September 2021 additions to NERDB

September 2021 additions to NERDB

NERDB is the New and emerging risks database. This bibliographic database is an initiative of Nicole Palmen and Annet Lenderink with the support of Modernet and is currently powered by Airtable.

More information on this database on the NERDB page

On the website, we will publish regular updates on new disease-exposure combinations we added to the database. Currently, we have 312 entries. Ordered by year in which the abstract is published

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Last new entries:

Pouring concrete van annawaldl via Pixabay

Rahimi Moghadam S, Khanjani N, Mohamadyan M, Emkani M, Yari S, Layegh Tizabi MN, Ganjali A. Changes in Spirometry Indices and Lung Cancer Mortality Risk Estimation in Concrete Workers Exposed io Crystalline Silica. Asian Pac J Cancer Prev. 2020 Sep 1;21(9):2811-2817. doi: 10.31557/APJCP.2020.21.9.2811. PMID: 32986385; PMCID: PMC7779439.

The health of workers in the concrete and cement industries can be at risk due to occupational exposure to silica dust. The purpose of this study was to evaluate the changes in pulmonary parameters and risk of mortality from lung cancer in concrete workers exposed to crystalline silica.

This cross-sectional study was performed on 72 male workers exposed to silica at a concrete manufacturing plant in Neyshabur, Iran. Respiratory zone air sampling was performed using the standard NIOSH7602 method using individual sampling pumps and membrane filters. Then, the amount of silica in the samples was determined using the Fourier Transform Infrared technique. The risk of death from lung cancer was determined using Rice et al.’s model. Respiratory indices were measured using a spirometer. Data were analyzed by the SPSS 20 software.

Occupational exposure to silica was 0.025 mg/m3 and mortality was estimated to be 7-94 per thousand. All spirometry indices significantly decreased during these 4 years of exposure to silica dust. The respiratory pattern of 22% of the exposed workers was obstructive, and this prevalence was significantly higher than the control group.

The results showed that although the average occupational exposure to silica in these concrete workers was below the recommended threshold of national and international organizations, their risk of death was significantly higher; and workers’ lung indices had significantly decreased over four years. Therefore, appropriate measures should be taken to reduce silica exposure among these workers.

Beijer, E., Meek, B., Bossuyt, X. et al. Immunoreactivity to metal and silica associates with sarcoidosis in Dutch patientsRespir Res 21, 141 (2020).

The involvement of metals or silica in the pathogenesis of sarcoidosis has been suggested by several case reports and specific epidemiological studies. However, the combination of occupational exposure and an immunological reaction has not been studied before in a group of sarcoidosis patients and non-sarcoidosis controls.

In 256 sarcoidosis patients and 73 control patients with obstructive sleep apnea, exposure to metal and silica was assessed using a questionnaire consisting of a complete occupational history subsequently linked to job-exposure matrices. Next, immunoreactivity to aluminum, beryllium, zirconium, and silica was determined in 33 sarcoidosis and 19 control patients using a lymphocyte proliferation test.

In sarcoidosis, 83 out 256 patients (32.4%) had occupational exposure to metals or silica, compared to 24.7% in the control group (p = 0.21). A significantly higher percentage of the sarcoidosis patients tested showed immunoreactivity to metals or silica compared to the control group (21.2 and 0% respectively, p = 0.039).

Immunoreactivity to silica and metals was only found in sarcoidosis patients, supporting the hypothesis that these antigens may be involved in the pathogenesis of a distinct subgroup of sarcoidosis patients. This indicates that when searching for causative agents in sarcoidosis patients, besides beryllium, also zirconium, aluminum, and silica deserve clinical investigation.

N Magnavita, R R Di Prinzio, P M Soave, Systemic sclerosis in an anaesthetistOccupational Medicine, Volume 70, Issue 6, August 2020, Pages 442–444

Systemic sclerosis is a potentially devastating disease in which the etiology and pathogenesis have not yet been fully understood. It has been associated with occupational exposure to silica, vinyl chloride, solvents and other chemical agents.

Case summary: In this paper, the authors present the case of an anesthetist who developed scleroderma after occupational exposure to volatile anesthetic gases (halothane, sevoflurane, isoflurane and enflurane) in operating theaters with poor scavenging systems. The possible causal link between occupational exposure and the disease is discussed.

The case reported is the second that they were aware of in recent years. Reporting scleroderma cases in workers may be the first step in assessing the causal link between occupational exposure to anesthetic gases and the disease.

Rao N, Bendall A, Lanteri M. ANCA vasculitis and IgA nephropathy linked to silica exposure. Occup Med (Lond). 2020 Sep 9;70(6):445-448. doi: 10.1093/occmed/kqaa122. PMID: 32678425.

There is a recognized association between silica exposure and Antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV); however, no clear association between silica exposure and Immunoglobulin A (IgA) nephropathy.

The authors describe the case of a 26-year-old male stonemason who presents with hilar lymphadenopathy, haematuria and acute kidney injury related to silica exposure, AAV, and IgA nephropathy. He was asymptomatic on presentation; urinalysis revealed glomerular haematuria (>1000 red blood cells/L) and proteinuria (protein-to-creatinine ratio 84 mg/mmol). ANCA anti-myeloperoxidase serology was strongly positive. Mediastinal lymph node biopsy revealed multiple necrotizing granulomas with silica inclusions, and renal biopsy demonstrated crescentic glomerulonephritis and mesangial IgA staining.

The patient was treated with cyclophosphamide and high-dose prednisolone, with subsequent improvement in renal function. To our knowledge, this is the first report of both ANCA vasculitis and IgA nephropathy in the setting of silica exposure. This case highlights the relevance of occupational exposures in renal disease and the immune-stimulatory effect of silica.



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