Engineered stone countertop workers may have atypical silicosis pattern
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Key takeaways:
- This population consisted of Hispanic men.
- A small proportion were initially identified with silicosis by radiologists.
- A little over one-third had a restrictive pattern on pulmonary function testing.
Close to 40% of Hispanic men employed as engineered stone countertop workers with silicosis had an atypical pattern of the disease on CT imaging, according to research presented at the Radiological Society of North America Annual Meeting.
“[This patient population] all presented with silicosis, a disease that has been characterized for over 100 years and is entirely preventable with the appropriate equipment and ventilation,” Sundus S. Lateef, MD, diagnostic radiology resident at the University of California in Los Angeles (UCLA), told Healio. “The majority had atypical imaging findings for silicosis, which may catch the providers and radiologists off-guard.”
In a cross-sectional pilot study, Lateef and colleagues assessed 54 Hispanic men (median age, 47 years) from the Olive-View UCLA Medical Center who reported being engineered stone countertop workers diagnosed with silicosis (median silica dusts exposure, 19 years) to determine how many individuals were identified as having the disease by a radiologist and how many individuals had atypical CT imaging features.
“The workers included in this study are all Spanish-speaking, immigrant workers in the Southern California engineered stone countertop industry,” Lateef told Healio. “The U.S. Occupational Safety and Health Administration has limited permissible exposure to 0.05 mg/m3 for silica, but many workplaces do not comply with these standards. We must better advocate for these vulnerable patient populations.”
Within the total cohort, 81% experienced symptoms. Dyspnea was the most frequently reported symptom (80%), followed by cough (63%), according to Lateef.
Nineteen percent of the population had initially been identified as having silicosis by radiologists. Despite this low percentage, researchers also found that in most cases, radiologists noted mycobacterial/atypical infection and other diagnoses during this initial encounter.
When asked to determine whether an individual’s pattern of silicosis on CT was typical or atypical (“diffuse nodularity, multiple cavitary lesions, ground-glass/mosaic attenuation and/or crazy paving”), Lateef told Healio a slightly higher proportion of individuals had an atypical pattern based on agreement from two B-reader radiologists (37% vs. 33%).
“We hope to increase awareness of this unique disease presentation,” Lateef said.
Researchers also evaluated pulmonary function tests and found that 35% of the population had a restrictive pattern.
Further, diffusing capacity of the lungs for carbon monoxide (DLCO) was 18.6% predicted among those with opacities greater than 1 cm, a significantly (P < .001) lower value compared with those without opacities of this size (24.9% predicted), according to Lateef.
Looking ahead, Lateef outlined plans for study expansion.
“Not only do we aim to characterize the existing cohort of patients with silicosis at Olive View-UCLA Medical Center in Sylmar, California, but we intend to expand our study,” Lateef said. “We are part of the California Artificial Stone and Silicosis Project, which aims to improve screening and advocacy for workers in these industries.”
Reference:
- Countertop workers exposed to serious lung disease. https://press.rsna.org/timssnet/media/pressreleases/14_pr_target.cfm?ID=2542. Published Dec. 2, 2024. Accessed Dec. 2, 2024.
For more information:
Sundus S. Lateef, MD, can be reached at slateef@mednet.ucla.edu.