title: Silica exposure and disease in semi-precious stone craftsmen, Minas Gerais, Brazil.
abstract: BACKGROUND
  Brazil is an exporter of precious stones and craftsmen often work in poor conditions. We assessed silica-related diseases among crystal craftsmen and the complexity of its control.
  
  
  METHODS
  Case-series including 118 subjects evaluated from 2006 to 2015, based on medical interviews, chest X-rays, spirometry, and respirable silica samples.
  
  
  RESULTS
  Median age and length of exposure were 32 and 13 years, respectively. Silicosis, with 1/0 as a threshold, was diagnosed radiologically in 57 individuals (48.3%). Respirable silica concentrations were 0.9-29.3 times greater than the Brazilian occupational exposure limit. A Receiver Operating Characteristic (ROC) curve with the same diagnosis threshold showed best discrimination at a cut point of 12.5 years of exposure, corresponding to 4.85 mg-y/m3of cumulative silica exposure. There was a significant decline in FEV1across radiological and cumulative silica exposure categories. Eleven individuals (9.3%) had mycobacterial diseases at baseline or follow-up.
  
  
  CONCLUSIONS
  Crystal craftsmen continue to suffer from silicosis, lung function impairment, comorbidity, and death due to silicosis. To date collective protection in some work sheds has not diminished silica levels. Long-term follow-up is needed to evaluate further improvements in preventive measures. Am. J. Ind. Med. 60:239-247, 2017. © 2017 Wiley Periodicals, Inc.
authors.affiliation: State Workers' Health Service, The Clinics Hospital, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Ana Paula S
authors.initials: AP
authors.lastname: Carneiro
authors.affiliation: Interdisciplinary Laboratory for Medical Research, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Nayara F T
authors.initials: NF
authors.lastname: Braz
authors.affiliation: Division of Medicine, FUNDACENTRO, São Paulo, São Paulo, Brazil.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Algranti
authors.affiliation: School of Medicine, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil.
authors.forename: Olivia M P A
authors.initials: OM
authors.lastname: Bezerra
authors.affiliation: Department of Biological Sciences, Experimental Pathophysiology Laboratory, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil.
authors.forename: Natália P S
authors.initials: NP
authors.lastname: Araujo
authors.affiliation: Division of Occupational Hygiene, FUNDACENTRO-CRMG, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Lênio S
authors.initials: LS
authors.lastname: Amaral Eng Hyg
authors.affiliation: Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on human health), Lille, France.
authors.forename: Jean L
authors.initials: JL
authors.lastname: Edmé
authors.affiliation: Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on human health), Lille, France.
authors.forename: Annie
authors.initials: A
authors.lastname: Sobaszek
authors.affiliation: Univ. Lille, CHU Lille, Institut Pasteur de Lille, EA4483 - IMPECS (IMPact of Environmental ChemicalS on human health), Lille, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Chérot-Kornobis
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005541:Forced Expiratory Volume; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects* / Q000032:analysis; D055498:Jewelry; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D011859:Radiography; D012822:Silicon Dioxide / Q000032:analysis / Q000633:toxicity*; D012829:Silicosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D013147:Spirometry
chemical_list: D012822:Silicon Dioxide
keywords: occupational exposure; silicosis; spirometry; stone craftsmen; tuberculosis