| Causes of Scleroderma (MAIN MENU) | | | |
| Causes of Scleroderma: Silica Exposure |
| This page was written by Shelley Ensz and has not yet been medically edited. |
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| Overview of Silica Exposure |
| Silica exposure can cause autoimmune diseases such as lupus, scleroderma, and vasculitis. It can also cause silicosis, kidney disease, lung cancer, tuberculosis, and other airways diseases. Environmental exposure to silica can occur in workers and bystanders in many industries, including agriculture, construction, and potters. |
| Materials Containing Silica | | Silica occurs in the following materials, but there is a potential for danger ONLY when crystalline silica particles are in the air. If you can answer YES to any of these, then it is likely that Silica is used at your work and that it is airborne. | Abrasives
Coal Dust
Concrete
Dirt
Filter Aids
Graphite, natural
Mica
Mineral Products
Paints
Pavement | Perlite
Plant Materials
Plastic Fillers
Polishing Compounds
Portland Cement
Sands
Silicates
Slag
Soapstone
Soil | Source: Occupational Safety & Health Administration (OSHA).
Read more... | |
| Silica occurs as a natural component of many materials used or encountered in construction activities. Crystalline silica is present in substantial quantities in sand, sandstone and granite, and often forms a significant proportion of clay, shale and slate. It can also be found in chalk, limestone and other rock and soil. Products such as concrete and mortar also contain crystalline silica. 2003, Health and Safety Executive. |
Silica Exposure
can occur to workers and bystanders in the following type of industries: | abrasives (manufacturing and use)
agriculture
ceramics, clay, pottery
construction
detergent manufacturing
foundry work
glass manufacturing | masonry work
mining
railroad construction
sandblasting
shipbuilding
soap making
stone cutting | | Source: National Institute for Occupational Health and Safety. Read more... | |
| Silica. At least 1.7 million U.S. workers are exposed to respirable crystalline silica in a variety of industries and occupations, including construction, sandblasting, and mining. Occupational exposures to respirable crystalline silica are associated with the development of silicosis, lung cancer, pulmonary tuberculosis, and airways diseases. These exposures may also be related to the development of autoimmune disorders, chronic renal disease, and other adverse health effects. CDC National Institute for Occupational Health and Safety. |
| Health Effects of Occupational Exposure to Respirable Crystalline Silica Occupational exposures to respirable crystalline silica are associated with the development of silicosis, lung cancer, pulmonary tuberculosis, and airways diseases. These exposures may also be related to the development of autoimmune disorders, chronic renal disease, and other adverse health effects. Publication No. 2002-129, April 2002, NIOSH Hazard Review. |
| Silica Flour The risk of developing silicosis may be very high for workers exposed to silica flour. Silica flour is used industrially as an abrasive cleaner and as an inert filler. It is found in toothpaste, scouring powder, and metal polish, paint, wood fillers, road surfacing mixtures, and foundry processes. Workers in industries that use silica flour may be unaware that it is a hazardous material because of either the absence of labelling or the mislabelling of silica flour containers. 1987 Bulletin, NIOSH. |
| Silica and Silicosis |
| Understanding a complex killer. Respirable silica, a material present in cement construction products, including roof tiles, has been a known occupational health hazard for more than a century. Silicosis has been associated with other connective tissue diseases such as rheumatoid arthritis, scleroderma, lupus and sarcoidosis. In addition, it has been linked with various kidney disorders. Professional Roofing Magazine. August 2005. |
| Silicosis Epidemics The worst epidemic of silicosis occurred in 1930-1931, during the construction of Gauley Bridge tunnel in West Virginia; more than 400 of the estimated 2000 men who drilled rocks died of silicosis, and almost all the survivors developed silicosis. eMedicine. |
| Silica and Lupus |
| Silica accelerated systemic autoimmune disease in lupus-prone New Zealand mixed mice. Lungs of the silica-exposed mice had increased inflammatory infiltrates as well as fibrotic lesions characterized by excess collagen deposition. Silica exposure significantly exacerbated the course of disease. PubMed. Clin Exp Immunol 2003 Mar;131(3):415-21. (Also see: Lupus) |
| Silica and Scleroderma |
| What is Scleroderma? ISN. |
| Brochure: What is Scleroderma? (PDF Format) Includes a symptom checklist for systemic scleroderma. International Scleroderma Network. |
| Occupational exposure and systemic sclerosis. Literature review and result of a self-reported questionnaire. Occupational exposure (labour and leisure) must be searched for when faced with a scleroderma patient for two reasons: the possible declaration of an occupational disease and a better knowledge on toxics involved in scleroderma. Granel B (PubMed) Rev Med Interne. 2008 Nov;29(11):891-900. (Also see: Causes of Scleroderma: Solvents) |
| Genetic basis for systemic sclerosis. Investigations into the genetics of systemic sclerosis may shed light on the complex pathophysiology of this disease, help to identify factors that predict organ involvement, and suggest new treatment strategies. Science Direct. Oct 2007. (Also see: Causes of Scleroderma: Genetics, Solvents, and Environmental Factors) |
| Silica and the immune system. In view of the double involvement of the Innate and the Adaptive Immune Systems and their cooperation in the stimulation of fibrosis, Silicosis can be considered as a "Collagen" Disease, related to other diseases of that group like rheumatoid arthritis, lupus erythematosus and scleroderma. PubMed. Acta Biomed Ateneo Parmense.2005;76 Suppl 2:38-44. |
| Silicone Breast Implants and Scleroderma. Are some cases of connective tissue disease, such as scleroderma, related to artificial joints or silicone breast implants? Contradictory findings continue to plague research into this area. ISN. |
| Silicosis, usually a nodular pulmonary fibrosis, is the disease most associated with exposure to respirable crystalline silica. Although the reported mortality associated with silicosis has declined over the past several decades, many silicosis associated deaths still occur. An unknown number of workers also continue to die from silica-related diseases such as pulmonary tuberculosis (TB), lung cancer, and scleroderma. Publication No. 2002-129, April 2002, NIOSH Hazard Review. |
| Interim Report to the Workers' Compensation Board on Scleroderma. The repeated occurrence of a very rare disease, at least three times more common in women, in males occupationally exposed to silica is suggestive of a causal association. What is striking in the literature on scleroderma reviewed for this report is the repetition of the association between this disease and an occupational history of exposure to free silica and/or vibratory tools. 03-31-92, Industrial Disease Standards Panel (ODP), IDSP Report of Findings No. 8, Toronto, Ontario. |
| In a hospital-based case-referent study of systemic sclerosis (SSc) and occupational risk factors (55 cases and 171 referents), an excess risk for SSc was observed in men with previous occupational exposure to solvents and certain chemicals (vinyl chloride, formaldehyde). SSc was associated, even though not significantly, with occupational exposure to solvents and silica among women. PubMed. G Ital Med Lav Ergon. 2003 Jul-Sep;25 Suppl(3):46-7. |
| Occupational silica exposure and risk of various diseases: an analysis using death certificates from 27 states of the United States. A matched case-control design was employed to examine each of several diseases (including silicosis, lung cancer, stomach cancer, oesophageal cancer, COPD, pulmonary tuberculosis, sarcoidosis, systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis, and various types of renal disease). PubMed. Occup Environ Med 2003 Feb;60(2):122-129. |
| Silica and Vasculitis |
| Exposure to silica and risk of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis. Long-term silica exposure may be one of the exogenous factors contributing to ANCA production, however, silica exposure alone, without typical silicosis, was not associated with ANCA positivity. PubMed. Am J Ind Med. 2006 May 11. (Also see: Vasculitis and Antibodies) |
| Silica exposure and systemic vasculitis. I present the case of a 63-year-old male who worked in DOE (Department of Energy) facilities for 30 years as a weapons testing technician. In addition to silica, other workplace exposures included beryllium, various solvents and heavy metals, depleted uranium, and ionizing radiation. The patient's diagnoses included microscopic polyangiitis, systemic necrotizing vasculitis, leukocytoclastic vasculitis, and glomerulonephritis. PubMed. Environ Health Perspect. 2003 Dec;111(16):1933-8. (Also see: Vasculitis) |
| Silica Environmental and Occupational Exposures |
Silica Exposure
can occur to workers and bystanders in the following type of industries: | abrasives (manufacturing and use)
agriculture
ceramics, clay, pottery
construction
detergent manufacturing
foundry work
glass manufacturing | masonry work
mining
railroad construction
sandblasting
shipbuilding
soap making
stone cutting | | Source: National Institute for Occupational Health and Safety. Read more... | |
| Silica-dust-exposed mine workers with scleroderma (systemic sclerosis). There was a significant increase in the prevalence of tuberculosis in the past in the group with scleroderma, compared with a group of men with silicosis from the same population. The nature of the association of tuberculosis with scleroderma has not been defined. Chest, Vol 92, 260-262, 1987. |
| Study Looks at Possible Link Between Skin Exposure to Silica and Autoimmune Disorders. While the link between occupational exposure to silica and autoimmune disorders has been well-established, most studies have focused on inhalation exposure. This hypothesis is that "skin exposure to fine and ultrafine silica— probably crystalline silica— can result in a susceptible or predisposed individual developing an autoimmune disorder such as SLE, rheumatoid arthritis or scleroderma." Occupational Hazards. 10/11/05. |
| Determining Silica Exposure Because silica is so abundant in our natural resources, it's possible that you use silica and don't even know it! There is potential for danger ONLY when crystalline silica particles are in the air. There may be materials that contain silica but if the operations on those materials do not generate dust, there is little chance of inhaling the silica. Likewise, there may be silica particles in the air even though you don't see any dust. |
| Deaths from Silica in the Workplace The first column is the occupational title. The second column (PMR) is the observed number of deaths from silicosis per occupation divided by the expected number of deaths. U.S. Department of Labor, Occupational Safety & Health Administration. |
| Scleroderma from silica is listed as a an occupational disease, recognized by the U.S. Worker's Compensation Bureau guidelines.> |
| From the "Interim Report to the Worker's Compensation Board on Scleroderma" (Ontario, Canada): |
| "Scleroderma was recognized as an occupational disease in the former German Democratic Republic. Its status after reunification is unclear. Dr. U. Haustein of Karl Marx University, Leipzig, has described the adjudication process as case-by-case (19). Each patient is discussed by a committee of experts (Obergutachtenkommission). Careful consideration is given to all facts such as occupational exposure time to silica, working conditions, interval until the manifestation of the disease, association with silicosis, etc. |
| "In South Africa, scleroderma is mentioned in the Occupational Diseases in Mines and Works Act (78 of 1973). This act originated in 1911 and was aimed at improving working conditions in all South African mines. Many aspects of the Act relate to "risk work" and "compensatable disease". Risk work, in practice, is all work below the natural surface of the earth and certain surface operations (work in crusher houses, reduction plants, and on slime dams)." |
| Silicosis: Medical/Legal Pitfalls To evaluate disability due to silicosis, one must document a reduction in pulmonary function that is sufficient to prevent the person from engaging in gainful employment or activities of daily living. 2004 eMedicine. |
| Silica Research |
| Immunoglobulin and lymphocyte responses following silica exposure in New Zealand mixed mice. These studies begin to provide possible mechanisms for environmentally induced autoimmune diseases that have been reported in many epidemiological studies. PubMed. Inhal Toxicol. 2004 Mar;16(3):133-9. |
