8287288 The epidemiology of artificial stone silicosis

<h3>Objective</h3> Cases of artificial stone (AS) silicosis caused by inhalation of respirable crystalline silica dust derived from engineered or artificial stone primarily used in kitchen and bathroom worktops have risen in the last 15 years. This presentation will summarise the global epidemiology of AS silicosis. <h3>Methods</h3> A literature search was carried out and the findings summarised including data on incidence of AS silicosis, demographics, occupational exposures and clinical outcomes. <h3>Results</h3> Since first reported in 2010 in Spain, the incidence of AS silicosis has increased rapidly with case series now published from Italy, Israel, Australia, USA, China, Belgium and the UK. The size of the exposed workforce is estimated to be over 100,000 in the USA alone. Over 1000 cases have been reported globally but are likely underestimated with large-scale screening programmes using CT scans identifying a prevalence of up to 28% in exposed workers in Australia. In each country both the epidemic curve and the clinical pictures are strikingly similar. Typically, it affects young male workers in their 30s and 40s working in worktop fabrication and installation roles and who are often migrant workers. Compared with silicosis from natural stone, AS silicosis is associated with a high prevalence of acute and accelerated disease, disease progression to progressive massive fibrosis and need for lung transplant. Key risk factors include dry cutting, inadequate ventilation and inappropriate or no respiratory protection. Emerging clusters have also been linked to small-scale, informal workshops lacking regulatory oversight. <h3>Conclusion</h3> AS silicosis is a preventable occupational health crisis and cases are likely to continue to rise globally. Under-recognition and under-reporting of cases is likely to be high. Urgent action is required to reduce workers’ exposures and implement comprehensive screening programs to reduce disease burden and prevent further cases.