In what could be a preview of an even greater disease burden for those workers in the artificial stone benchtop industry, Monash researchers have conducted a large study finding that those workers exposed to silica dust show a higher incidence of blood markers that are the hallmark of autoimmune diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE).
The researchers looked for symptoms or diagnoses of autoimmune disease as well as markers in the blood that could indicate early stages of autoimmune disease.
Amongst the 1238 workers 0.9% were confirmed with autoimmune disease, however almost one quarter (24.6%) had detectable anti-nuclear antibodies – 24.6% compared to less than 6% in similarly aged male controls.
This data suggests that – as well as screening for silicosis in these workers, they should also be screened for autoimmune disease, as these individuals need specialised management and may be entitled to compensation.
Autoimmune diseases, autoantibody status and silicosis in a cohort of 1238 workers from the artificial stone benchtop industry
Objectives Autoimmune disorders are multifactorial but occupational exposures have long been implicated, including respirable crystalline silica (RCS). A modern epidemic of silicosis is emerging internationally, associated with dry processing of engineered stone with high (>90%) RCS content. We aimed to investigate the prevalence of clinical autoimmune disease and common autoantibodies in exposed workers.
Conclusion The proportion of workers with detectable ANAs or ENAs was considerably higher than the 5%–9% expected in the general population. Some of the antibodies detected (eg, Scl-70, CENPB) have high sensitivity and specificity for systemic sclerosis. Long-term follow-up will be needed to estimate incidence. Rheumatologists should explore occupational history in new cases of autoimmune disease. Screening for autoimmune disease is indicated in workers exposed to RCS as these individuals need specialised management and may be entitled to compensation.