Research review strengthens link between sarcoidosis, workplace exposures

First published by Safety+Health an NSC publication

Toronto — Findings over the past decade – including the results of case studies in the past two to three years – have strengthened the link between the lung disease sarcoidosis and on-the-job exposures to, most notably, silica and silicates, dust from the World Trade Center, and metals, according to a recent research review.

Conducted by a pair of Canadian researchers, the review of epidemiologic studies includes a Swedish study of nearly 11,000 workers that showed respirable crystalline silica exposure among concrete workers, miners, casters, masons, and ceramic and glass manufacturers led to an increased risk of sarcoidosis, described by the National Institutes of Health as “an inflammatory disease characterized by the development and growth of tiny lumps of cells called granulomas,” which, if they clump together in an organ, “can lead to permanent scarring or thickening of the organ tissue.”

A nearly twofold disease risk increase was discovered in a study of almost 298,000 Swedish construction workers with medium to high silica exposure. Among Swedish iron foundry workers with high exposure to silica, researchers observed a higher risk for both sarcoidosis and rheumatoid arthritis.

A study of New York City firefighters showed that cases of a sarcoid-like pulmonary disease occurred at a rate of 12.9 cases per 100,000 workers from 1985 to 1998. In the 12 months after the Sept. 11 attacks on the World Trade Center, that rate rose to 86 cases per 100,000 workers.

Although the two researchers note that not all sarcoidosis cases have an identified cause, recognizing occupational causes is important. When the cause of the disease is work-related, the duo says its recognition is critical “to enable effective treatment through the removal of the affected worker from exposure and to inform intervention aimed at primary prevention.”

The researchers also note that because of a more firm link to on-the-job exposures, the practice of assigning sarcoidosis cases as idiopathic by default should be discontinued.

The study was published online June 5 in the journal CHEST.


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Michigan OSHA launches emphasis program on silica

First published by Safety+Health an NSC publication.
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Lansing, MI — Michigan OSHA intends to conduct inspections at jobsites where workers are most likely to be exposed to respirable crystalline silica, as part of the agency’s recently launched state emphasis program aimed at reducing exposure to silica and preventing silicosis.

Silica is a carcinogen found in sand, stone and artificial stone. MIOSHA’s 12-month emphasis program, announced in the agency’s Fall 2020 online newsletter, includes outreach to affected industries to consult, educate and train employers and the public about the dangers of silica.

MIOSHA has compiled a list of industries with historically high silica exposures and a prevalence of silicosis cases. Establishments on the list could get an unannounced investigation visit to ensure compliance with federal and MIOSHA standards.

The agency has a goal of completing 88 inspections – 2% of the total number of inspections conducted in fiscal year 2019. This matches the goal set by federal OSHA for each of its regions in its national emphasis program, announced Feb. 4.

The agency is offering consultative audits to help establishments identify silica hazards. The audits will help employers develop and implement a comprehensive safety and health system as well as silica exposure monitoring.

Federal OSHA notes that 2.3 million workers nationwide are exposed to silica. When inhaled, these tiny particles – the product of cutting, sawing, grinding, drilling, and crushing stone, rock, concrete, brick, blocks and mortar – increase the risk of serious silica-related diseases such as silicosis, an incurable lung disease. Workers exposed to silica are also at risk for kidney disease, lung cancer and chronic obstructive pulmonary disease.


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New OSHA directive details enforcement of silica standards

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Image: simazoran/iStockphoto

Washington — Seeking “uniformity” in the enforcement of its silica standards, OSHA has published an instructional directive for its compliance safety and health officers.

Dated June 25, the directive outlines inspection procedures for addressing respirable crystalline silica exposures in general industry, maritime and construction. The directive guides OSHA inspectors on the enforcement of the silica standards’ requirements, which include:

  • Methods of compliance
  • Exposure assessments
  • Table 1 tasks and specified exposure control methods
  • Housekeeping
  • Communication of hazards
  • Respiratory protection
  • Regulated areas
  • Recordkeeping
  • Employee information and training
  • Medical surveillance

“The directive also provides clarity on major topics, such as alternative exposure control methods when a construction employer does not fully and properly implement Table 1, variability in sampling, multiemployer situations, and temporary workers,” a June 26 agency press release states.

The standards call for a permissible exposure limit of 50 micrograms per cubic meter of air over an 8-hour time-weighted average. As of June 23, general industry and maritime employers must offer medical surveillance to all employees who are exposed to the silica standard’s “action level” of 25 micrograms per cubic meter for 30 or more days a year.

Hydraulic fracturing operations in the oil and gas industry have until June 23, 2021, to comply with OSHA requirements for the standard’s engineering controls.

Union leaders call for new MSHA silica standard

Image: NIOSH

Washington — Alarmed by a recent spike in cases of coal workers’ pneumoconiosis, a deadly but preventable condition commonly known as black lung, union presidents Cecil Roberts of the United Mine Workers of America and Leo Gerard of United Steelworkers have sent a letter to Mine Safety and Health Administration leader David Zatezalo requesting stricter regulation of respirable silica dust.

In the letter, dated June 19, Roberts and Gerard cite extensive research documenting the impact of silica dust exposure on the resurgence of black lung. One study, released by the University of Illinois at Chicago in May 2018, found that more than 4,600 coal miners have developed the most severe form of black lung disease since 1970, with almost half the cases emerging after 2000.

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