Annals of Occupational and Environmental Medicine

Silica exposure and work-relatedness evaluation for occupational cancer in Korea: Hyoung-Ryoul Kim, Boowook Kim, Bum Seak Jo, Ji-Won Lee; Ann Occup Environ Med 2018;30:4. Published online January 31, 2018; DOI: https://doi.org/10.1186/s40557-018-0216-1

Crystalline silica has been classified as a definite carcinogen (Group 1) causing lung cancer by the International Agency for Research on Cancer (IARC). In Korea, crystalline silica has been the most common causal agent for workers to apply to the Korea Workers’ Compensation and Welfare Service (KWCWS). We used KWCWS data to evaluate workers’ crystalline silica exposure levels according to their occupations and industries, and reviewed research papers describing the dose-response relationship between cumulative exposure levels and lung cancer incidence. In addition, we reviewed lung cancer cases accepted by the KWCWS, and suggest new criteria for defining occupational cancer caused by crystalline silica in Korea. Rather than confining to miners, we propose recognizing occupational lung cancer whenever workers with pneumoconiosis develop lung cancer, regardless of their industry. Simultaneous exposure and lag time should also be considered in evaluations of work-relatedness.

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The association between lung cancer and silicosis: from theory to practice in occupational medicine
Marina Ruxandra Oțelea
Romanian Journal of Occupational Medicine.2022; 73(1): 45. CrossRef
Occupational exposure to respirable crystalline silica in municipal household waste collection and road cleaning workers
Boowook Kim, Eunyoung Kim, Wonseok Cha, Jungah Shin, Byung-Soon Choi, Daeho Kim, Miyeon Kim, Wonyang Kang, Sungwon Choi
Scientific Reports.2021;[Epub] CrossRef
Neuroprotective effects of sonochemical- synthesized SiO2 nanoparticles in vivo models of ischemic/reperfusion injury in stroke
Chengcheng Cui, Dayong Shen, Dandan Zuo, Xinchun Ye
Arabian Journal of Chemistry.2021; 14(11): 103416. CrossRef
Break-even Analysis of Respirable Crystalline Silica (RCS) Exposure Interventions in the Construction Sector
Emile Tompa, Amirabbas Mofidi, Chaojie Song, Victoria Arrandale, Katherine J. Jardine, Hugh Davies, Thomas Tenkate, Paul A. Demers
Journal of Occupational & Environmental Medicine.2021; 63(11): e792. CrossRef
Subradiological silicosis
Rodney Ehrlich, Jill Murray, David Rees
American Journal of Industrial Medicine.2018; 61(11): 877. CrossRef

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Systemic sclerosis due to crystalline silica exposure among jewelry workers in Korea: two case reports: Jae Yoon Kim, Sang Yoon Do, Young Hoon Moon, Chul Gab Lee, Yun Sung Kim, Byung Soon Choi, Eun-A Kim, Han Soo Song; Ann Occup Environ Med 2017;29:18. Published online June 19, 2017; DOI: https://doi.org/10.1186/s40557-017-0176-x

Abstract PDF PubReader ePub

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.

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Systemic Sclerosis in Males—Deciphering the Enigma of Erasmus Syndrome
Reena K. Sharma, Mudita Gupta
Indian Journal of Dermatology.2024; 69(1): 48. CrossRef
Silikose und systemische Sklerose bei einem Steinmetz
Ulrike Brückner, Elisabeth Bonifer, Joachim Schneider
Zentralblatt für Arbeitsmedizin, Arbeitsschutz und Ergonomie.2023; 73(5): 247. CrossRef
A Pathological Study of Acute Pulmonary Toxicity Induced by Inhaled Kanto Loam Powder
Yoshimi Kobayashi, Akinori Shimada, Takehito Morita, Kenichiro Inoue, Hirohisa Takano
International Journal of Molecular Sciences.2018; 19(2): 416. CrossRef
Erasmus syndrome: systemic sclerosis and silicosis co‐occurrence
Zühre Sarı Sürmelİ, Nurdan Oruçoğlu
International Journal of Rheumatic Diseases.2018; 21(6): 1326. CrossRef

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Overlap syndrome with Sjögren’s syndrome and systemic sclerosis in a steel rolling mill worker: a case report: Min-Kee Yi, Won-Jun Choi, Sung-Woo Han, Seng-Ho Song, Dong-Hoon Lee, Sun Young Kyung, Sang-Hwan Han; Ann Occup Environ Med 2016;28:24. Published online June 2, 2016; DOI: https://doi.org/10.1186/s40557-016-0106-3

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Background

There are few reports about work-related factors associated with Sjögren’s syndrome. We report a case of overlap syndrome with Sjögren’s syndrome and systemic sclerosis.

Case presentation

A 54-year-old man was admitted due to dyspnea on exertion. The results of physical examination and laboratory findings were compatible with Sjögren’s syndrome with systemic sclerosis. The patient had no pre-existing autoimmune disease, and denied family history of autoimmune disease. The patient worked in the large-scale rolling department of a steel manufacturing company for 25 years. Hot rolling is a rolling process performed at between 1100 °C and 1200 °C, generating a high temperature and a large amount of fumes, involving jet-spraying of water throughout the process to remove the instantaneously generated oxide film and prevent the high generation of fumes. In this process, workers could be exposed to silica produced by thermal oxidation. Other potential toxic substances including nickel and manganese seemed to be less likely associated with the patient’s clinical manifestations.

Conclusions

Occupational exposure to silica seemed to be associated with the patient’s clinical manifestations of overlap syndrome with Sjögren’s syndrome and systemic sclerosis. Although the underlying mechanism is still unclear, autoimmune disease including Sjögren’s syndrome affects women more often than men and there was no family history of autoimmune disease. These suggested that there was an association between occupational silica exposure and the disease of the patient. Future research about the association between long-term low dose exposure to silica and the development of autoimmune diseases should be encouraged.

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Environmental pollutants and phosphoinositide signaling in autoimmunity
Chang Ren, Noah D. Carrillo, Vincent L. Cryns, Richard A. Anderson, Mo Chen
Journal of Hazardous Materials.2024; 465: 133080. CrossRef
Silicosis y síndrome de Sjögren
Miguel Martín Asenjo, Javier Miguel Martín Guerra, Claudia Iglesias Pérez, José María Prieto de Paula
Archivos de Bronconeumología.2019; 55(10): 536. CrossRef
Silicosis and Sjögren's Syndrome
Miguel Martin Asenjo, Javier Miguel Martín Guerra, Claudia Iglesias Pérez, José Maria Prieto de Paula
Archivos de Bronconeumología (English Edition).2019; 55(10): 536. CrossRef
Systemic sclerosis due to crystalline silica exposure among jewelry workers in Korea: two case reports
Jae Yoon Kim, Sang Yoon Do, Young Hoon Moon, Chul Gab Lee, Yun Sung Kim, Byung Soon Choi, Eun-A Kim, Han Soo Song
Annals of Occupational and Environmental Medicine.2017;[Epub] CrossRef

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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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Occupational and Environmental Exposure Influences the Inflammatory (Pro-and Anti-) Status in Benign Prostate Hyperplasia and Prostate Carcinoma Patients: A Retrospective Analysis
Shailendra Dwivedi, Praveen Sharma, Apul Goel, Sanjay Khattri, Sanjeev Misra, Kamlesh Kumar Pant
Indian Journal of Clinical Biochemistry.2024; 39(2): 241. CrossRef
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Prasert Kham-ai, Karen Heaton, Peng Li
Workplace Health & Safety.2023; 71(2): 89. CrossRef
SiO2 prompts host defense against Acinetobacter baumannii infection by mTORC1 activation
Xiaomin Guo, Chaoming Wang, Tao Xu, Lu Yang, Chaohong Liu, Xiaopeng Qi
Science China Life Sciences.2021; 64(6): 982. CrossRef
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BMC Pulmonary Medicine.2021;[Epub] CrossRef
Work Lung Disease Due to Rice Dust
Ariani Permatasari, Reagen Irwan Kolibu
Jurnal Respirasi.2020; 6(3): 79. CrossRef
IMMUNOLOGICAL EVALUATION OF INFLAMMATORY PROCESS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE OF PROFESSIONAL ETIOLOGY
V. V. Ivchuk, T. Yu. Kopteva, T. A. Kovalchuk
World of Medicine and Biology.2019; 15(70): 082. CrossRef
Prevalence and Risk Factors Associated with Self-Rated Morbidities Among South Asian Migrant Gas Station Workers in Kuwait
Najla Al-ayyadhi, Saeed Akhtar
Journal of Immigrant and Minority Health.2018; 20(6): 1324. CrossRef
Non-smoking Chronic Obstructive Pulmonary Disease Attributed to Occupational Exposure to Silica Dust
Kazuo Tsuchiya, Mikio Toyoshima, Yosuke Kamiya, Yutaro Nakamura, Satoshi Baba, Takafumi Suda
Internal Medicine.2017; 56(13): 1701. CrossRef

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Two Cases of Lung Cancer in Foundry Workers: Inchul Jeong, Innshil Ryu, Boowook Kim, Inhyo Park, Jong-Uk Won, Eun-A Kim, Inah Kim, Jaehoon Roh; Ann Occup Environ Med 2013;25:16-16. Published online September 16, 2013; DOI: https://doi.org/10.1186/2052-4374-25-16

Abstract PDF PubReader ePub: Background
Iron and steel foundry workers are exposed to various toxic and carcinogenic substances including crystalline silica, polycyclic aromatic hydrocarbons, and arsenic. Studies have been conducted on lung cancer in iron and steel founding workers and the concentration of crystalline silica in foundries; however, the concentration of crystalline silica and cases of lung cancer in a single foundry has never been reported in Korea. Therefore, the authors report two cases of lung cancer and concentration of crystalline silica by the X-ray diffraction method.
Case presentation
A 55-year-old blasting and grinding worker who worked in a foundry for 33 years was diagnosed with lung cancer. Another 64-year-old forklift driver who worked in foundries for 39 years was also diagnosed with lung cancer. Shot blast operatives were exposed to the highest level of respirable quartz (0.412 mg/m³), and a forklift driver was exposed to 0.223 mg/m³.
Conclusions
The lung cancer of the two workers is very likely due to occupationally related exposure given their occupational history, the level of exposure to crystalline silica, and epidemiologic evidence. Further studies on the concentration of crystalline silica in foundries and techniques to reduce the crystalline silica concentration are required.

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A Case of Silicosis and Pneumothorax in a Workplace Producing Dental Porcerlain: Youngjoong Kang, Won Jun Choi, Sang Yun Lee, Jong Wan Yun, Hyung Sik Kim, Jong Uk Won, Sang Hwan Han; Korean Journal of Occupational and Environmental Medicine 2010;22(1):58-63. Published online March 31, 2010; DOI: https://doi.org/10.35371/kjoem.2010.22.1.58

Abstract PDF: BACKGROUND
Silicosis is more likely to occur in people working in the mining industry. However, workers suffering from silicosis have recently been reported frequently in other areas. We present a case of silicosis occuring in a 43-year-old man who had worked for 20 years in a workplace producing dental porcelain.
CASE
The man was admitted to the emergency room with acute chest pain caused by pneumothorax. Chest X-ray indicated numerous small opacities spread over the whole lung field and a large opacity in the right middle lung field. According to ILO classification, the shape of the small opacities was t/s, the profusion rate was 2/3 and the large opacity was classified into the B category. Following this diagnosis of silicosis, the patient's medical history and work exposure history were examined. According to his medical history, he had undergone closed thoracostomy in 2006 because he had suffered pneumothorax twice (in 2005 and 2006) and his smoking history was 7 pack years. In particular, he had been exposed to silica dust for 20 years in his workplace.
CONCLUSION
Despite the absence of any specific risk factor that caused pneumothorax, the patient suffered this condition three times. All clinical results and the progress of his physical symptoms, including radiologic findings from chest X-ray and computed tomography, clearly supported the diagnosis of silicosis. Except for exposure to silica dust in the workplace, no other risk factors causing silicosis were found. Therefore, he was finally diagnosed as having silicosis caused by exposure to silica dust in the workplace and followed by pneumothorax.

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A Case of Goodpasture's Syndrome in a Foundry Worker: Min Gi Kim, Dong Hee Koh, Sun Wong Lee, Min Heui Jo, Hee Yong Yoo, Bo Yeon Kim, June Hyuk Lee; Korean Journal of Occupational and Environmental Medicine 2008;20(1):46-53. Published online March 31, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.1.46

Abstract PDF

BACKGROUND
Smoking, upper respiratory tract infection, genetic factors and hydrocarbons are known as risk factors of Goodpasture's syndrome. We studied a patient with Goodpasture's syndrome who had worked for 27 years in a foundry company. Based on a study on the work-relatedness of the syndrome, we describe and discuss our study results.
CASE
A 46-year-old man, who had worked as a foundry worker for 27 years and had a 12 1/2 packyear history of smoking cigarettes, was admitted into a hospital on 15th February 2006 with coughing, chest pain and dyspnea. On admission, he had hematuria, proteinuria, severe restrictive pulmonary function disorder and rapid elevation of blood urea nitrogen/creatinine. Immunological examination showed ANA (+), ANCA (-) and Anti-GBM Ab (+). Kidney biopsy showed pauci-immune crescentic glomerulonephritis. Mild bleeding was revealed through bronchoscopy and no vasculitis and granuloma were present on at lung biopsy. Finally, we diagnosed the worker's illness as Goodpasture's syndrome and carried out hemodialysis and plasmapheresis. In the workplace survey, the exposure level of respirable crystalline silica exceeded the TLV-TWA (0.0106 mg/m3), which was calibrated for overtime.
CONCLUSION
Based on both the clinical test and industrial hygiene examination, we concluded that the Goodpasture's syndrome in this case was caused by long-term silica exposure.

Citations

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Cause-Specific Mortality Due to Malignant and Non-Malignant Disease in Korean Foundry Workers
Jin-Ha Yoon, Yeon-Soon Ahn, Suminori Akiba
PLoS ONE.2014; 9(2): e88264. CrossRef
Goodpasture’s Syndrome and p-ANCA Associated Vasculitis in a Patient of Silicosiderosis: An Unusual Association
Amanjit Bal, Ashim Das, Dheeraj Gupta, Mandeep Garg
Case Reports in Pulmonology.2014; 2014: 1. CrossRef
Goodpasture's Syndrome and Silica: A Case Report and Literature Review
James Dahlgren, Marla Wardenburg, Trevor Peckham
Case Reports in Medicine.2010; 2010: 1. CrossRef

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Autoproliferation of Fibroblast by Exposure to Crystalline Silica - Evaluation by H2O2 and PDGF-AA and TGF beta: Byoung Young Ahn, Kyoung Ah Kim, Je Hyeok Mun, Jin Sook Jeong, Eun Kyung Kim, Young Lim; Korean Journal of Occupational and Environmental Medicine 2000;12(2):209-217. Published online June 30, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.2.209

Abstract PDF: OBJECTIVES
The aim of this study is to find out the activity of autoproliferation of ratfibroblast exposed to crystalline silica and the role of mediators secreted from rat fibroblast.
METHODS
The effect of alpha-quartz on production of growth factor (platelet-derived growth factor-AA and transforming growth factor beta)from rat fibroblasts were evaluated by ELISA and immunocytochemical analysis. Gene expression of these growth factors in rat fibrobast exposed to crystalline silica was evaluated by RT-PCR. Furthermore, fibroblast proliferation by culture supernatant of rat fibroblast was assayed by the neutral red test.
RESULTS
The amounts of H2O2 and growth factors synthesized in rat fibroblasts were significantly increased by the stimulation of crystalline silica(alpha-quartz), which showed the dose-dependent manner to the concentration of alpha-quartz with the maximum response at the dosage of 100 microgram/cm2. The result of RT-PCR demonstrated that alpha-quartz induced gene expression of PDGF-AA and TGFbeta in rat fibroblast. We also found that supernatant of alpha-quartz-cocultured rat fibroblast induced a significant proliferation of fibroblast.
CONCLUSION
Crystalline silica directly induce functional change in fibroblast such as increased release of reactive oxygen species and growth factors. The products of these functional change promote fibroblast proliferation via autocrine loop.

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The Effect of Silica Dust on Ventilatory Function in Foundry Workers: Jung Wan Koo, Kyoung Ah Kim, Chee Kyung Chung; Korean Journal of Occupational and Environmental Medicine 1998;10(1):94-104. Published online February 28, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.1.94

Abstract PDF: In order to study the exposure level of silica dust and the effects of silica dust on ventilatory function, respirable dust samples were collected by personal air samplers using NIOSH method 0500 from the selected foundry operations, and ventilatory function tests were performed on 209 male foundry workers and 239 male control subjects. Ventilatory indices such as forced vital capacity (FVC) , one-second forced expiratory volume (FEV1), ratio of FEV1 to FVC(FEV1 %), maximal mid-expiratory flow(MMF), peak expiratory flow rate (PEFR) and maximal expiratory flow at 25, 50 and 75 % of expired FVC (FEF25, FEF50, FEF75 were obtained by analyzing forced expiratory spirogram and maximal expiratory flow-volume curve which were simultaneously measured by Vitalography in standing position. The results were as follows : 1. The average quartz concentrations of respirable dust were the highest in melting operation (0.079 mg/m3) and followed by molding operation (0.051 mg/m3), finishing operation (0.041 mg/m3) and coremaking operation (0.023 mg/m3) in the descending order. 2. No significant differences for mean values of all ventilatory indices expressed as percent of predicted value were demonstrated between smokers and nonsmokers In foundry workers and control subjects. 3. Mean values of all ventilatory indices except FVC of foundry workers were significantly lower than those of control subjects. 4. Mean values of FEV1 %, MMF, FEF25, FEF50 and FEF75 expressed as percent of predicted value tended to decrease with increasing cumulative dust exposure. 5. In foundry workers, proportions of workers with low MMF, FEF50 and FEF75 were markedly higher than those with other indices, and were significantly increased with increasing cumulative dust exposure. 6. In foundry workers, 2 workers(1.0 %) were diagnosed as silicosis and the profusion of radiographic opacities were category 1/0 and q type. With the above considerations in mind, it suggested that increasing exposure of silica dust be associated with progressive deterioration in ventilatory function of an obstructive nature and that MMF, FEF50 and FEF75 be more sensitive indices in the detection of the early obstructive changes of air flow of workers exposed to silica dust.

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Cytotoxicity and Apoptosis by Silica, Asbestos and Man-Made Mineral Fibers: Young Lim, Kyoung Ah Kim, Heung Nam Kim, Dong Won Lee, Won Seop Cho, Im Goung Yun; Korean Journal of Occupational and Environmental Medicine 1997;9(4):641-649. Published online December 31, 1997; DOI: https://doi.org/10.35371/kjoem.1997.9.4.641

Abstract PDF

Exposure to various particles and fibers can result in lung inflammation that may progress to fibrosis, even lung cancer for which there is no effective clinical treatment now. The mechanism involved in pulmonary injury has not been well defined ; however, most current evidence implicates a central role for alveolar macrophages (AM) in this process. Also apoptosis or programmed cell death is regarded as a mechanism which is related with the pulmonary fibrosis. We propose that the cytotoxic potential of various particles may be evaluated by measuring lactic dehydrogenase (LDH) from particle co-cultured supernatant and theses particles may induce the characteristics of apoptosis, DNA ladder. We analyzed rat AM culture media which was incubated for 3 days with the same concentration (10 ug/ml) of silica(Si), chrysotile(Ch), crocidolite(Cr), ceramic fiber(CF), rock wool(RW) and glass wool (GW). And each particles (50ug/cm(2)) was incubated with A549 (pneumocyte in tracheal epithelium) cell lines for 24 hours to confirm the DNA ladder. Additionally, silica induced apoptosis in vivo was confirmed by electromicroscopic observation. The results were as follows; 1. Silica, asbestos and man-made mineral fibers (MMMF) co-cultured with AM showed the increase of LDH significantly with the time interval of 24, 48, 72 hours except for ceramic fiber in 48 and 72 hours and crocidolite in 72 hours. 2. Silica, asbestos and man-made mineral fibers (CF, GF) showed the characteristics of apoptosis, DNA ladder, which was induced by incubating A549 cell with each particles for 24 hours in vitro 3. Apoptotic alveolar macrophage was observed the findings of zeiosis (membrane blebbing), condensation of nuclear chromosome and many vacuoles in cytoplasm, electomicroscopically.

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Kyung-Taek Rim
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Tian Zhu Li, Soo-Jin Lee, Se-Jong Park, Byung-Joon Chang, Jong-Hwan Lee, Kil-Soo Kim, Myoung-Heon Lee, Nong-Hoon Choe
Tuberculosis and Respiratory Diseases.2006; 60(5): 554. CrossRef

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