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Manufacture: Process using vibrocompression vacuum technology to form AS slabs from crushed stone / sand, resin, and pigments.
Silicosis: Progressive fibrotic lung disease caused by inhalation of respirable crystalline silica( RCS); occurs almost exclusively in the occupational setting across a range of industries and occupations with silica exposure, including construction, mining, quarrying, and sandblasting.
Medical Screening: Clinical evaluation of asymptomatic exposed workers using medical tests to identify silicosis at the individual level.
Surveillance: Ongoing, systematic identification, reporting, and analysis of silicosis cases to track trends, identify risks, and inform prevention efforts.
Introduction
Silicosis among workers who manufacture AS slabs and fabricate and install AS countertops has emerged as a global occupational lung disease epidemic. This form of silicosis has been characterized by short latency from first exposure to AS dust to disease onset, rapid disease progression, and high morbidity and mortality. 1, 2 AS refers to composite stone slabs made of crystalline silica mixed with resins and pigments. AS typically contains more than 90 % crystalline silica and is commonly used to fabricate domestic kitchen and bathroom countertops( also known as benchtops or worktops) and other decorative surfaces. It is also called“ engineered stone” or“ quartz.” AS silicosis develops with as little as three years of exposure to dust generated from AS and has often been diagnosed in workers in their 30s and 40s, 2 echoing the epidemic among young denim sandblasters in Turkey. 3 Thousands of cases of AS silicosis have been reported worldwide, predominantly among vulnerable populations, including minorities and young immigrant and migrant men. 4 – 8 These workers, frequently employed under precarious and inequitable conditions, face disproportionate risks, limited protections, and barriers to care. 9, 10 AS silicosis is not only an epidemic, but also a profound issue of occupational health, workers’ rights, and social justice.
The consumer market for crystalline silica-containing AS has continued to grow internationally despite the high morbidity and mortality among workers. 11 The process for manufacturing AS slabs was invented in Italy in the early 1970’ s, and the technology has been disseminated to manufacturers worldwide. Industry reports estimate that 60 manufacturing plants produce more than 20 million square meters of AS annually, 12 and AS’ s share of the countertop market is anticipated to continue to grow. 11 A careful examination of the current state of the exposure science, epidemiology, public health efforts, and therapeutics is required to combat this growing international epidemic.
Methods
The co-chairs convened a multidisciplinary, international panel of experts in occupational and pulmonary medicine, pneumoconiosis, industrial hygiene, epidemiology, public health, and translational science for the workshop. Participants were invited based on their subject-matter expertise, and all financial disclosures were reviewed and managed in accordance with ATS conflict-of-interest policies.
The workshop was held entirely virtually and consisted of four sessions organized using a flipped classroom model. Before each session, participants viewed approximately one hour of pre-recorded lectures by workshop participants that summarized current knowledge and highlighted research gaps. These presentations were followed by a 1.5-hour live, structured discussion session, which was recorded. Discussion questions were circulated in advance to designated discussants to facilitate preparation and ensure diverse contributions. One co-chair served as moderator for each session, while the others documented proceedings and synthesized key
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