Background

Silicosis is a rapidly emerging major health concern for workers in the artificial stone benchtop industry. The association between serum angiotensin converting enzyme (sACE) levels and artificial stone silicosis is unknown.

Methods

We investigated 179 male workers (median age 40 years, interquartile range (IQR) 33–48 years) from the stone benchtop industry in Victoria, Australia. All had worked in an environment where dry processing of artificial stone had occurred and were registered with the Victorian Silica-associated Disease Registry between June 2019 and August 2020. Workers had undergone protocolised assessments including respiratory function testing, high resolution CT chest and blood tests panel, including sACE.

Findings

Sixty workers with artificial stone silicosis were identified and they had a higher median sACE level (64.1 U/L, IQR 51.5, 87.5), compared to 119 without silicosis (35.0 U/L, IQR 25.0, 47.0). Compared to those with a normal assessment, regression modelling noted significantly higher average differences in sACE levels for workers with lymphadenopathy alone (12.1 U/L, 95% confidence interval (CI): 1.3, 22.9), simple silicosis (28.7 U/L, 95% CI: 21.3, 36.0) and complicated silicosis (36.0 U/L, 95% CI 25.2, 46.9). There was a small negative association with gas transfer, but no associations with exposure duration or spirometry.

Conclusion

sACE levels were noted to be higher in artificial stone workers with silicosis compared to those without disease and was highest in those with complicated silicosis. Longitudinal follow up is required to evaluate sACE as a prognostic biomarker for workers with this rapidly emerging occupational lung disease.

中文翻译：

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血清血管紧张素转换酶升高与人造石矽肺相关

背景

硅肺病是人造石台面行业工人快速出现的主要健康问题。血清血管紧张素转换酶（sACE）水平与人造石硅肺病之间的关联尚不清楚。

方法

我们调查了来自澳大利亚维多利亚州石凳行业的 179 名男性工人（中位年龄 40 岁，四分位距 (IQR) 33-48 岁）。所有人都在人造石干法加工的环境中工作，并于 2019 年 6 月至 2020 年 8 月期间在维多利亚二氧化硅相关疾病登记处登记。工人接受了协议评估，包括呼吸功能测试、高分辨率胸部 CT 和血液测试面板，包括 sACE。

发现

60 名患有人造石硅肺病的工人被发现，他们的 sACE 中位水平（64.1 U/L，IQR 51.5，87.5）高于 119 名没有硅肺病的工人（35.0 U/L，IQR 25.0，47.0）。与正常评估的工人相比，回归模型发现，仅患有淋巴结肿大的工人（12.1 U/L，95% 置信区间 (CI)：1.3、22.9）、单纯性硅肺病（28.7 U/L， 95% CI: 21.3, 36.0) 和复杂性矽肺 (36.0 U/L, 95% CI 25.2, 46.9)。与气体转移存在小的负相关，但与暴露时间或肺量测定没有相关。

结论

与没有患病的工人相比，患有硅肺病的人造石工人的 sACE 水平较高，并且在患有硅肺病的工人中最高。需要进行纵向随访来评估 sACE 作为患有这种迅速出现的职业性肺病的工人的预后生物标志物。