One-year lung transplantation outcomes for engineered stone countertop workers with silicosis at a single center in Southern California, 2019 to 2023

Area of Science:

• Occupational Medicine
• Pulmonology
• Transplant Surgery

Background:

• Engineered stone (ES) product manufacturing leads to increasing occupational exposure to respirable crystalline silica.
• This exposure causes rapidly progressive and irreversible silicosis, resulting in a rise in lung transplantations for ES-related lung disease.
• Limited data exists on post-lung transplant outcomes for patients with ES silicosis.

Purpose of the Study:

• To compare perioperative and one-year post-transplant outcomes.
• To evaluate outcomes between patients with silicosis due to ES exposure and those with other interstitial lung diseases (ILD).

Main Methods:

• Retrospective study using electronic health records and the United Network for Organ Sharing database.
• Identified 7 patients with silicosis and 69 with nonsilicosis ILD who underwent double lung transplantation from 2019-2023.
• Compared pre-transplant, perioperative, and 1-year post-transplant outcomes between the two groups.

Main Results:

• Silicosis recipients were significantly younger (43.1 vs 59.3 years) and predominantly male and of Hispanic/Latino ethnicity, all employed in the ES countertop industry.
• Silicosis patients had markedly lower pre-transplant pulmonary function (FEV1 and FVC).
• Despite longer ischemic times for silicosis patients, perioperative complication rates were similar, and 1-year survival, rejection rates, and pulmonary function were comparable between groups.

Conclusions:

• Lung transplantation is a viable therapeutic option for end-stage silicosis caused by ES exposure.
• The findings underscore the critical need for improved prevention strategies to mitigate occupational silica exposure in the ES industry.
• This study provides crucial insights into the outcomes of lung transplantation for a growing population affected by occupational lung disease.