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Query: UMLS:C0037116 (silicosis)
 1,822 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Silicosis, an interstitial lung disease prevalent among miners, sand blasters, and quarry workers, is manifested as a chronic inflammatory response leading to severe pulmonary fibrotic changes. Proinflammatory cytokines, such as TNFalpha and IL-1, produced in the lung by type II epithelial cells and alveolar macrophages, have been strongly implicated in the formation of these lesions. Recently, a number of single nucleotide polymorphisms (SNPs), which quantitatively affect mRNA synthesis, have been identified in the TNFalpha promoter and IL-1 gene cluster and their frequency is associated with certain chronic inflammatory diseases. To assess the role of these SNPs in silicosis, we examined their frequency in 325 ex-miners with moderate and severe silicosis and 164 miners with no lung disease. The odds ratio of disease for carriers of the minor variant, TNFalpha (-238), was markedly higher for severe silicosis (4.0) and significantly lower for moderate silicosis (0.52). Regardless of disease severity, the odds ratios of disease for carriers of the IL-1RA (+2018) or TNFalpha (-308) variants were elevated. There were no significant consistent differences in the distribution of the IL-1alpha (+4845) or IL-1beta (+3953) variants with respect to disease status. In addition, several significant gene-gene and gene-gene-environment interactions were observed. Different associations between moderate cases and controls versus severe cases and controls were also observed in a number of these multigene comparisons. These studies suggest that gene-environment interactions involving cytokine polymorphisms play a significant role in silicosis by modifying the extent of and susceptibility to disease.
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PMID:Association of tumor necrosis factor-alpha and interleukin-1 gene polymorphisms with silicosis. 1126 25

Silicosis is a crippling fibrotic lung disease induced by inhaling crystalline silica. In addition to fibrosis, silica inhalation by humans is associated with a number of immunological effects including increased levels of serum immunoglobulins (in particular IgG), increased prevalence of autoantibodies, and autoimmune disease. Recent studies using rodent models have shown that experimental silicosis is associated with a T-helper (TH)1 pattern of T-cell activation in the lungs and lung-associated lymph nodes after silica inhalation, which are also the sites of increased IgG production. We therefore hypothesized that the subclass distribution of IgG production occurring in experimental silicosis would suggest TH1 activation as the primary stimulus for IgG production. Using an ELISPOT assay, we found increased IgG-secreting spot-forming cells of all IgG subclasses in lung-associated lymph nodes taken from silica-exposed rats 3 to 4 months after aerosol exposure to silica. Neither TH1- nor TH2-dependent IgG subclass-secreting cells were selectively enhanced. Our findings suggest that TH1 activation alone does not account for increased production of IgG in experimental silicosis.
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PMID:IgG subclass responses in experimental silicosis. 1157 Jun 75

This review sets out to define the role of surgical biopsy in the diagnosis and prognosis of diffuse parenchymal lung disease, the pros and cons of each procedure and the interpretation of the results in the context of clinical and other investigative data. Surgical lung biopsy remains the investigation with the greatest overall diagnostic sensitivity for diffuse parenchymal lung disease. Rates of diagnosis are approximately 90-95%, compared with approximately 70% for both high-resolution computed tomography (HRCT) and transbronchial biopsy. Although open lung biopsy, and more recently videoassisted thoracoscopic surgery, have good safety records, neither technique has been utilised as frequently as might be expected, with wide regional variation for various reasons. More recently, HRCT used in conjunction with clinical and other investigative modalities, has increased the accuracy of diagnosis for some diseases, including the majority of cases of cryptogenic fibrosing alveolitis (HRCT & bronchoalveolar lavage), Langerhans' cell histiocytosis (HRCT), lymphangioleiomyomatosis (HRCT), and silicosis (HRCT). At present, the vasculitides and the idiopathic interstitial pneumonias, other than cryptogenic fibrosing alveolitis, always require a surgical biopsy. As experience with high resolution computed tomography grows, it is possible that other diseases will be able to be diagnosed without surgical biopsy. These newer modalities of investigation do have appreciable limitations and where sufficient doubt exists about diagnosis, surgical lung biopsy must continue to be utilised.
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PMID:Lung biopsy in diffuse parenchymal lung disease. 1166 2

Concrete is an extremely important part of the infrastructure of modern life and must be replaced as it ages. Many of the methods of removing, repairing, or altering existing concrete structures have the potential for producing vast quantities of respirable dust. Since crystalline silica in the form of quartz is a major component of concrete, airborne respirable quartz dust may be produced during construction work involving the disturbance of concrete, thereby producing a silicosis hazard for exposed workers. Silicosis is a debilitating and sometimes fatal lung disease resulting from breathing microscopic particles of crystalline silica. Between 1992 and 1998, the National Institute for Occupational Safety and Health (NIOSH) made visits to construction projects where concrete was being mechanically disturbed in order to obtain data concerning respirable crystalline silica dust exposures. The construction activities studied included: abrasive blasting, concrete pavement sawing and drilling, and asphalt/concrete milling. Air samples of respirable dust were obtained using 10-mm nylon cyclone pre-separators, 37-mm polyvinyl chloride (PVC) filters, and constant-flow pumps calibrated at 1.7 L/min. In addition, high-volume respirable dust samples were obtained on 37-mm PVC filters using 1/2" metal cyclones (Sensidyne model 18) and constant-flow pumps calibrated at 9.0 L/min. Air sample analysis included total weight gain by gravimetric analysis according to NIOSH Analytical Method 600 and respirable crystalline silica (quartz and cristobalite) using x-ray diffraction, as per NIOSH Analytical Method 7500. For abrasive blasting of concrete structures, the respirable crystalline silica (quartz) concentration ranged up to 14.0 mg/m3 for a 96-minute sample resulting in an eight-hour time-weighted average (TWA) of 2.8 mg/m3. For drilling concrete highway pavement the respirable quartz concentrations ranged up to 4.4 mg/m3 for a 358-minute sample, resulting in an eight-hour TWA of 3.3 mg/m3. For concrete wall grinding during new building construction the respirable quartz measurements ranged up to 0.66 mg/m3 for a 191-minute sample, resulting in an eight-hour TWA of 0.26 mg/m3. The air sampling results for concrete sawing ranged up to 14.0 mg/m3 for a 350-minute sample resulting in an eight-hour TWA of 10.0 mg/m3. During the milling of asphalt from concrete highway pavement, the sampling indicated a respirable quartz concentration ranging up to 0.34 mg/m3 for a 504-minute sample, resulting in an eight-hour TWA of 0.36 mg/m3. The results of this work indicate the potential for respirable quartz concentrations involving disturbance of concrete to range up to 280 times the NIOSH Recommended Exposure Limit (REL) of 0.05 mg/m3 assuming exposure for an eight- to ten-hour workday. Considering the aging of the concrete infrastructure in the United States, these results pose a challenge to all who have an interest in preventing silica exposures and the associated disease silicosis.
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PMID:Respirable concrete dust--silicosis hazard in the construction industry. 1187 57

The Transkei is one of two regions from which a majority of South African mine workers used to be recruited, and the destination to which many return. The study was done to determine the prevalences of lung diseases in these ex-workers, links between these diseases and age, links between diseases and duration of mining, and the association between silicosis and tuberculosis. It was done in Umtata General Hospital. Participants' (n = 300) ages ranged from 35 to 66+ years (mean 51.6). Durations of mining ranged from < 1 to 31+ years. 29/300 X-rays (9.6%) were unreadable; 59 (21.8%) were disease-free; and 212 (78.2%) showed lung abnormalities. Pulmonary tuberculosis (PTB) with or without silicosis was evident in 64.2% of the x-rays, silicosis with or without PTB in 34%, COPD in 7%, and asbestosis in 1.5%. The relative risk for tuberculosis was 5.08 (2.58-9.88) for men with silicosis compared with others, p < 0.01. The extremely high burden of lung disease in ex-mine workers places enormous challenges on health service delivery systems and compensation authorities.
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PMID:Patterns of lung diseases in former mine workers of the former Republic of the Transkei: an X-ray-based study. 1201 76

Over the last decade the role of genetic data in epidemiological research has expanded considerably. We recently published a case-control study that evaluated the interaction between silica exposure and minor variants in the genes coding for interleukin-1alpha (IL-1alpha), interleukin-1 receptor antagonist (IL-1RA) and tumor necrosis factor alpha (TNFalpha) as risk factors associated with silicosis, a fibrotic lung disease. In contrast, this report uses data generated from these studies to illustrate the utility of genetic information for the purposes of risk assessment and clinical prediction. Specifically, this study will address how, given a known exposure, genetic information affects the characterization of risk groups. Relative operating characteristic (ROC) curves were then used to determine the impact of genetic information on individual classification. Logistic regression modeling procedures were used to estimate the predicted probability of developing silicosis. This probability was then used to construct predicted risk deciles, first for a model with occupational exposure only and then for a model containing occupational exposure and genetic main effects and interactions. Results indicate that the exposure-only model effectively captures an increasing relationship between predicted risk deciles and prevalence of observed silicosis cases. Individuals comprising the highest risk decile were almost four times as likely to have silicosis as opposed to the lowest risk decile. The addition of genetic data, however, substantially improved characterization of risk categories; the proportion of cases in the highest risk decile was almost eight times that in the lowest risk decile. However, the ROC curve and classification analysis demonstrated that the addition of genetic main effects and interactions did not significantly impact on prediction of the individual's case status. These results indicate that genetic information plays a valuable role in effectively characterizing risk groups and mechanisms of disease operating in a substantial proportion of the population. However, in the case of fibrotic lung disease caused by silica exposure, information about the presence or absence of the minor variants of IL-1alpha, IL-1RA and TNFalpha is unlikely to be a useful tool for individual classification.
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PMID:Significance of genetic information in risk assessment and individual classification using silicosis as a case model. 1217 6

Diffuse parenchymal lung disease (also known as interstitial lung disease) and acute irritant reactions are much less commonly managed by primary care physicians than asthma. Acute irritant reactions are typically readily recognized because of the immediate exposure-response relationship. As with asthma, a diagnosis of diffuse parenchymal lung disease should prompt a careful review of the patient's work history. Findings from history taking and radiography provide most of the data needed to establish a diagnosis of asbestosis or silicosis. A pulmonologist should be consulted about lung disease that eludes diagnosis. In cases in which a link between work and illness is strongly suspected, an occupational medicine specialist may be consulted for assistance with preparing reports for a workers' compensation claim as well as characterizing and quantifying impairment. Various government agencies provide extensive information about specific toxic exposures and occupational lung diseases by telephone and on the World Wide Web.
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PMID:Occupational lung disease. Part 2. Discovering the cause of diffuse parenchymal lung disease. 1271 37

Upper lobe fibrotic lung disease is most often associated with sarcoidosis, Langerhans cell histiocytosis, silicosis, and other pneumoconioses but is usually not associated with drug-induced lung disease. Carmustine (BCNU) is a chemotherapeutic agent known to cause pulmonary toxicity. The radiographic pattern is usually diffuse bilateral lung disease predominantly in the lung bases. Upper lobe fibrotic disease associated with BCNU has been reported to occur in children treated for central nervous system gliomas. Often the lung disease occurs years after the exposure. Despite the widespread use of BCNU in the treatment of malignancy in adults, to our knowledge, the complication of upper lobe fibrotic disease has not been reported in adults. We describe a patient who presented with pneumothorax and bilateral upper lobe pulmonary fibrosis that we believe was due to BCNU given for bone marrow transplantation as part of therapy for breast cancer. Bilateral upper lobe pulmonary fibrosis can be associated with chemotherapeutic drugs.
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PMID:Upper lobe pulmonary fibrosis associated with high-dose chemotherapy containing BCNU for bone marrow transplantation. 1274 52

Silicas and silicates are some of the most abundant compounds found naturally in the earth's crust. Excessive exposure to crystalline silicas can cause serious lung disease such as silicosis and has been associated with lung cancer in some studies, but the potential health effects of amorphous silicas (silicon dioxide without crystalline structure) have not been well studied. Results from animal studies of amorphous silicas, unlike those seen with crystalline silicas, have suggested limited and largely reversible cytotoxic and possibly fibrogenic effects associated with some forms, but data on cancer outcomes are scanty and for the most part negative. Epidemiologic investigations to date for any potential cancer risk are not informative because the effects of crystalline and amorphous silicas have not been separated. Any future epidemiologic study should attempt to clarify the health effects of amorphous silicas from those of crystalline silicas, particularly with regard to any potential for carcinogenicity.
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PMID:Amorphous silica: a review of health effects from inhalation exposure with particular reference to cancer. 1527 29

The relationship between silicosis and tuberculosis is well known. Also other mycobacteria such as Mycobacterium kansasii often occur in association with pneumoconiosis. However, there are few reports describing an association of M. avium-intracellulare complex (MAC) lung disease and pneumoconiosis. The purpose of the present study is to describe clinical features of MAC respiratory infection associated with pneumoconiosis. Eleven patients with MAC respiratory infection associated with pneumoconiosis (all men, 6 with silicosis and 5 with welders' pneumoconiosis) were collected. A determination of whether or not MAC caused pulmonary disease was made using the 1997 criteria required by the American Thoracic Society. Radiologically, cavity formation as well as upper lung field predominance of MAC disease were observed in 8 of 11 cases (72.7%). Two of 11 patients died of respiratory failure. Our present study clearly demonstrates that clinical features of MAC respiratory infection associated with pneumoconiosis were different from MAC without underlying diseases.
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PMID:Clinical features of eleven cases of Mycobacterium avium-intracellulare complex pulmonary disease associated with pneumoconiosis. 1530 35


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