Rutile is a mineral composed of titanium dioxide (Ti02) and it can be found incrusted in quartz, thus being called rutilated quartz. In Brazil it´s extracted in underground mines, often artisanal, and marketed as semiprecious stone. We describe 11 cases, all male, of rutilated quartz miners from a small region of northeastern Brazil (Chapada Diamantina/Bahia) who were attended in an outpatient clinic of a tertiary hospital in São Paulo (1850 km from the mine) between 2015 and 2022.
| Table 1. Demographic and exposure information | |
| Age at first evaluation,years | 46±8 |
| Never/Former smoker | 55/45 |
| Pack/years | 18±6 |
| Exposure,years | 15(6-28) |
| Years between exposure and first evaluation | 17(5-32) |
| Data expressed as:%; mean±standard deviation; median(range) | |
Symptoms reported were dry cough, wheezing and dyspnea. All 11 workers had progressive massive fibrosis on X-ray and CT scan, with bilateral hilar lymph nodes and mediastinal increased and calcified. Seven subjects had an obstructive respiratory impairment, three had mixed impairment and one no impairment according to spirometry. Two subjects had a history of treatment for pulmonary tuberculosis and two for latent tuberculosis (PPD?10mm). At this time, 9 of the 11 patients have died from complications of silicosis, one was lost to follow-up and one is being managed at the clinic. Ten patients were considered for lung transplant: four were contraindicated and five died before being placed in the transplant list. Median time between first consultation and death was one year (range:8 months;4 years). Exposure to rutilated quartz mining is related to severe silicosis forms due to poor working conditions. Public policies are needed to identify and protect workers at risk and implement safe working measures.