Annals of Occupational and Environmental Medicine

Case Report

Diagnosis of perinuclear anti-neutrophil cytoplasmic antibody-associated microscopic polyangiitis in silicotics: case report: Ji-Won Lee, Jun-Pyo Myong, Yeong-Jin Choi, Seyoung Lee, Bum Seak Jo, Jung-Wan Koo; Ann Occup Environ Med 2016;28:21. Published online May 14, 2016; DOI: https://doi.org/10.1186/s40557-016-0108-1

Background

An association between silica exposure and autoimmune diseases including rheumatoid arthritis, systemic sclerosis, systemic lupus erythematosus, and anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis has been made.

Case presentation

A 56-year-old male presented with silicosis and had an occupational history of precious metal processing for 30 years and a 30 pack-year smoking history. The patient was diagnosed with pneumoconiosis and received compensation. No other complications were reported for pneumoconiosis. The patient suddenly presented with a non-specific headache for several days and microscopic hematuria was identified upon examination in the outpatient clinic. Following several weeks, the patient presented with aggravated dyspnea and hemoptysis, and his Modification of Diet in Renal Disease estimated glomerular filtration rate indicated acute kidney injury. Diagnostic analysis revealed perinuclear ANCA-associated microscopic polyangiitis (p-ANCA-associated MPA).

Conclusion

Exposure to silica dust was likely one of the cause of p-ANCA-associated MPA. Possible pathogenic mechanisms of autoimmune diseases in silicotics and emphasis of the necessity for early diagnosis are discussed.

Citations

Citations to this article as recorded by

Occupational Silica Exposure as a Potential Risk for Microscopic Polyangiitis
Alper Alp, Melike Ersoy, İbrahim Meteoğlu, Nesibe Kahraman Çetin, Hakan Akdam, Yavuz Yeniçerioğlu
Wilderness & Environmental Medicine.2023; 34(4): 543. CrossRef
Renal involvement in a silicosis patient – case report and literature review
Fei-Fei Chen, Hai-Yan Tang, Feng Yu, Cheng-Li Que, Fu-de Zhou, Su-Xia Wang, Guang-Fa Wang, Ming-Hui Zhao
Renal Failure.2019; 41(1): 1045. CrossRef
IL-10-Producing B Cells Suppress Effector T Cells Activation and Promote Regulatory T Cells in Crystalline Silica-Induced Inflammatory Response In Vitro
Yiping Lu, Fangwei Liu, Chao Li, Ying Chen, Dong Weng, Jie Chen
Mediators of Inflammation.2017; 2017: 1. CrossRef

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Case Report

Work-related COPD after years of occupational exposure: YounMo Cho, JongIn Lee, Min Choi, WonSeon Choi, Jun-Pyo Myong, Hyoung-Ryoul Kim, Jung-Wan Koo; Ann Occup Environ Med 2015;27:6. Published online February 19, 2015; DOI: https://doi.org/10.1186/s40557-015-0056-1

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Background

Cigarette smoking is known as the most important risk factor of chronic obstructive pulmonary disease (COPD). However, occupational exposure to other substances can result in COPD.

Case report

A 76-year-old man with occupational exposures to mixtures of silica dust, gas, and fumes for 10 years and with a 25 pack-year smoking history was diagnosed with COPD. His computed tomogram scan revealed some hyperinflation with emphysematous change in both upper lobes. In the pulmonary function tests, his post-bronchodilator forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), and FEV₁/FVC% were 2.20 L (67% of the predicted value), 1.12 L (52% of the predicted value), and 51%, respectively, indicating moderate COPD. This case of COPD was confirmed as a work-related disease by the Occupational Lung Disease Research Institute in Korea Workers’ Compensation & Welfare Service.

Conclusion

Exposure to various substances such as silica dust, gas, and fumes from furnace and boiler installation was likely the cause of COPD in this patient. Thus, occupational exposure should be considered an important risk factor of COPD.

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Research Article

The effect of organisational system on self-rated depression in a panel of male municipal firefighters: Se-Jin An, Yun Kyung Chung, Bong Hyun Kim, Kyeong Min Kwak, Jun-Seok Son, Jung-wan Koo, Young-Su Ju, Young-Jun Kwon; Ann Occup Environ Med 2015;27:1. Published online January 14, 2015; DOI: https://doi.org/10.1186/s40557-014-0044-x

Abstract PDF PubReader ePub

Objectives

The present study evaluated the effects of job stress, including organisational system to self-rated depression through a panel study of male municipal firefighters in the Republic of Korea.

Methods

A panel of 186 municipal firefighters reported self-rated depressive symptoms according to the Beck Depression Inventory (BDI). The effects of job stress were evaluated using the Korea Occupational Stress Scale, taken one year earlier and classified by the median value. Panel members were classified into Depression or Control groups according to BDI scores, with a cut-off level of ‘over mild depression’ in a follow-up survey.

Results

The Depression group included 17 (9.1%) workers. Firefighters who scored high on occupational system had an 8.3 times greater risk of being assigned to the Depression group than those who had not (adjusted odds ratio [OR] = 8.03, 95% confidence interval (CI) = [1.73–37.22]). In contrast, job stress from a ‘difficult physical environment’ revealed negative risks related to being classified in the Depression group (AOR = 0.20, 95% CI = [0.04–0.92]).

Conclusions

Although the healthy worker effect may be involved, job stress based on perceptions of organisational system was a strong risk factor for depression. A comprehensive approach should be considered that encompasses social issues when assessing or mental health in high-risk groups, as well as the practical issue of physiochemical hazards.

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