45 granite crushers and 45 age and smoking matched referents underwent pulmonary function tests in 1976 and 1988. On average, the granite crushers at follow up had worked for 22 years, were 52 (range 36-78) years old, and had inhaled a cumulated amount of 7 mg of silica in the respirable dust fraction. Between 1976 and 1988 the average concentration of respirable quartz in air was 0.16 mg/m3 (threshold limit value (TLV) = 0.10 mg/m3). In 1988 the granite crushers had somewhat lower forced expiratory flows (forced expiratory volume in one second/vital capacity (FEV1/VC) -4.5% and forced midexpiratory flow FEF50 -15%) compared with the referents and a more uneven ventilation distribution (17% higher slope of phase III in the nitrogen single breath curve). Five smoking granite crushers, but none of the referents, had an FEV1 < 80% of the predicted. During the 12 year interval the granite crushers had--compared with the matched referents--a greater decrease in FEV1 (-4.6%), FEV1/VC (-5.4%), maximal
expiratory flow, (-8%) and FEF50 (-14%), and a larger increase in phase III and static compliance (p < 0.02 in all variables). The functional changes suggest the presence of airways obstruction and increased compliance of the lungs. Exposure to silica at concentrations of about twice the present TLV was thus associated with airways obstruction and loss of elastic recoil rather than fibrosis and a restrictive function loss as seen in silicosis. The changes were on average small, but in some tobacco smokers more pronounced changes were found.

Publication Types Research Support, Non-U.S. Gov't MeSH Terms Adult Aged Dust* Follow-Up Studies Forced Expiratory Volume Humans Lung/physiology* Male Middle Aged Occupational Exposure* Residual Volume Respiratory Function Tests Silicon Dioxide* Smoking Time Factors Total Lung Capacity Vital Capacity Substances Dust granite Silicon Dioxide
Thorax. 1993 Aug;48(8):840-4.
Phospholipid content of bronchoalveolar lavage fluid in granite workers with silicosis in Quebec.
Bgin R, Lesur O, Bouhadiba T, Guojian L, Larive P, Melloni B, Martel M, Cantin A.
Source
Unit de Recherche Pulmonaire, Universit de Sherbrooke, Quebec, Canada.
Abstract
BACKGROUND:
Some of the prominent features of silicosis are hyperplasia and hypertrophy of epithelial type II cells, which in experimental animals are often accompanied by accumulation of phospholipids in the lung.
METHODS:
The total phospholipid content of lung lavage fluid and its composition in 28 granite stone cutters with long term exposure to silica dust (23 with radiological silicosis) was compared with that of lavage fluid in 15 normal volunteers, 15 patients with untreated idiopathic pulmonary fibrosis, and 19 patients with untreated stage 2 or 3 sarcoidosis. All lavage fluid was obtained at the time of first pulmonary investigation, which also included lung function tests.
RESULTS:
In the normal subjects total phospholipid content was 1.13 (0.16) micrograms phosphorus/ml of lung lavage, in the patients with idiopathic pulmonary fibrosis 0.52 (0.07) microgram/ml (p < 0.05), and in the patients with sarcoidosis 1.02 (0.20) microgram/ml composition being in the range reported in humans. In the patients with silicosis total phospholipid content was significantly decreased to an average of 0.46 (0.08) microgram/ml compared with the findings in normal subjects and patients with sarcoidosis. Within the group exposed to silica changes in total phospholipid content did not correlate with the severity of the radiographic disease, changes in lung function, the
cellularity of lung lavage fluid, or hyaluronate concentrations. The secretory capacity of rat epithelial type II cells was not significantly different when cultured with bronchoalveolar lavage fluid from all four groups of subjects.
CONCLUSIONS:
Total phospholipid content in lung lavage fluid was significantly reduced in granite workers with radiological evidence of lung disease, but showed no correlation with radiological or functional markers of disease severity.

Publication Types Research Support, Non-U.S. Gov't MeSH Terms Adolescent Adult Bronchoalveolar Lavage Fluid/chemistry* Cell Division Epithelium/metabolism Humans Lung/physiopathology Male Phospholipids/analysis* Pulmonary Fibrosis/physiopathology Sarcoidosis/physiopathology Silicosis*/physiopathology Substances Phospholipids
Eur Respir J. 1992 Sep;5(8):986-91.
Lung function in relation to silicosis and silica exposure in granite workers.

Ng TP, Chan SL.
Source
Dept of Community, Occupational and Family Medicine, National University of Singapore, Lower Kent Ridge.
Abstract
Lung function tests (forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC %) were related to silica exposure and the extent of radiological opacities in a study of 206 active and 132 previously employed granite workers from two quarries. The investigations included detailed personal interviews, spirometric testing and radiographic examination of the chest. The chest X-ray films were read randomly and independently by three readers, using International Labour Office (ILO) standard films. Cumulative exposure to respirable silica (mg.m3-yr) and total granite dust (million particles per cubic foot (mppcf-yr)) were estimated for each subject based on his years of employment at various jobs and historical and current measurements of quarry-, period- and job-specific exposures. The results suggest that chronic simple silicosis, especially for profusion category 2 and 3, was associated with significant lung function loss. As expected, mixed dust fibrosis was associated with little or no functional disturbance. Massive fibrosis was associated with significant obstructive and restrictive impairment. No additional effect of exposure to respirable silica on lung function loss was found after allowing for the presence of "silicosis". However, exposure to total dust (mppcf-yr) appeared to be associated with some lung function loss independent of silicosis. Our results indicate that chronic simple silicosis is not a benign disease; silica exposure is the primary cause, but the lung function loss in silicotics is directly attributable to the fibrotic lung disease. However, exposure to total granite dust beyond the respirable size range may separately produce additional lung function loss.
MeSH Terms Adult Aged Forced Expiratory Volume* Humans Lung/radiography Middle Aged Mining* Occupational Exposure/analysis* Regression Analysis Silicon Dioxide/adverse effects Silicon Dioxide/analysis* Silicosis/etiology Silicosis/physiopathology* Silicosis/radiography Spirometry Vital Capacity* Substances Silicon Dioxide
Ann Acad Med Singapore. 1992 May;21(3):312-7.
An epidemiological survey of respiratory morbidity among granite quarry workers in Singapore: chronic bronchitis and lung function impairment.
Ng TP, Phoon WH, Lee HS, Ng YL, Tan KT.
Source
Department of Community, Occupational & Family Medicine, National University of Singapore.
Abstract
Respiratory symptoms of chronic bronchitis and measurements of lung function were studied in an epidemiological survey of the total population of workers currently employed in granite quarries in Singapore. There were 85 rock drilling and crushing workers with current exposure in high levels of silica dust. Their respiratory parameters were studied with reference to an internal comparison group of 154 quarry maintenance and transport workers with low dust exposure, and an external comparison group of 148 Telecoms postal delivery workers with no granite dust
exposure. The highly exposed workers showed greater prevalences of chronic cough and phlegm, a mean reduction of 5% in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). The increased respiratory morbidity were independent of other factors such as age and smoking. Similar results were also noted after excluding those with silicosis (defined radiologically as profusion greater than 1/1 as read by at least two of three readers). This study strongly indicates a demonstrable risk of "occupational" bronchitis (mucus hypersecretion) and obstructive and restrictive lung function impairment, apart from the "classical" risk of silicosis. Measures taken to protect the health of workers exposed to silica dust should also be based on considerations taken to protect against the risk of these respiratory disorders as well.

Publication Types Comparative Study MeSH Terms Adult Bronchitis/epidemiology* Bronchitis/physiopathology Dust/adverse effects* Forced Expiratory Volume/physiology* Humans Male Occupational Exposure* Prevalence Risk Factors Smoking Vital Capacity/physiology* Substances Dust
Ann Acad Med Singapore. 1992 May;21(3):305-11.
An epidemiological survey of respiratory morbidity among granite quarry workers in Singapore: radiological abnormalities.
Ng TP, Phoon WH, Lee HS, Ng YL, Tan KT.
Source
Abstract
This report presents baseline findings from the first of a series of epidemiological studies to evaluate inter alia the effects of control measures introduced in 1972-79 to reduce dust exposure in all quarries in Singapore. The prevalence of radiological abnormalities among 219 currently employed quarry workers were estimated according to a number of parameters of dust exposure. Large-sized chest x-ray films were read, independently and in random order, by a panel of three experienced readers, who were "blinded" to the personal particulars and exposure of the subjects, using standard chest x-ray films to record opacities according to the International Standard Classification of Radiographs of Pneumoconioses. Silicosis as defined by radiological small opacities (both rounded and irregular) of profusion 1/1 or greater as read by at least two readers were noted in 11 subjects. The prevalence of silicosis was 12.5% in highly exposed drilling and crushing workers, and 0.8% in maintenance and transportation workers with low level exposure to granite dust. Among those who were first exposed to granite dust after 1979, no cases of silicosis were noted in any quarry worker. It is concluded that reduction in dust exposure since 1979 has so far been successful in producing nil or negligible risks of silicosis among active quarry workers over ten years, but further follow-up studies are needed.

MeSH Terms
Adult Dust/adverse effects* Female Humans Male Occupational Exposure* Prevalence Pulmonary Fibrosis/epidemiology Pulmonary Fibrosis/etiology Pulmonary Fibrosis/radionuclide imaging* Risk Factors Silicosis/epidemiology Silicosis/etiology Silicosis/radionuclide imaging* Singapore/epidemiology Substances Dust
Am J Ind Med. 1992;22(2):155-62.
Small airways function of silica-exposed workers.

Chia KS, Ng TP, Jeyaratnam J.
Source
Department of Community, Occupational and Family Medicine, National University of Singapore.
Abstract
Small airways obstruction may be present for many years before chronic airway obstruction becomes evident. Several spirometric indices, especially flow rates at low lung volumes, may reflect the status of small airways. Time domain indices, by using moments analysis of the volume time spirogram, have also been shown to be sensitive indicators of small airways obstruction. In this study, we have applied the various spirometric indices as well as time domain indices to a group of granite quarry workers without radiographic evidence of silicosis or physiological evidence of obstruction to the larger airways. The aim was to evaluate small airways function in relation to dust exposure in subjects with normal ratio of the forced expiratory volume in one second to the forced vital capacity (FEV1/FVC) and normal FVC. The volume-time spirograms of 140 quarry workers were digitized using an electronic digitizer connected to a microcomputer where flow and time domain indices were computed. The workers were
divided into three exposure groups based on their occupational history. With adjustment for age, height, and smoking status, all the time domain indices showed significant small airways obstruction with increasing dust exposure. Smokers had greater degree of airways obstruction than the non-smokers, with a similar trend of increase in small airways obstruction in relation to higher exposure. Our present study suggests that small airways obstruction is present among silica exposed workers in the absence of radiological evidence of silicosis and large airways obstruction. There was also evidence of increasing small airways obstruction in higher dust exposure group. Our study also suggests that time domain indices are more sensitive to small airways obstruction.

MeSH Terms Adult Airway Obstruction/physiopathology* Airway Resistance Chronic Disease Forced Expiratory Volume Humans Male Middle Aged Occupational Exposure/adverse effects* Silicon Dioxide/adverse effects* Silicosis/diagnosis Vital Capacity Substances Silicon Dioxide
Am Rev Respir Dis. 1991 Dec;144(6):1307-13.
Effects of work exposure, retirement, and smoking on bronchoalveolar lavage measurements of lung dust in Vermont granite workers.
Christman JW, Emerson RJ, Hemenway DR, Graham WG, Davis GS.
Source
Department of Medicine, University of Vermont, Burlington.
Abstract
Estimation of the exposure to respirable dust in the workplace is an important aspect of industrial hygiene. We performed bronchoalveolar lavage (BAL) on 42 healthy nonindustrial control subjects and 44 workers in the Barre, Vermont granite industry to determine whether BAL materials reflected occupational exposure. The granite workers held jobs with a range of dust exposure intensities and had employment histories from 1 to 43 yr; 12 workers were retired. None of the workers had radiologic evidence of silicosis. The granite dust content of BAL materials was measured by enumerating the percentage of cells positive for particulates by polarized light microscopy, by analysis for silicon by scanning electron microscopy with energy-dispersive X-ray spectrometry, and by chemical analysis. Minerals were present in greater quantity in the BAL cells from granite workers than from nonindustrial control subjects. Polarized light microscopy was comparable in sensitivity, specificity, and overall accuracy to electron microscopy; chemical analysis was less accurate than either microscopic technique. Tobacco smoking did not interfere with the detection of the occupationally related minerals or influence the quantity of dust present. The mineral in BAL cells was partially related to the intensity of exposure within the granite industry and to the duration of employment, but there was great individual variation among subjects. Retirement led to a decrease in BAL mineral content, but substantial dust remained for many years.

Publication Types Research Support, U.S. Gov't, P.H.S. MeSH Terms Bronchoalveolar Lavage Fluid/pathology*
Female Humans Lung/pathology Male Microscopy, Electron, Scanning Microscopy, Polarization Middle Aged Occupational Exposure* Retirement Silicon Dioxide Silicosis/diagnosis Silicosis/epidemiology* Time Factors Vermont/epidemiology Substances granite Silicon Dioxide Grant Support HL-14212/HL/NHLBI NIH HHS/United States RR-109/RR/NCRR NIH HHS/United States
Chest. 1991 Dec;100(6):1507-14.
Radiographic abnormalities in Vermont granite workers exposed to low levels of granite dust.
Graham WG, Ashikaga T, Hemenway D, Weaver S, O'Grady RV.
Source
Pulmonary Division, Biometry Facility, University of Vermont, Burlington.
Abstract
The issue of whether low levels of granite dust exposure lead to radiographic abnormalities after a lifetime of exposure has not been settled. In 1983, we carried out a radiographic survey of the Vermont granite industry, consisting of quarry and stone shed workers who had been exposed to the low dust levels prevailing in the industry since 1938 to 1940. Films were read by three "B" readers, using the ILO classification system, which requires the identification of both rounded and irregular opacities, as well as combinations of both. X-ray films were taken of 972
workers, out of a total work force of approximately 1,400. Of these films, 28 (3 percent) were interpreted by either two or three of the three readers as showing abnormalities consistent with pneumoconiosis. Only seven films (or 0.7 percent of the entire cohort) showed nodular or rounded opacities of the type typically seen in uncomplicated silicosis. The remainder of the abnormal x-ray films showed irregular opacities, largely in the lower lung zones, which are of uncertain significance, but may be related to heavy cigarette smoking and aging, and possibly dust inhalation. In addition, total gravimetric dust concentrations in the workplace were measured; 417 respirable-size mass samples showed concentrations of 601 micrograms/cu m +/- 368 micrograms/cu m. Using previously published estimates of 10 percent quartz in granite dust, the average quartz concentration was 60 micrograms/cu m. Twelve percent of the samples exceeded 100 micrograms/cu m, the current OSHA standard for quartz. We conclude that control of quartz exposure in the Vermont granite industry to levels which are on average less than the current OSHA standard has essentially eliminated definite radiographic changes of silicosis. The significance of the irregular opacities in the lower lung zones seen on a majority of the 28 x-ray films judged to be abnormal is not clear.
Comment in
Chest. 1991 Dec;100(6):1482-3.

Publication Types Research Support, U.S. Gov't, P.H.S. MeSH Terms Adult Aged Dust/adverse effects* Female Humans Lung/radiography* Male Middle Aged Occupational Exposure*
Pneumoconiosis/epidemiology Pneumoconiosis/radiography Silicon Dioxide* Smoking Time Factors Vermont/epidemiology Substances Dust granite Silicon Dioxide Grant Support R01 OHO1035-04/OH/NIOSH CDC HHS/United States
Scand J Work Environ Health. 1991 Jun;17(3):170-4.
Silicosis and lung cancer among Chinese granite workers.

Chia SE, Chia KS, Phoon WH, Lee HP.
Source
Abstract
Of the 184 cases of silicosis registered between 1 January 1970 and 31 December 1984 in Singapore, all the relevant information was available for 159, which were linked to the population-based National Cancer Register for lung cancer. Nine cases of lung cancer were found. The standardized incidence ratio (SIR) was computed with the age- and calendar-specific incidence of lung cancer rates of Chinese males in Singapore as a basis. Excess risk of lung cancer was found (SIR 2.01, 95% confidence interval 0.92-3.81). Adjustment for smoking showed that it alone could not account for the excess lung cancer risk. There was an increasing, but not significant, trend with increasing severity of silicosis and exposure duration. The results suggest that the severity of silicosis and possibly exposure to free silica may have contributed to the excess of lung cancer among the cases of silicosis studied.
PMID: 1648788
[PubMed - indexed for MEDLINE] Related citations

MeSH Terms Cohort Studies Continental Population Groups Dust/adverse effects Humans Lung Neoplasms/epidemiology* Male Middle Aged Mining Occupational Diseases/epidemiology* Risk Factors Silicon Dioxide* Silicosis/epidemiology* Singapore Smoking/epidemiology Substances Dust granite Silicon Dioxide
Rev Clin Esp. 1990 Oct;187(6):275-9.
[The epidemiology of silicosis in the El Escorial region].

[Article in Spanish] Ubeda Martnez E, Sibn Galindo JM, Valle Martn M, Muoz Mateos F.
Source
Hospital de El Escorial, Madrid.
Abstract
In a sample of 186 stone workers who performed granite "tearing" and "stone work" (either manual or mechanical) we have found silicosis in 50.5% (simple silicosis 47.3%, and complicated silicosis 3.2%). The most commonly
found radiologic manifestation was a round opacity type "p" and a 1/1 to 1/3 profusion. From a functional respiratory perspective, a mild reduction of FVC, DLco (SB) and pO2 similar to that described in coal miners' pneumoconiosis was observed. It seems that "stone workers" had a higher incidence of suffering severe silicosis than stone "tearing" workers. Surprisingly, in the analysis of inhaled dust of such an activity which is performed in the open air the rates of dust and SiO2 are much higher than those found in coal workers. We believe that this is the first time that these measurements are performed, and published, in a group of stone workers.

Publication Types Comparative Study English Abstract MeSH Terms Humans Incidence Lung/radiography Mining Respiratory Function Tests Silicon Dioxide Silicosis/diagnosis Silicosis/epidemiology* Spain/epidemiology Substances granite Silicon Dioxide
30. Lung. 1990;168(3):151-8.
Enzyme activities of lung lavage in silicosis.

Larive P, Cantin A, Dufresne A, Bgin R.
Source
Unit de Recherche Pulmonaire, Universit de Sherbrooke, Qubec, Canada.
Abstract
The cytotoxic effect of quartz on lung cells has been well documented by in vitro and animal studies, but the pertinence of these findings to humans has not yet been documented. We measured lactate dehydrogenase (LDH) activities in the lung lavage of 24 long-term workers in the Qubec granite industry and 25 control subjects. We found significant increases in LDH activities in the workers' lung lavage, even in the absence of established silicosis (9 subjects). We looked at a similar observation in the sheep model of early silicosis, measured quartz content of lung lavage, and found significant correlation with LDH levels (R = 0.64, p less than 0.001). All of the quartz particles in human and sheep lung lavage were in the alveolar macrophages. To test further the relationship of macrophage damage (cytotoxicity of quartz) we measured the release of LDH by sheep alveolar macrophage in 24 h cell culture under control conditions, exposure to inert dust, titanium, minusil-5 quartz, or aluminum-treated quartz. The LDH release was at control levels during titanium exposure and showed a significantly dose-related increase during quartz exposure. The latter cytotoxic effect was largely attenuated by aluminum treatment of quartz. These in vitro data agreed with previous reports. This study presents evidence of a cytotoxic effect of quartz inhalation in humans. The effect is related to the intensity of quartz retention in the lung macrophages; it is not a nonspecific dust exposure effect and can be attenuated by surface modification of the quartz.

MeSH Terms
Adult Aged Animals Bronchoalveolar Lavage Fluid/enzymology* Disease Models, Animal Dose-Response Relationship, Drug Humans L-Lactate Dehydrogenase/analysis L-Lactate Dehydrogenase/metabolism Macrophages/enzymology Middle Aged Quebec Sheep Silicosis/enzymology* Silicosis/etiology Substances L-Lactate Dehydrogenase
Singapore Med J. 1989 Jun;30(3):269-72.
A study on the usage of respirators among granite quarry workers in Singapore.

Chia SE.
Abstract
The frequency and correctness of respirators were studied in 5 granite quarries in Singapore involving 201 workers. The overall prevalence of usage of correct respirators was 45.8%. 10.4% of the workers were found to be using the wrong respiratory protective devices. Age, years of exposure and types of occupations were found to affect the usage of respirators. Some common reasons given by workers for not wearing the respirators were 'breathing difficulty', 'hot & sweaty', and 'respirator smells after a while'.
MeSH Terms Adult Aged Dust/adverse effects* Humans Male Middle Aged Mining* Protective Devices* Respiratory Protective Devices* Risk Factors Silicon Dioxide* Silicosis/prevention & control* Singapore Substances Dust granite Silicon Dioxide
32. Chest. 1988 Sep;94(3):539-45.
Lung function in silica-exposed workers. A relationship to disease severity assessed by CT scan.

Bgin R, Ostiguy G, Cantin A, Bergeron D.
Source
Centre Hospitalier Universitaire, Universit de Sherbrooke, Qubec, Canada.
Abstract
To investigate the relationship of lung function, airflow limitation, and lung injury in silica-exposed workers, we analyzed the clinical, functional, and radiologic data of 94 long-term workers exposed in the granite industry or in foundries. The subjects were divided into four subsets based on chest roentgenogram and CT scan of the thorax: group 1 consisted of 21 subjects with category 0 chest roentgenogram and category 0 CT scan; group 2, 28 subjects
with category E 1 on both chest roentgenogram and CT scan; group 3, 18 subjects with category E 1 on chest roentgenogram but with coalescence or conglomeration or both seen only on CT scan; and group 4, 27 subjects with category E 1 and coalescence or conglomeration or both on roentgenogram and CT scan. The groups did not differ in terms of age, height, cigarette smoking, or years of exposure. Lung volumes were significantly reduced only in group 4 (p less than 0.05). Lung compliance, diffusion capacity, and the rest-exercise P(A-a)O2 gradient were reduced in groups 3 and 4 (p less than 0.05). Expiratory flow rates were significantly reduced in groups 2, 3, and 4, with the lowest values in group 4. The expiratory flow rates in group 3 were significantly lower in group 3 than in group 2. These results support the concept that airflow in silica-exposed workers is significantly reduced when the disease is detectable on simple chest roentgenogram; coalescence or conglomeration or both on chest roentgenogram or CT scan is associated with significant loss of lung volumes, gas exchange function, and increased airflow obstruction.
Publication Types, MeSH Terms

Publication Types Comparative Study Research Support, Non-U.S. Gov't MeSH Terms Humans Lung/radiography Lung Volume Measurements Maximal Expiratory Flow Rate Middle Aged Pulmonary Diffusing Capacity Pulmonary Gas Exchange Respiratory Function Tests* Silicosis/physiopathology* Silicosis/radiography Tomography, X-Ray Computed*
Am J Ind Med. 1988;13(4):483-97.
Vermont granite workers' mortality study.
Costello J, Graham WG.
Source
Appalachian Laboratory for Occupational Safety and Health, Morgantown, West Virginia.
Abstract
A cohort mortality study was carried out in Vermont granite workers who had been employed between the years 1950 and 1982. The cohort included men who had been exposed to high levels of granite dust prior to 1938-1940 (average cutters to 40 million parts/cubic foot), and those employed at dust levels after 1940, which on average were less than 10 million parts/cubic foot. Deaths were coded by a qualified nosologist and standardized mortality ratios were calculated. The results confirm previous studies that show that death rates from silicosis and tuberculosis, the major health threats in the years before 1940, were essentially eliminated after dust controls. However, we found excessive mortality rates from lung cancer in stone shed workers who had been employed prior to 1930, and hence had been exposed to high levels of granite dust. When information was available, 100% of those dying from lung cancer had been smokers.

MeSH Terms Adult Aged Humans Lung Neoplasms/etiology Lung Neoplasms/mortality Male Middle Aged Mortality* Risk Factors Silicon Dioxide* Silicosis/mortality Silicotuberculosis/mortality Smoking
Vermont Substances granite Silicon Dioxide
Chest. 1987 Dec;92(6):1061-7.
Spectrum of alveolitis in quartz-exposed human subjects.

Bgin RO, Cantin AM, Boileau RD, Bisson GY.
Source
Unit de Recherche Pulmonaire, CHUS, Sherbrooke, Qubec, Canada.
Abstract
To characterize silica-induced alveolitis in human subjects, we studied 22 workers in the granite stone cutting industry of Quebec and compared results with those of 22 manual workers without quartz exposure (group 1). All were nonsmokers and were of comparable age. On the basis of chest roentgenogram, seven were without disease (group 2), nine had silicosis without coalescence/conglomeration (group 3), and six had silicosis with coalescence/conglomeration (group 4). The alveolitis in subsets of silica-exposed workers with distinct clinical stages of disease was found to have distinct biologic characteristics.
PMID: 2824136

Publication Types Research Support, Non-U.S. Gov't MeSH Terms Adult Aged Alveolitis, Extrinsic Allergic/chemically induced*
Bronchoalveolar Lavage Fluid/analysis Environmental Exposure Fibroblast Growth Factors/analysis Fibronectins/analysis Humans Lung Volume Measurements Male Middle Aged Mining* Procollagen/analysis Quartz/poisoning* Silicon Dioxide/poisoning* Silicosis/etiology Substances Fibronectins Procollagen Quartz Fibroblast Growth Factors Silicon Dioxide
Br Med J (Clin Res Ed). 1987 Jul 18;295(6591):164-8.
Radiological progression and lung function in silicosis: a ten year follow up study.
Ng TP, Chan SL, Lam KP.
Source
Labour Department, Hong Kong.
Abstract
Chest radiographs and spirometric tests were performed on 81 patients who had silicosis from two granite quarries in 1975, 73 of whom were followed up for two to 10 (mean 7.2) years. Each patient's initial and most recent chest radiographs were assessed independently by three experienced readers, and the yearly declines in forced expiratory volume in one second and forced vital capacity were estimated from two to four (mean 3.45) serial spirometric readings. Estimates of individual dust exposure were based on extensive historical data on hygiene. All but 11 patients were no longer exposed to dust by the start of follow up, but 24 (45%) of 53 patients who had simple silicosis and 11 (55%) of 20 who had the complicated disease showed radiological evidence of disease progression.
In patients who had simple silicosis and showed no radiological progression the yearly declines in forced expiratory volume in one second and forced vital capacity were modest (64 ml/year and 59 ml/year, respectively), whereas significantly greater declines in lung function were seen in those who showed radiological evidence of progression (97 ml/year and 95 ml/year, respectively). In addition to radiological progression the previous average dust concentration to which patients had been exposed also influenced declines in both forced expiratory volume in one second and forced vital capacity after allowing for the effects of age, smoking, duration of exposure, history of tuberculosis, initial state of disease, and baseline lung function. The probability of radiological progression was most strongly influenced by the average dust concentration previously exposed to. The progression of simple silicosis is thus accompanied by appreciable declines in lung function and is strongly affected by previous levels of exposure to dust.
PMID: 3115361 [PubMed - indexed for MEDLINE] PMCID: PMC1247028

MeSH Terms Dust/adverse effects Follow-Up Studies Forced Expiratory Volume Humans Longitudinal Studies Lung/pathology Lung/physiopathology* Lung/radiography Male Silicosis/pathology Silicosis/physiopathology* Silicosis/radiography Smoking/adverse effects Time Vital Capacity Substances Dust
AJR Am J Roentgenol. 1987 Mar;148(3):509-14.
CT assessment of silicosis in exposed workers.

Bgin R, Bergeron D, Samson L, Boctor M, Cantin A.
Abstract
For evaluation of the clinical usefulness of CT of the thorax in workers exposed to silica, 58 workers with long-term exposure to silica in the granite and foundry industries of the Eastern Townships of Quebec were examined. CT scans were compared with standard posteroanterior chest radiographs by using the International Labour Office 1980 grading system for silicosis. Six areas of the lung in each patient were assessed by both techniques for profusion (number) of opacities (small nodules), coalescence, and the presence of large opacities. CT scans and chest radiographs yielded similar average scores for detection of opacities. CT identified significantly more coalescence and large opacities in patients with simple silicosis. In patients with complicated silicosis, CT results were comparable with those of chest radiographs. CT of the thorax in workers exposed to silica does not identify more patients with minimal parenchymal disease, but it does detect earlier changes of coalescence.

Publication Types Comparative Study Research Support, Non-U.S. Gov't MeSH Terms Humans Lung/radiography Male Middle Aged Quebec Silicosis/radiography* Time Factors Tomography, X-Ray Computed*
Int J Epidemiol. 1986 Sep;15(3):337-42.
Estimation of ventilatory capacity in subjects with unacceptable lung function tests.

Eisen EA, Robins JM.
Abstract
Based on pulmonary function data collected annually for six years on 540 Vermont granite workers, FEV1 in survey 1 was estimated by extrapolating back from subsequent measurements. The extrapolation method was found to fit the observed data of subjects with reproducible initial values very well (R2 = 0.87). Extrapolated FEV1s for workers unable to perform an adequate pulmonary function test according to the standards of the American Thoracic Society were compared to extrapolated values in the rest of the cohort. After adjusting for confounding, subjects with test failure in survey 1 had a lower extrapolated FEV1 than the rest of the cohort (p = 0.07). The mean extrapolated FEV1 of the 71 workers with an initial test failure was only 95% of a predicted value derived from the group with reproducible data, and the per cent predicted decreased from 98% to 71% as the number of test failures in the followup surveys increased (p = 0.0004). The American Thoracic Society and the Epidemiology Standardization Project currently recommend that test failures be excluded from the analysis of epidemiological data. Our findings suggest that alternative strategies for handling non-reproducible lung function may need to be explored in order to avoid selection bias.
MeSH Terms
MeSH Terms Adult Forced Expiratory Volume* Humans Male Mathematics Regression Analysis Respiratory Function Tests
Silicosis/prevention & control Smoking
Am J Ind Med. 1986;9(2):189-201.
A proportionate mortality study of granite cutters.

Steenland K, Beaumont J.
Abstract
Several recent studies (animal and human) have suggested an association between lung cancer and silica exposure. To test the hypothesis, we have studied death benefit records of 1,905 members of the Granite Cutters Union. A proportionate mortality analysis (PMR) was conducted, using U.S. deaths as a comparison population. Statistically (PMR) was conducted, using U.S. deaths as a comparison population. Statistically significant excesses were observed for death from nonmalignant respiratory significant excesses were observed for death from nonmalignant respiratory disease (largely silicosis) (183 obs, 43.7 exp) and for tuberculosis (largely silicotuberculosis) (262 obs, 19.3 exp). Other significant excesses were observed for bone cancer (6 obs, 1.9 exp) and arthritis (5 obs, 1.5 exp). A significant decrease was observed for leukemia (5 obs, 13.0 exp). For lung cancer a slight but nonsignificant excess was observed (97 obs, 81.1 exp, PMR = 1.19, 95% CI 0.97-1.46). A proportionate cancer mortality analysis (PCMR) showed similar results for lung cancer (PCMR = 1.09, 95% CI 0.89-1.33). Lung cancer mortality also failed to show any trend with either calendar time or duration of exposure. Although no significant excess of lung cancer was observed for the entire silica-exposed cohort, there was an indication that those who were silicotic had an excess risk of lung cancer, based on a review of contributing causes on the death certificate.
MeSH Terms
MeSH Terms Construction Materials*
Humans Industry* Labor Unions Male Mortality* Neoplasms/mortality Respiratory Tract Diseases/mortality Tuberculosis, Pulmonary/mortality
Am J Ind Med. 1983;4(6):705-23.
Mortality experience of Vermont granite workers.

Davis LK, Wegman DH, Monson RR, Froines J.
Abstract
The proportional mortality experience (1952-1978) of 969 deceased white male granite workers was compared with that of United States white males. Industrial hygiene information was combined with work histories to develop an estimate of lifetime granite dust exposure for each individual. Subjects were grouped into four cumulative exposure categories, and exposure-response relationships were examined. Trends of increasing silicosis and tuberculosis with increasing lifetime exposure were observed. These are consistent with earlier findings. With the exception of excess suicide among granite workers dying before 1970, there was little evidence of association between other causes of death and employment in the granite industry.

Publication Types Comparative Study Research Support, U.S. Gov't, P.H.S. MeSH Terms Adult
Humans Lung Neoplasms/etiology Lung Neoplasms/mortality Male Middle Aged Neoplasms/etiology Neoplasms/mortality* Occupational Diseases/etiology Occupational Diseases/mortality* Regression Analysis Silicon Dioxide/adverse effects* Silicosis/etiology Silicosis/mortality* Silicotuberculosis/etiology Silicotuberculosis/mortality* Suicide/epidemiology United States Vermont Substances granite Silicon Dioxide Grant Support 5 T OHO7O-6/OH/NIOSH CDC HHS/United States SS 5 P30 E50002/PHS HHS/United States
Ann Acad Med Singapore. 1982 Jan;11(1):115-7.
A profile of silicosis cases who died.

Phoon WH.
Abstract
Silicosis cases which had been notified by doctors and confirmed after investigations were followed up by the Industrial Health Division. Up to August 1981, a total of 313 persons were confirmed as having the disease. Of these, 59 had died. The majority of these 59 persons had had their silica exposure in the granite quarries. 13 had been exposed to "rubber powder" which contained a high percentage of free silica. 52 of those who died were male, and their average age at death was 60.87 years. This did not appear to be significantly shorter than their life expectancy of 65.1 years. But the average age of death for the 7 women was 58.86 years, which was much shorter than their life
expectancy of 70 years. Many of the men died from causes unrelated to silicosis. But 6 of the 7 women had progressive massive fibrosis (PMF) and they apparently died of the disease or complications arising from it.
MeSH Terms
MeSH Terms Adult Aged Female Humans Life Expectancy Male Middle Aged Silicosis/mortality* Singapore
JAMA. 1980 Oct 24-31;244(17):1939-41.
Cryptic pulmonary lesions in workers occupationally exposed to dust containing silica.

Craighead JE, Vallyathan NV.
Abstract
Fibrotic lesions associated with deposits of crystalline silica were found postmortem in the lungs of 15 granite workers who lacked radiological evidence of pneumoconiosis. All members of this occupational group had been employed in the granite quarrying and monument industry of Vermont since ambient air-dust standards were introduced in 1937. Although particulate silica was not revealed in the lesions by traditional polarization light microscopy, it was identified by scanning electron microscopy in conjunction with backscatter imaging and x-ray spectrometry. The etiologic basis of the fibrotic pulmonary disease would not have been diagnosed without the aid of these modern analytical tools. Exposure to silica-containing dust can result in cryptic pulmonary disease that is not
detectable radiologically. In these retrospective postmortem studies, it was not possible to define the distribution of the lesions in the lungs.

MeSH Terms Adult Air Pollutants, Occupational/analysis Autopsy Dust/analysis Humans Lung/pathology Male Middle Aged Pulmonary Fibrosis/radionuclide imaging Retrospective Studies Silicon Dioxide/analysis Silicosis/radionuclide imaging* Spectrometry, X-Ray Emission Vermont Substances Air Pollutants, Occupational Dust Silicon Dioxide
Prax Klin Pneumol. 1979 Apr;33 Suppl 1:627-32.
[Silicotuberculosis in Austria and the industrial injuries act (author's transl)].

[Article in German] Muhar F, Neuberger M, Raber A.
Abstract
The case material comprising all persons who developed silico-tuberculosis since it was listed as an occupational disease almost 50 years ago is analysed. The relationship between various occupations and the incidence of silicosis is reviewed with special reference to the most exposed group: the wokers in the granite quarries of Upper Austria. The changes in the clinical picture of the lesion, legal aspects, diagnostic difficulties in distinguishing between silicosis with or without complicating tuberculosis are discussed.

Publication Types English Abstract MeSH Terms Adult Austria Diagnosis, Differential Humans Middle Aged Occupational Diseases Silicosis/diagnosis Silicotuberculosis/diagnosis Silicotuberculosis/epidemiology* Workers' Compensation
Med J Malaysia. 1977 Jun;31(4):277-80.
The prevelance of silicosis among granite quarry workers, of the government sector, in Peninsular Malaysia.
Singh A. PMID: 927231 [PubMed - indexed for MEDLINE]
Related citations
MeSH Terms
MeSH Terms Adult Humans Malaysia Male Middle Aged Silicosis/epidemiology*
Am Rev Respir Dis. 1977 May;115(5):769-76.
Pulmonary function in granite dust exposure: a four-year follow-up.

Musk AW, Peters JM, Wegman DH, Fine LJ.
Abstract
Pulmonary function studies were performed on 974 workers in Vermont granite sheds in 1974. Of these subjects, 668 had been studied 4 years earlier and had remained in jobs in which their exposure to granite dust had not changed based on dust concentrations measured during 1970. The yearly decrement in pulmonary function observed in the 668 granite shed workers was excessive (0.07 to 0.08 liter per year for forced vital capacity and 0.05 to 0.07 liter per year for forced expiratory volume in 1 sec). This exceeded the expected decrement derived from several other occupational and population groups. Studies from this laboratory and published cross-sectional and longitudinal data consistently indicate a decrement of no more than 0.03 to 0.04 liter per year in both forced vital capacity and forced expiratory volume in 1 sec. The observed decrements were independent of exposure groups and not accounted for by cigarette smoking. In 528 additional granite shed workers, decrements in ventilatory capacity had been measured for one, 2, or 3 years and were consistently of the same order of magnitude. Dust concentrations within defined jobs and between granite sheds showed great variability. Despite this, a suggestive relationship between exposure and decrement in ventilatory function was demonstrated at the end of 2 years; however, at the end of 4 years the relationship could no longer be shown with these exposure groupings. The difficulty in characterizing individual dust exposures and projecting dust concentrations for several years is considered to account for the absence of a dose-response relationship at the 4-year follow-up. The results of this study suggest that our previous
estimates of annual deterioration in ventilatory capacity attributable to work in granite sheds are underestimates. We conclude that present dust concentrations in Vermont granite sheds cause excessive deterioration of lung capacity. To prevent these effects, dust concentrations must be lowered.

Publication Types Research Support, U.S. Gov't, Non-P.H.S. Research Support, U.S. Gov't, P.H.S. MeSH Terms Adult Environmental Exposure Follow-Up Studies Forced Expiratory Volume Humans Lung/physiopathology* Male Middle Aged Silicosis/complications Silicosis/physiopathology* Smoking/complications Vermont Vital Capacity
Scand J Work Environ Health. 1975 Jun;1(2):109-16.
A health survey of granite workers in Finland: radiographic findings, respiratory function, hearing, electric sensory thresholds of the fingers and subjective symptoms.
Ahlman K, Backman AL, Partanen T.
Abstract
Results from a health survey of 777 granite workers, exposed to quartz dust, noise and/or machine vibration, and 122 unexposed "controls" are reported. The survey included chest X-rays, pulmonary function tests, a hearing examination, the determination of the electric sensory thresholds of the fingers, and questionnaires on the subjective symptoms of the respiratory system and upper limbs. The exposed workers' radiographic findings (except for a 2.6 % rate of silicosis), respiratory functions, and sensory thresholds did not differ significantly from those of the controls. Granite drillers had a high prevalence of hearing defects. Respiratory symptoms were common among drillers and sandblasters, and subjective symptoms of the upper limbs due to vibration occurred among the granite dressing workers who used pneumatic hammers. Both primary and secondary measures of prevention are strongly recommended for the granite industry, primarlily for quartz dust exposure and its health effects.

MeSH Terms Adult Environmental Exposure Fingers/innervation Finland Galvanic Skin Response Hearing Disorders/etiology* Humans Male Middle Aged Noise/adverse effects* Occupational Diseases/chemically induced Occupational Diseases/etiology* Pulmonary Fibrosis/chemically induced Pulmonary Fibrosis/radiography Raynaud Disease/etiology* Respiratory Function Tests Respiratory Tract Diseases/chemically induced* Silicon Dioxide/toxicity* Silicosis/etiology Silicosis/radiography Vibration/adverse effects* Substances
Silicon Dioxide
Arch Environ Health. 1974 Jan;28(1):23-7.
Pulmonary function and roentgenographic changes in granite dust exposure.

Theriault GP, Peters JM, Johnson WM. PMID: 4357263 [PubMed - indexed for MEDLINE] Related citations

MeSH Terms Adult Dust* Environmental Exposure Humans Lung/radiography Male Middle Aged Respiration/drug effects* Silicon Dioxide/toxicity* Silicosis/etiology Silicosis/radiography* Smoking/complications Spirometry Statistics as Topic Time Factors Vermont Vital Capacity/drug effects Substances Dust Silicon Dioxide
Br J Ind Med. 1970 Apr;27(2):110-20.
Progressive silicosis in granite workers.
Grndorfer W, Raber A. PMID: 5428630 [PubMed - indexed for MEDLINE] PMCID: PMC1009084 Free PMC Article Related citations

MeSH Terms Adult Aged Air Pollution Austria Dust Humans Lung/radiography Male Middle Aged Mining* Occupational Diseases/epidemiology* Silicosis/epidemiology* Silicosis/radiography Silicotuberculosis/epidemiology Silicotuberculosis/radiography Substances Dust
J Trop Med Hyg. 1968 Oct;71(10):267-70.
Occupational hazards among granite workers in Ceylon.

Uragoda CG. PMID: 5685305 [PubMed - indexed for MEDLINE] Related citations
MeSH Terms
MeSH Terms Accident Prevention Accidents, Occupational* Adult Eye Injuries/epidemiology Female Finger Injuries/epidemiology Hand Injuries/epidemiology Humans Male Middle Aged Occupational Diseases/epidemiology* Silicosis/epidemiology* Sri Lanka Wounds and Injuries/epidemiology*
Rev Tuberc Pneumol (Paris). 1966 May-Jun;30(5):693-700.
[Medico-social aspects of tuberculopneumoconiosis in non-syphilitic and non-alcoholic granite workers].

[Article in French] Lambert J. PMID: 5955865 [PubMed - indexed for MEDLINE] Related citations
MeSH Terms
MeSH Terms Adult Humans Male Middle Aged Silicotuberculosis*
Br J Ind Med. 1965 Oct;22(4):285-90.
Silicosis from quarrying and working of granite.

Ahlmark A, Bruce T, Nystrm A. PMID: 5836568 [PubMed - indexed for MEDLINE] PMCID: PMC1069380
MeSH Terms
MeSH Terms Humans Mortality Silicosis/epidemiology* Silicotuberculosis/epidemiology Sweden
51. Ind Med Surg. 1964 Feb;33:73-8.
TWENTY-SIX YEARS' EXPERIENCE WITH DUST CONTROL IN THE VERMONT GRANITE INDUSTRY.
ASHE HB, BERGSTROM DE. PMID: 14123817 [PubMed - indexed for MEDLINE] Related citations

MeSH Terms Air Pollution* Dust* Mass Chest X-Ray*
Preventive Medicine* Silicon Dioxide* Silicosis* Statistics as Topic* Vermont* Substances Dust Silicon Dioxide
Prac Lek. 1963 Dec;15:426-31.
[SILICOSIS FOLLOWING WORK WITH SANDSTONE AND GRANITE].

[Article in Czech] JINDRICHOVA J. PMID: 14107390 [PubMed - indexed for MEDLINE]
MeSH Terms
MeSH Terms Czechoslovakia* Disability Evaluation* Radiography, Thoracic* Silicosis*
Br J Ind Med. 1963 Jul;20:218-25.
SILICOSIS IN WEST COUNTRY GRANITE WORKERS.

HALE LW, SHEERS G. PMID: 14046159 [PubMed - indexed for MEDLINE] PMCID: PMC1039203 Free PMC Article
MeSH Terms
MeSH Terms England* Silicosis*
Med J Malaya. 1961 Sep;16:46-80.
Granite quarrying and silicosis--being a report of a survey of silicosis in a granite quarry in Singapore.
KHOO OT, D'SOUZA EJ. PMID: 14455691 [PubMed - OLDMEDLINE] AMA Arch Ind Health. 1956 Jan;13(1):97-9.
RESURVEY of Vermont granite sheds and quarries.

[No authors listed] PMID: 13275142 [PubMed - indexed for MEDLINE] Related citations
MeSH Terms
MeSH Terms Silicosis/prevention & control*
Public Health Rep. 1955 Oct;70(10):983-5.
Silicosis and dust control; Vermont's granite industry.

ASHE HB. PMID:
13266952 [PubMed - indexed for MEDLINE] PMCID: PMC2024659

MeSH Terms Dust* Silicosis/prevention & control* Substances Dust
57. Occup Health (Auckl). 1951 Dec;11(12):183.
DECADE of surveys in Georgia granite sheds and quarries raise health standards.
[No authors listed] PMID: 14891106 [PubMed - indexed for MEDLINE] Related citations
MeSH Terms
MeSH Terms Silicosis/prevention & control*
Edinb Med J. 1951 Oct;58(10):457-80.
A survey of the granite industry in Aberdeen with reference to silicosis.
MAIR A. PMID: 14872808 [PubMed - indexed for MEDLINE] Related citations
MeSH Terms
MeSH Terms Silicosis/epidemiology* Silicosis/statistics & numerical data*
J Med Assoc Ga. 1948 Oct;37(10):393.
Silicosis control in the Georgia granite industries.

PETRIE LM. PMID: 18888623 [PubMed - OLDMEDLINE]

Silicosis and Granite

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Silicosis and Granite

Uploaded by

Copyright:

Available Formats

Pub Med search 2 July 2011 Silicosis AND granite

J Occup Environ Hyg. 2011 Feb;8(2):71-9.

Silica exposure assessment in a mortality study of Vermont granite workers.

PMID: 21229455 [PubMed - indexed for MEDLINE]

Publication Types, MeSH Terms, Substances

2. Occup Environ Med. 2011 May;68(5):312-8. Epub 2010 Sep 19.

Research Support, Non-U.S. Gov't

J Occup Environ Med. 2008 Jul;50(7):827-33.

PMID: 18617839 [PubMed - indexed for MEDLINE] Related citations

Publication Types, MeSH Terms, Substances

Rev Environ Health. 2007 Oct-Dec;22(4):255-72.

Chronic obstructive pulmonary disease and occupational exposure to silica.

PMID: 18351226 [PubMed - indexed for MEDLINE] Related citations

Publication Types, MeSH Terms, Substances

Occup Environ Med. 2007 Oct;64(10):681-7. Epub 2007 Apr 20.

Publication Types, MeSH Terms, Substances, Grant Support

J Public Health Policy. 2005 Jul;26(2):192-202; discussion 203-5.

PMID: 16022212 [PubMed - indexed for MEDLINE]

Publication Types, MeSH Terms, Substances, Grant Support

Am J Ind Med. 2004 Jul;46(1):89; author reply 90.

PMID: 15202130 [PubMed - indexed for MEDLINE]

Publication Types, MeSH Terms, Substances

J Occup Environ Med. 2004 May;46(5):459-66.

Vermont granite mortality study: an update with an emphasis on lung cancer.

PMID: 15167394 [PubMed - indexed for MEDLINE]

MeSH Terms, Substances

Am J Ind Med. 2004 Feb;45(2):129-38.

PMID: 14748044 [PubMed - indexed for MEDLINE]

MeSH Terms, Substances

Appl Occup Environ Hyg. 2002 Jun;17(6):424-9.

PMID: 12049432 [PubMed - indexed for MEDLINE]

Publication Types, MeSH Terms, Substances

granite Silicon Dioxide

Cancer Causes Control. 2001 Nov;12(9):773-84.

PMID: 11714104 [PubMed - indexed for MEDLINE]

Publication Types, MeSH Terms, Substances

Occup Environ Med. 2001 Jul;58(7):467-71.

Radiological progression and its predictive risk factors in silicosis.

PMID: 11404452 [PubMed - indexed for MEDLINE] PMCID: PMC1740153

MeSH Terms, Substances

J Occup Environ Med. 2001 Apr;43(4):412-7.

PMID: 11322102 [PubMed - indexed for MEDLINE] Related citations

Publication Types, MeSH Terms, Substances

Appl Occup Environ Hyg. 1999 Sep;14(9):577-82.

Silica exposure during granite countertop fabrication.

PMID: 10510518 [PubMed - indexed for MEDLINE] Related citations

Publication Types, MeSH Terms, Substances

Singapore Med J. 1996 Apr;37(2):160-4.

Occupational respiratory diseases in Singapore.

PMID: 8942254 [PubMed - indexed for MEDLINE] Related citations

Int J Epidemiol. 1995 Dec;24(6):1154-61.

PMID: 8824857 [PubMed - indexed for MEDLINE]

Publication Types, MeSH Terms, Substances, Grant Support

Chest. 1994 Jul;106(1):125-30.

Longitudinal pulmonary function losses in Vermont granite workers. A reevaluation.

PMID: 8020257 [PubMed - indexed for MEDLINE]

Publication Types, MeSH Terms, Substances, Grant Support

[Silicosis in the granite industry].

Publication Types, MeSH Terms, Substances

Br J Ind Med. 1993 Oct;50(10):907-12.

Further evidence of human silica nephrotoxicity in occupationally exposed workers.

MeSH Terms, Substances

20. Br J Ind Med. 1993 Aug;50(8):726-31.