Evaluation of bone mineral density and 25-hydroxyvitamin D levels in subjects with silica exposure

  • Mustafa Turgut YıldızgörenEmail author
  • Türkan Nadir Öziş
  • Ali Erdem Baki
  • Engin Tutkun
  • Hınç Yılmaz
  • Tülay Tiftik
  • Timur Ekiz
  • Neşe Özgirgin
Regular Article



The purpose of the study was to evaluate the bone mineral density (BMD) and 25-hydroxyvitamin D (25(OH)D) levels in patients with silica exposure.

Materials and methods

The study included 104 male subjects with silica exposure and 36 healthy subjects. Posterior–anterior radiographs were classified according to the International Labour Office (ILO) Classification. Category 0 patients were classified as Group I (n = 54), category I patients were classified as Group II (n = 25), Category II and III patients were classified as Group III (n = 25).


Femoral neck BMD values were significantly lower in Group III (p = 0.007). Lumbar vertebrae BMD values were significantly lower in all groups with silica exposure than in the control group (p = 0.000). The osteoporosis rate was significantly higher in Group III (p = 0.000). Subjects with silica exposure were determined to have diminished 25(OH)D levels (p = 0.012).


The results of this study demonstrated that subjects with silica exposure have diminished BMD and 25(OH)D levels.


Silicosis Bone mineral density Osteoporosis Pneumoconiosis Vitamin D 



No funding was received for this article.

Compliance with ethical standards

Conflict of interest



  1. 1.
    Thomas CR, Kelley TR. A brief review of silicosis in the United States. Environ Health Insights. 2010;4:21–6.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Pernis B. Silica and the immune system. Acta Biomed. 2005;2:38–44.Google Scholar
  3. 3.
    Chaudhury N, Paliwal R, Phatak A. Co-morbidities among silicotics at Shakarpur: a follow up study. Lung India. 2012;29:6–10.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Liu HB, Yan B, Han B, Sun JK, Yang Y, Chen J. Determination of ameliorable health impairment influencing health-related quality of life among patients with silicosis in China: a cross-sectional study. J Int Med Res. 2011;39:1448–55.CrossRefPubMedGoogle Scholar
  5. 5.
    Fenwick S, Main J. Increased prevalence of renal disease in silica-exposed workers. Lancet. 2000;356:913–4.CrossRefPubMedGoogle Scholar
  6. 6.
    Steenland K, Goldsmith DF. Silica exposure and autoimmune diseases. Am J Ind Med. 1995;28:603–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Yildizgören MT, Ekiz T, Nadir Öziş T, Baki AE, Tutkun E, Özgirgin N. Osteoporosis: can it be related to silicosis? Tuberk Toraks. 2014;62:98–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Arens AM, Barr B, Puchalski SM, Poppenga R, Kulin RM, Anderson J, et al. Osteoporosis associated with pulmonary silicosis in an equine bone fragility syndrome. Vet Pathol. 2011;48:593–615.CrossRefPubMedGoogle Scholar
  9. 9.
    Durham MG. The silicosis and osteoporosis syndrome. In: Robinson NE, Sprayberry KA, editors. Current therapy in equine medicine, 6th ed. Missouri: Elsevier Health Sciences; 2009. p. 303–6.Google Scholar
  10. 10.
    Garn H, Friedetzky A, Kirchner A, Jager R, Gemsa D. Experimental silicosis: a shift to a preferential IFN-gamma-based Th1 response in thoracic lymph nodes. Am J Physiol Lung Cell Mol Physiol. 2000;278:1221–30.Google Scholar
  11. 11.
    Rimal B, Greenberg AK, Rom WN. Basic pathogenetic mechanisms in silicosis: current understanding. Curr Opin Pulm Med. 2005;11:169–73.CrossRefPubMedGoogle Scholar
  12. 12.
    Weitzmann MN. The role of inflammatory cytokines, the RANKL/OPG Axis, and the immunoskeletal interface in physiological bone turnover and osteoporosis. Scientifica (Cairo). 2013;2013:125705.Google Scholar
  13. 13.
    Wu X, Pan G, McKenna MA, Zayzafoon M, Xiong WC, McDonald JM. RANKL regulates Fas expression and Fas-mediated apoptosis in osteoclasts. J Bone Miner Res. 2005;20:107–16.CrossRefPubMedGoogle Scholar
  14. 14.
    International Labour Organization (2011) Guidelines for the use of the ILO International Classification of radiographs of pneumoconioses. Occupational Safety and Health Series. No. 22 (Rev. 2011). International Lavour Office, Geneva.Google Scholar
  15. 15.
    World Health Organization. Assessment of osteoporosis at the primary health care level. Summary report of a WHO scientific Group. Geneva: WHO; 2007.Google Scholar
  16. 16.
    Kanis JA, On behalf of the World Health Organization Scientific Group (2007) Assessment of osteoporosis at the primary healthcare level. Technical Report. WHO Collaborating Centre, University of Sheffield, Sheffield.Google Scholar
  17. 17.
    Herrera A, Lobo-Escolar A, Mateo J, Gil J, Ibarz E, Gracia L. Male osteoporosis: a review. World J Orthop. 2012;3:223–34.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© The Japanese Society for Hygiene 2016

Authors and Affiliations

  • Mustafa Turgut Yıldızgören
    • 1
    Email author
  • Türkan Nadir Öziş
    • 2
  • Ali Erdem Baki
    • 1
  • Engin Tutkun
    • 3
  • Hınç Yılmaz
    • 3
  • Tülay Tiftik
    • 4
  • Timur Ekiz
    • 4
  • Neşe Özgirgin
    • 4
  1. 1.Department of Physical Medicine and RehabilitationAnkara Occupational Diseases HospitalAnkaraTurkey
  2. 2.Department of Chest DiseasesAnkara Occupational Diseases HospitalAnkaraTurkey
  3. 3.Department of ToxicologyAnkara Occupational Diseases HospitalAnkaraTurkey
  4. 4.Department of Physical Medicine and RehabilitationAnkara Physical Medicine and Rehabilitation Training and Research HospitalAnkaraTurkey

Personalised recommendations