Systemic sclerosis due to crystalline silica exposure among jewelry workers in Korea: two case reports.
10.1186/s40557-017-0176-x
- Author:
Jae Yoon KIM
1
;
Sang Yoon DO
;
Young Hoon MOON
;
Chul Gab LEE
;
Yun Sung KIM
;
Byung Soon CHOI
;
Eun A KIM
;
Han Soo SONG
Author Information
1. Department of Occupational and Environmental Medicine, School of Medicine, Chosun University, 558 Pilmun-daero Dong-gu, Gwangju, 61453 Republic of Korea. oemsong@gmail.com.
- Publication Type:Case Report
- Keywords:
Crystalline silica;
Jewelry;
Systemic sclerosis;
Occupational exposure;
Korea
- MeSH:
Autoimmune Diseases;
Crystallins*;
Cyanosis;
Dust;
Epidemiologic Studies;
Foot;
Hand;
Humans;
Jewelry*;
Korea*;
Middle Aged;
Occupational Exposure;
Quartz;
Risk Factors;
Scleroderma, Systemic*;
Sclerosis;
Silicon Dioxide*;
Tuberculosis;
Ventilation
- From:Annals of Occupational and Environmental Medicine
2017;29(1):18-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Occupational exposure to crystalline silica is a potential risk factor for various systemic autoimmune diseases including systemic sclerosis. The etiology of systemic sclerosis is not conclusively known, but there are epidemiological studies that show the relationship between exposure to crystalline silica and risk of systemic sclerosis. Here we report, for the first time, two cases of crystalline silica-related systemic sclerosis in patients who worked in crystal processing in the jewelry-manufacturing field. CASE PRESENTATION: Case 1 is a 57-year-old man who had worked mainly in crystal processing for multiple jewelry-processing companies for 17 years, since the age of 15 years. He contracted tuberculosis at the age of 25 years and showed Raynaud's phenomenon of both the hands and feet at age 32 years. Digital cyanosis and sclerosis developed at approximately age 41 years. The patient was diagnosed with systemic sclerosis at age 48 years. Case 2 is a 52-year-old man who worked in crystal processing for various jewelry-processing companies for 7 years, since the age of 23 years. He first showed signs of cyanosis in the third and fourth digits of both hands at age 32 years, was diagnosed with Raynaud's syndrome at age 37 years, and was diagnosed with systemic sclerosis at age 38 years. Crystal processing is a detailed process that involves slabbing and trimming the selected amethyst and quartz crystals, which requires close proximity of the worker's face with the target area. In the 1980s and 1990s, the working hours were 12 h per day, and the working environment involved 15 workers crowded into a small, 70-m2 space with poor ventilation. CONCLUSION: Two workers who processed crystals with a maximum crystalline silica content of 56.66% developed systemic sclerosis. Considering the epidemiological and experimental evidence, exposure to crystalline silica dust was an important risk factor for systemic sclerosis. An active intervention is necessary to reduce exposure in similar exposure groups in the field of jewelry processing.
