Objective: To study the impact of occupational silica exposure on the incidence rates of sarcoidosis and rheumatoid arthritis (RA) in a cohort of exposed workers in Swedish iron foundries. Design: The prevalence of sarcoidosis and RA in a cohort of silica exposed workers was compared with the prevalence in the general Swedish population in this register study. A mixed model was used to calculate silica exposure, and individual silica exposures were used to compute dose responses. Setting: Personnel records from 10 iron foundries were used to identify workers whose employment began before 2005 which was then linked to the national non-primary outpatient visits register. Participants: The final cohort consisted of 2187 silica-exposed male workers who had been employed for at least 1 year and were still alive without having emigrated when the follow-up study began. The cohort’s employment period covers 23 807 person-years at risk. Main outcome: The presented results indicate that moderate to high levels of silica exposure increase risks for sarcoidosis and seropositive RA. Results: Mean levels of airborne silica dust in the foundries decreased significantly between the 1970s and 2000s. Incidence rates of sarcoidosis (3.94; 95% CI 1.07 to 10.08) and seropositive RA (2.59; 95% CI 1.24 to 4.76) were significantly higher among highly exposed individuals. Conclusion: Our results reveal increased risks for sarcoidosis and seropositive RA among individuals with high exposure to silica dust (>0.048 mg/m ³ ) compared with non-exposed and less-exposed groups.

Summary: Additive manufacturing that creates three‐dimensional objects by adding layer upon layer of material is a new technique that has proven to be an excellent tool for the manufacturing of complex structures for a variety of industrial sectors. Today, knowledge regarding particle emissions and potential exposure‐related health hazards for the operators is limited. The current study has focused on particle numbers, masses, sizes, and identities present in the air during additive manufacturing of metals. Measurements were performed during manufacturing with metal powder consisting essentially of chromium, nickel, and cobalt. Instruments used were Nanotracer (10 to 300 nanometers [nm]), Lighthouse (300 nm to 10 micrometers), and traditional filter‐based particle mass estimation followed by inductively coupled plasma mass spectrometry. Results showed that there is a risk of particle exposure at certain operations and that particle sizes tended to be smaller in recycled metal powder compared to new. In summary, nanosized particles were present in the additive manufacturing environment and the operators were exposed specifically while handling the metal powder. For the workers’ safety, improved powder handling systems and measurement techniques for nanosized particles will possibly have to be developed and then translated into work environment regulations. Until then, relevant protective equipment and regular metal analyses of urine is recommended.

Additive manufacturing (AM) is a rapidly expanding new technology involving challenges to occupational health. Here, metal exposure in an AM facility with large-scale metallic component production was investigated during two consecutive years with preventive actions in between. Gravimetric analyzes measured airborne particle concentrations, and filters were analyzed for metal content. In addition, concentrations of airborne particles <300 nm were investigated. Particles from recycled powder were characterized. Biomonitoring of urine and dermal contamination among AM operators, office personnel, and welders was performed. Total and inhalable dust levels were almost all below occupational exposure limits, but inductively coupled plasma mass spectrometry showed that AM operators had a significant increase in cobalt exposure compared with welders. Airborne particle concentrations (<300 nm) showed transient peaks in the AM facility but were lower than those of the welding facility. Particle characterization of recycled powder showed fragmentation and condensates enriched in volatile metals. Biomonitoring showed a nonsignificant increase in the level of metals in urine in AM operators. Dermal cobalt and a trend for increasing urine metals during Workweek Year 1, but not in Year 2, indicated reduced exposure after preventive actions. Gravimetric analyses showed low total and inhalable dust exposure in AM operators. However, transient emission of smaller particles constitutes exposure risks. Preventive actions implemented by the company reduced the workers' metal exposure despite unchanged emissions of particles, indicating a need for careful design and regulation of the AM environments. It also emphasizes the need for relevant exposure markers and biomonitoring of health risks.

Objective To determine whether occupational exposure to silica dust is associated with an increased risk of developing sarcoidosis. Design Case–control study of all individuals between 20 and 65 years of age diagnosed with sarcoidosis (D86) in Sweden between 2007 and 2016. Controls were matched to cases (2:1) based on age, sex and county at the time of diagnosis. A Job Exposure Matrix was used to estimate the occupational silica exposure of all cases and controls. Setting Medical and occupational data from the National Outpatient Register were used to implement a case–control analysis, while the two controls used for each case were selected from the National Register of the Total Population. Information about occupation and time of employment were collected from the Swedish Occupational Register. Participants All men and women aged 20–65 years old who were diagnosed sarcoidosis (D86) from 2007 to 2016 were included and assigned two controls. Main outcomes Silica dust exposure correlates with an increased risk of developing sarcoidosis in men. Results The prevalence of silica exposure at work was statistically significantly higher among male cases than controls (OR 1.27, 95% CI 1.13 to 1.43). For men of an age of 35 years or younger the correlation seems to be stronger (OR 1.48, 95% CI 1.1 to 1.87) than in older men (OR 1.21, 95% CI 1.05 to 1.39). For men older than 35 with exposure to silica the prevalence of sarcoidosis increased with the exposure time, with an OR of 1.44 (95% CI 1.04 to 2.00) for exposure of more than 10 years. Conclusions Occupational exposure to silica dust seems to increase the risk of sarcoidosis among men between 20 and 65 years of age. The risk is higher among exposed men 35 years or younger and older men with longer exposure (>6 years).