{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T11:06:05Z","timestamp":1765278365377,"version":"3.46.0"},"reference-count":22,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T00:00:00Z","timestamp":1641168000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_pp-2021-0135_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Exposure to silica nanoparticles has been associated with pleural effusions (PEs) in animal models and case series. We hypothesized that some PEs labelled as \u201cidiopathic\u201d could, in fact, be secondary to inhalation of silica.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_pp-2021-0135_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective case control study was designed utilizing a prospectively maintained pleural database. Cases, represented by idiopathic PEs, were matched by age and gender to control patients who had been diagnosed with malignant, cardiac, or infectious PEs. A survey consisting of questions about occupational life and possibility of silica inhalation was conducted. In a subgroup of patients, pleural fluid concentrations of silica were quantified by plasma atomic emission spectrometry analysis. Also, the pleural biopsy of a silica-exposed case was subjected to an energy dispersive X-ray spectroscopy (EDX) to identify the mineral, the size of which was determined by electron microscopy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_pp-2021-0135_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 118 patients (59 cases and 59 controls) completed the survey. There were 25 (42%, 95% CI 31\u201355%) and 13 (22%, 95% CI 13\u201334%) silica-exposed workers in case and control groups, respectively. The exposure attributable fraction was 0.62 (95% CI 0.14\u20130.83). Four of eight exposed cases showed detectable levels of silica in the pleural fluid (mean 2.37\u00a0mg\/L), as compared to none of 16 tested controls. Silica nanoparticles of 6\u20137\u00a0nm were identified in the pleural biopsy of an exposed case patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_pp-2021-0135_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>It is plausible that some idiopathic PEs could actually be caused by occupational silica inhalation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/pp-2021-0135","type":"journal-article","created":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T01:51:46Z","timestamp":1641261106000},"page":"27-33","source":"Crossref","is-referenced-by-count":4,"title":["Some pleural effusions labeled as idiopathic could be produced by the inhalation of silica"],"prefix":"10.1515","volume":"7","author":[{"given":"Silvia","family":"Bielsa","sequence":"first","affiliation":[{"name":"Department of Internal Medicine , Pleural Medicine Unit, Arnau de Vilanova University Hospital, Biomedical Research Institute of Lleida (IRBLleida), University of Lleida , Lleida , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Guitart","sequence":"additional","affiliation":[{"name":"Chemical Analysis Service , Science Faculty, Zaragoza University, Zaragoza , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aureli","family":"Esquerda","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine , Arnau de Vilanova University Hospital, IRBLleida , Lleida , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo","family":"Fern\u00e1ndez-Pacheco","sequence":"additional","affiliation":[{"name":"Aragon Nanoscience Institute , Advanced Microscopy Laboratory, Zaragoza University , Zaragoza , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"Barangu\u00e1n","sequence":"additional","affiliation":[{"name":"Chemical Analysis Service , Science Faculty, Zaragoza University, Zaragoza , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfonso","family":"Ibarra","sequence":"additional","affiliation":[{"name":"Aragon Nanoscience Institute , Advanced Microscopy Laboratory, Zaragoza University , Zaragoza , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 M.","family":"Porcel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine , Pleural Medicine Unit, Arnau de Vilanova University Hospital, Biomedical Research Institute of Lleida (IRBLleida), University of Lleida , Lleida , Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2022,1,3]]},"reference":[{"key":"2025120909240603251_j_pp-2021-0135_ref_001","doi-asserted-by":"crossref","unstructured":"Napierska, D, Thomassen, LCJ, Lison, D, Martens, JA, Hoet, PH. The nanosilica hazard: another variable entity. Part Fibre Toxicol 2010;7:39. https:\/\/doi.org\/10.1186\/1743-8977-7-39.","DOI":"10.1186\/1743-8977-7-39"},{"key":"2025120909240603251_j_pp-2021-0135_ref_002","doi-asserted-by":"crossref","unstructured":"Song, Y, Li, X, Du, X. Exposure to nanoparticles is related to pleural effusion, pulmonary fibrosis and granuloma. Eur Respir J 2009;34:559\u201367. https:\/\/doi.org\/10.1183\/09031936.00178308.","DOI":"10.1183\/09031936.00178308"},{"key":"2025120909240603251_j_pp-2021-0135_ref_003","doi-asserted-by":"crossref","unstructured":"Song, Y, Li, X, Wang, L, Rojanasakul, Y, Castranova, V, Li, H, et al.. Nanomaterials in humans: identification, characteristics and potential damage. Toxicol Pathol 2011;39:841\u20139. https:\/\/doi.org\/10.1177\/0192623311413787.","DOI":"10.1177\/0192623311413787"},{"key":"2025120909240603251_j_pp-2021-0135_ref_004","doi-asserted-by":"crossref","unstructured":"Zhu, X, Cao, W, Chang, B, Zhang, L, Qiao, P, Li, X, et al.. Polyacrylate\/nanosilica causes pleural and pericardial effusion, and pulmonary fibrosis and granuloma in rats similar to those observed in exposed workers. Int J Nanomed 2016;11:1593\u2013605. https:\/\/doi.org\/10.2147\/IJN.S102020.","DOI":"10.2147\/IJN.S102020"},{"key":"2025120909240603251_j_pp-2021-0135_ref_005","doi-asserted-by":"crossref","unstructured":"Cao, W, Zhu, X, Tang, Z, Song, Y. A pleural effusion model in rats by intratracheal instillation of polyacrylate\/nanosilica. J Vis Exp 2019;146:e58560. https:\/\/doi.org\/10.3791\/58560.","DOI":"10.3791\/58560-v"},{"key":"2025120909240603251_j_pp-2021-0135_ref_006","doi-asserted-by":"crossref","unstructured":"Ryman-Rasmussen, JP, Cesta, MF, Brody, AR, Shipley-Phillips, JK, Everitt, JI, Tewksbury, EW, et al.. Inhaled carbon nanotubes reach the subpleural tissue in mice. Nat Nanotechnol 2009;4:747\u201351. https:\/\/doi.org\/10.1038\/nnano.2009.305.","DOI":"10.1038\/nnano.2009.305"},{"key":"2025120909240603251_j_pp-2021-0135_ref_007","doi-asserted-by":"crossref","unstructured":"Murphy, FA, Poland, CA, Duffin, R, Al-Jamal, KT, Ali-Boucetta, H, Nunes, A, et al.. Length-dependent retention of carbon nanotubes in the pleural space of mice initiates sustained inflammation and progressive fibrosis on the parietal pleura. Am J Pathol 2011;178:2587\u2013600. https:\/\/doi.org\/10.1016\/j.ajpath.2011.02.040.","DOI":"10.1016\/j.ajpath.2011.02.040"},{"key":"2025120909240603251_j_pp-2021-0135_ref_008","doi-asserted-by":"crossref","unstructured":"Arsenopoulu, ZV, Taitzoglou, IA, Molyvdas, PA, Gourgoulianis, KI, Hatzoglou, C, Zarogiannis, SG. Silver nanoparticles alter the permeability of sheep pleural and of sheep and human pleural mesothelial cell monolayers. Environ Toxicol Pharmacol 2017;50:212\u20135. https:\/\/doi.org\/10.1016\/j.etap.2017.02.009.","DOI":"10.1016\/j.etap.2017.02.009"},{"key":"2025120909240603251_j_pp-2021-0135_ref_009","doi-asserted-by":"crossref","unstructured":"Arsenopoulu, ZV, Taitzoglou, IA, Molyvdas, PA, Gourgoulianis, KI, Hatzoglou, C, Zarogiannis, SG. Silver nanoparticles alter cell adhesion and proliferation of sheep primary mesothelial cells. In Vivo 2018;32:109\u201312. https:\/\/doi.org\/10.21873\/invivo.11211.","DOI":"10.21873\/invivo.11211"},{"key":"2025120909240603251_j_pp-2021-0135_ref_010","doi-asserted-by":"crossref","unstructured":"Browner, W, Newman, TB. Sample size and power based on the population attributable fraction. AJPH 1989;79:1289\u201394. https:\/\/doi.org\/10.2105\/ajph.79.9.1289.","DOI":"10.2105\/AJPH.79.9.1289"},{"key":"2025120909240603251_j_pp-2021-0135_ref_011","doi-asserted-by":"crossref","unstructured":"Salih, M, Aljarod, T, Ayan, M, Jeffrey, M, Shah, BH. Pulmonary silicosis presents with pleural effusion. Case Rep Med 2015;2015:543070. https:\/\/doi.org\/10.1155\/2015\/543070.","DOI":"10.1155\/2015\/543070"},{"key":"2025120909240603251_j_pp-2021-0135_ref_012","doi-asserted-by":"crossref","unstructured":"Arakawa, H, Honma, K, Saito, Y, Shida, H, Morikubo, H, Suganuma, N, et al.. Pleural disease in\u00a0silicosis: pleural thickening, effusion and invagination. Radiology 2005;236:685\u201393. https:\/\/doi.org\/10.1148\/radiol.2362041363.","DOI":"10.1148\/radiol.2362041363"},{"key":"2025120909240603251_j_pp-2021-0135_ref_013","doi-asserted-by":"crossref","unstructured":"Mossman, BT, Glenn, RE. Bioreactivity of the crystalline silica polymorphs, quartz and cristobalite, and implications for occupational exposure limits (OELs). Crit Rev Toxicol 2013;43:632\u201360. https:\/\/doi.org\/10.3109\/10408444.2013.818617.","DOI":"10.3109\/10408444.2013.818617"},{"key":"2025120909240603251_j_pp-2021-0135_ref_014","doi-asserted-by":"crossref","unstructured":"Rando, RJ, Vacek, PM, Glenn, RE, Kwon, CW, Parker, JE. Retrospective assessment of respirable quartz exposure for a silicosis study of the industrial sand industry. Ann Work Expo Health 2018;62:1021\u201332. https:\/\/doi.org\/10.1093\/annweh\/wxy064.","DOI":"10.1093\/annweh\/wxy064"},{"key":"2025120909240603251_j_pp-2021-0135_ref_015","doi-asserted-by":"crossref","unstructured":"Chen, W, Zhuang, Z, Attfield, MD, Chen, BT, Gao, P, Harrison, JC, et al.. Exposure to silica and silicosis among tin miners in China: exposure-response analysis and risk assessment. Occup Environ Med 2001;58:31\u20137. https:\/\/doi.org\/10.1136\/oem.58.1.31.","DOI":"10.1136\/oem.58.1.31"},{"key":"2025120909240603251_j_pp-2021-0135_ref_016","doi-asserted-by":"crossref","unstructured":"Barnes, H, Goh, NSL, Leong, TL, Hoy, R. Silica-associated lung disease: an old-world exposure in modern industries. Respirology 2019;24:1165\u201375. https:\/\/doi.org\/10.1111\/resp.13695.","DOI":"10.1111\/resp.13695"},{"key":"2025120909240603251_j_pp-2021-0135_ref_017","doi-asserted-by":"crossref","unstructured":"Wu, N, Xue, C, Yu, S, Ye, Q. Artificial stone-associated silicosis in China: a prospective comparison with natural stone-associated silicosis. Respirology 2020;25:518\u201324. https:\/\/doi.org\/10.1111\/resp.13744.","DOI":"10.1111\/resp.13744"},{"key":"2025120909240603251_j_pp-2021-0135_ref_018","doi-asserted-by":"crossref","unstructured":"Bonner, JC. Nanoparticles as a potential cause of pleural and interstitial lung disease. Proc Am Thorac Soc 2010;7:138\u201341. https:\/\/doi.org\/10.1513\/pats.200907-061rm.","DOI":"10.1513\/pats.200907-061RM"},{"key":"2025120909240603251_j_pp-2021-0135_ref_019","doi-asserted-by":"crossref","unstructured":"Kaewamatawong, T, Kawamura, N, Okajima, M, Sawada, M, Morita, T, Shimada, A. Acute pulmonary toxicity caused by exposure to colloidal silica: particle size dependent pathological changes in mice. Toxicol Pathol 2005;33:743\u20139. https:\/\/doi.org\/10.1080\/01926230500416302.","DOI":"10.1080\/01926230500416302"},{"key":"2025120909240603251_j_pp-2021-0135_ref_020","doi-asserted-by":"crossref","unstructured":"Ferrer, J, Orriols, R, Tura, JM, Lirola, J, Xaus, C, Vidal, X. Energy-dispersive X-ray analysis and scanning electron microscopy of pleura. Am J Respir Crit Care Med 1994;149:888\u201392. https:\/\/doi.org\/10.1164\/ajrccm.149.4.8143051.","DOI":"10.1164\/ajrccm.149.4.8143051"},{"key":"2025120909240603251_j_pp-2021-0135_ref_021","doi-asserted-by":"crossref","unstructured":"Song, Y, Tang, S. Nanoexposure, unusual diseases, and new health and safety concerns. Sci World J 2011;11:1821\u20138. https:\/\/doi.org\/10.1100\/2011\/794801.","DOI":"10.1100\/2011\/794801"},{"key":"2025120909240603251_j_pp-2021-0135_ref_022","doi-asserted-by":"crossref","unstructured":"Mann, CJ. Observational research methods. Research design II: cohort, cross sectional and case-control studies. Emerg Med J 2003;20:54\u201360. https:\/\/doi.org\/10.1136\/emj.20.1.54.","DOI":"10.1136\/emj.20.1.54"}],"container-title":["Pleura and Peritoneum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/pp-2021-0135\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/pp-2021-0135\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T11:01:09Z","timestamp":1765278069000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/pp-2021-0135\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,3]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,3,9]]},"published-print":{"date-parts":[[2022,3,9]]}},"alternative-id":["10.1515\/pp-2021-0135"],"URL":"https:\/\/doi.org\/10.1515\/pp-2021-0135","relation":{},"ISSN":["2364-768X"],"issn-type":[{"type":"electronic","value":"2364-768X"}],"subject":[],"published":{"date-parts":[[2022,1,3]]}}}