8289217 The case finding pathway for engineered stone-associated silicosis in New Zealand

<h3>Objective</h3> Engineered stone (ES) associated silicosis has killed young stonemasons around the world. In response, the New Zealand Accelerated Silicosis Assessment Pathway was implemented to ensure asymptomatic workers at risk of early disease are offered free health assessment and support to access services. We are conducting a study which aims to describe the exposure circumstances and health outcomes for all workers on the pathway including a case series of ES-associated silicosis in NZ diagnosed between 2019-24. <h3>Material and Methods</h3> For all pathway workers, the exposure and healthinformation will be analysed at a descriptive level and related to clinical outcome i.e. current silicosis (yes/no) and/or clinical abnormalities (yes/no), using lung-function, chest x-ray, CT scan, and blood biomarkers. Diagnoses of silicosis are made via a national Silica Multi-Disciplinary Meeting (MDM). To date, we have conducted descriptive analyses of a subset of MDM cases referred to Christchurch hospital since 2019 (reported here) with the full MDM case series being presented at the conference. <h3>Results</h3> From 222 workers entering the pathway (of ~1000 exposed workers), the majority were aged 25-59 years. About one quarter of these were referred to the MDM which resulted in 26 silica-related disease cases. The Christchurch subset (n=8) included four definite silicosis (one complicated progressive), three possible simple silicosis (with co-existing airways disease) and one silicolymphadenopathy. The age range at diagnosis was 32-62 years with an average duration of working with ES of 9 years (range 3-16; all dry cutting).Five were never smokers and 75% were born outside of NZ.. All but one had normal chest x-rays and spirometry at baseline and stability on CT thereafter. <h3>Conclusion</h3> This study will describe the first cases of engineered stone-associated silicosis in NZ and despite pathway uptake generally being poor, results will help answer key questions related to health outcomes of respirable crystalline silica exposure.