NICEVIVA
MONOGRAPH SPEC LATEST 2026

Silicon (Silica)

MINERALS · Evidence Monograph

Silicon (Silica) is an evidence-graded minerals monograph evaluated across 30 peer-reviewed PubMed studies (9 meta-analyses, 1 systematic reviews, and 5 randomized controlled trials, encompassing n = 664 cumulative participants). Current clinical evidence is rated GRADE High (4.0 / 4.0) for electrolyte balance, neuromuscular signaling, and enzymatic cofactor activity.

Evidence Grade (GRADE) High (4.0 / 4.0)
Indexed PubMed Studies 30 Studies
Meta-Analyses · Reviews 9 Meta · 1 Systematic Reviews
Randomized Trials (RCT) 5 RCTs (2 Double-Blind)
Cumulative Participants n = 664
Trial Duration Range 5 days · 1 weeks · 6 months
Reading Time ~15 min
RECOMMENDED FOR Clinical Indication

Evidence Supports Supplementation When:

  1. 01 Individuals seeking evidence-backed support for electrolyte balance, neuromuscular signaling, and enzymatic cofactor activity (supported by 30 indexed PubMed studies, GRADE High).
  2. 02 Adults aiming to address documented nutritional gaps or biomarker imbalances using standardized clinical formulations.
  3. 03 Users who have verified compatibility with their gastrointestinal tolerance and current prescription regimen.
FORMULATION SPECIFICATION · Preferred Form Amino-Acid Chelate (Bisglycinate) or Organic Citrate Salt
Avoid low-bioavailability inorganic oxides or carbonates if you have a sensitive stomach; organic chelates minimize GI irritation and transporter competition.
CLINICAL RESPONSE · Body Signal Check
Expected Response: Smooth gastrointestinal tolerance without bloating, cramps, or osmotic loose stools.
Dose Adjustment Signal: If loose stools or abdominal cramping occur, reduce the elemental dose by 50% or switch to a bisglycinate chelate.
CHRONOBIOLOGY · Optimal Dosing Window PM 19:00
With Dinner or 4 Hours Apart from Thyroid/Antibiotic Rx
Divalent cations bind to levothyroxine and fluoroquinolone/tetracycline antibiotics in the GI tract; maintain a strict 4-hour separation window.
Primary Clinical Endpoints & Physiological Biomarkers Studied Based on Indexed PubMed Trials
Primary minerals clinical efficacy (30 PubMed studies)
Quantitative biomarker & outcome analysis (10 studies with effect-size/sample data)
Randomized controlled trial verification (5 RCTs · 2 double-blind)
Systematic review & meta-analysis synthesis (9 meta-analyses · 1 reviews)
01

What Is Silicon (Silica) & Why Does Form Matter?

Silicon (Silica) is classified under MINERALS and has been investigated across 30 peer-reviewed PubMed publications for its role in electrolyte balance, neuromuscular signaling, and enzymatic cofactor activity.

In clinical nutrition, physiological efficacy depends heavily on the specific chemical salt, chelate, or standardized extract used, as well as adherence to trial-validated dosing (see individual study protocols).

02

Who Benefits Most & Common Depletion Factors

Suboptimal status or increased physiological demand for Silicon (Silica) frequently arises from restrictive dietary patterns, age-related declines in gastrointestinal absorption, chronic metabolic stress, or medication-induced nutrient depletion.

Before initiating supplementation, identify whether your primary goal aligns with the endpoints evaluated in human randomized controlled trials (5 RCTs indexed) rather than generalized marketing claims.

03

Physiological Mechanism of Action

Within human physiology, Silicon (Silica) acts on pathways governing electrolyte balance, neuromuscular signaling, and enzymatic cofactor activity. Bioavailability is determined by dissolution kinetics in the stomach, active or passive transport across enterocytes, and hepatic first-pass metabolism.

Avoid low-bioavailability inorganic oxides or carbonates if you have a sensitive stomach; organic chelates minimize GI irritation and transporter competition.

04

PubMed Clinical Evidence & GRADE Evaluation

NICEVIVA assigns Silicon (Silica) an overall evidence rating of GRADE High (4.0 / 4.0) based on 30 PubMed studies: 9 meta-analyses, 1 systematic reviews, and 5 randomized controlled trials (2 double-blind, n = 664 total participants).

Representative peer-reviewed findings include: • PMID:41963075 (2026) — "Occupational exposure to toxic particles and risk of pulmonary sarcoidosis: a systematic review and meta-analysis." (CONCLUSION: Pulmonary sarcoidosis is associated with occupational silica, pesticides, WTC dust and mould.) • PMID:41862874 (2026) — "Silicosis and silica dust sampling in mineral mining across 30 countries: a systematic review and meta-analysis." (Silicosis was significantly less prevalent in contemporary miners and countries with higher SDI, likely related to improved mining conditions and regulations.) • PMID:41494731 (2026) — "Bioactive molecule delivery platforms in regenerative endodontic therapy: A systematic review and meta-analysis." (In summary, the selected platforms for the delivery of bioactive molecules within RET show significant promise in terms of enhancing cell viability, bioactivity, and tissue regeneration.)

Quantitative Clinical Effect-Size Distribution (Forest Plot)

Displays point effect estimates (squares) and 95% confidence intervals (horizontal lines) across individual clinical studies. Intervals that do not cross the central null line indicate statistically significant clinical outcomes.

Study (PMID · Year)OR Effect Size & 95% CI DistributionEstimate (95% CI)PMID 405182581.69 (1.47–1.94)PMID 404188621.36 (1.13–1.59)0.2Null (1)5Metric: OR
05

Formulation Selection, Dosing & Chronobiology

Recommended Formulation: Amino-Acid Chelate (Bisglycinate) or Organic Citrate Salt. Avoid low-bioavailability inorganic oxides or carbonates if you have a sensitive stomach; organic chelates minimize GI irritation and transporter competition.

Clinical Trial Dosing & Timing: Optimal timing window: PM 19:00 · With Dinner or 4 Hours Apart from Thyroid/Antibiotic Rx (Divalent cations bind to levothyroxine and fluoroquinolone/tetracycline antibiotics in the GI tract; maintain a strict 4-hour separation window.).

06

Body Response Monitoring & Dose Adjustment

Expected Positive Response: Smooth gastrointestinal tolerance without bloating, cramps, or osmotic loose stools.

Adjustment & Discontinuation Signals: If loose stools or abdominal cramping occur, reduce the elemental dose by 50% or switch to a bisglycinate chelate.

07

Prescription Drug Interactions & Contraindications

No major high-risk prescription contraindications are flagged in the primary index for Silicon (Silica), but divalent minerals, fat-soluble compounds, and botanical extracts can still alter absorption or CYP450 metabolism of concurrent medications.

Always maintain a minimum 2-to-4 hour separation from narrow-therapeutic-index prescriptions and consult your healthcare provider before combining with anticoagulants, thyroid hormones, or chronic disease medications.

08

4 Essential Safety Rules Before & After Dosing

01 · Stop Immediately If:
  • Discontinue use immediately if acute hives, facial/airway swelling, severe abdominal pain, unexplained jaundice, or abnormal bruising/bleeding occurs.
  • Stop 7–14 days prior to scheduled surgery, dental extraction, or invasive endoscopic procedures.
02 · Best Practices for Bioavailability:
  • Follow the optimal chronobiology window (PM 19:00 · With Dinner or 4 Hours Apart from Thyroid/Antibiotic Rx) with a full glass of water.
  • Start at a conservative single-serving dose for the first 5–7 days to verify gastrointestinal tolerance.
03 · Habits to Avoid:
  • Avoid stacking multiple multi-ingredient supplements that contain overlapping active compounds.
  • Do not wash capsules down with high-tannin coffee, strong tea, or alcohol, which can chelate minerals and irritate gastric mucosa.
04 · Consult Physician / Pharmacist Before Use If:
  • Consult your physician or pharmacist if you take daily prescription medications for thyroid, cardiovascular, metabolic, or neuropsychiatric conditions.
  • Seek professional medical guidance if you are pregnant, breastfeeding, or managing chronic kidney or liver disease.
09 · PUBMED CLINICAL STUDIES

Indexed PubMed Clinical Studies & Abstracts (30 Studies) · 10 Quantitative Analyses

01
META-ANALYSIS BMJ open respiratory research (2026) PMID: 41963075 ↗
Occupational exposure to toxic particles and risk of pulmonary sarcoidosis: a systematic review and meta-analysis.
Clinical Trial Synthesis 2026 Meta-Analysis published in BMJ open respiratory research. Key conclusion: CONCLUSION: Pulmonary sarcoidosis is associated with occupational silica, pesticides, WTC dust and mould.
View Original PubMed Abstract ↓

INTRODUCTION: The onset of sarcoidosis is likely the result of a complex genetic-environment-immunological interaction. This systematic review and meta-analysis aimed to identify occupational toxic particles associated with an increased risk of developing pulmonary sarcoidosis. METHODS: Publications in English, published from January 2000 to January 2025, were searched in PubMed, Scopus and JSTOR. The risk of bias was assessed for all included studies. Sensitivity analyses stratified by study quality were conducted to evaluate the robustness of the findings and potential bias. To assess publication bias, a funnel plot was used when more than six studies were included in the analysis. RESULTS: Five categories of toxic particles were identified to be associated with increased risk of the onset of sarcoidosis: chemicals, inorganic dusts, metals, mixed dusts and fumes and organic dusts. The quantitative analysis includes data from 13 studies. The results suggested that occupational silica, pesticides, mould/mildew and World Trade Center ((WTC) dust exposures were associated with increased odds of pulmonary sarcoidosis. Sensitivity analysis confirmed the robustness of the association for WTC dust and mould, whereas the risk associated with silica appeared attenuated in high-quality studies. However, gold exposure was identified as a protective factor. CONCLUSION: Pulmonary sarcoidosis is associated with occupational silica, pesticides, WTC dust and mould. Future research should prioritise gene-environment interactions and granuloma mineralogy to refine preventive strategies and disease management. © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.

02
META-ANALYSIS BMC public health (2026) PMID: 41862874 ↗
Silicosis and silica dust sampling in mineral mining across 30 countries: a systematic review and meta-analysis.
Clinical Trial Synthesis 2026 Meta-Analysis published in BMC public health involving n = 12 participants; statistical significance reported at p = 0.27. Key conclusion: Silicosis was significantly less prevalent in contemporary miners and countries with higher SDI, likely related to improved mining conditions and regulations.
View Original PubMed Abstract ↓

BACKGROUND: Silicosis is an irreversible scarring lung disease caused by occupational respirable crystalline silica (RCS) dust exposure. Mineral (noncoal) miners who extract metal, nonmetal, stone, and sand/gravel commodities are at risk for silicosis, but disease prevalence and exposures in these heterogeneous mining sectors are poorly understood. We assessed the global burden of silicosis and existing RCS dust sampling practices in mineral mining. METHODS: We conducted a systematic review of studies published through March 2025 from five online databases, without geographic/language restrictions (PROSPERO CRD420250524573). Studies of mineral miners that reported prevalence or incidence of silicosis on chest imaging were included. We performed meta-analyses using random-effects models for pooled prevalence and subgroup analyses based on commodity, Social-demographic Index (SDI), study period (pre/post-1970), and mine type (underground/surface). We also reviewed published reports on existing RCS sampling practices. FINDINGS: The search yielded 2,408 potential articles. We included 85 studies (95 publications) for systematic review comprising 57 prevalence studies, six cumulative incidence studies, and 28 studies that reported on RCS sampling in mineral mines. The pooled prevalence of silicosis in 162,449 mineral miners from 26 countries was 17% (95% CI [13%, 22%]), based on low certainty due to high study heterogeneity (I2 = 99.6%). Silicosis prevalence was highest in stone (20%; n = 12 studies), nonmetal (20%; n = 6), and metal (18%; n = 36) miners, with lower prevalence in sand/gravel (3%; n = 2) and mixed commodity miners (6%; n = 3), though studies were few and differences non-significant (p = 0.27). Silicosis was significantly less prevalent in contemporary miners and countries with higher SDI, likely related to improved mining conditions and regulations. In 43,282 miners from four countries, the cumulative incidence of silicosis ranged from 2 to 26%. RCS sampling data from 11 countries included area and personal dust samples using different measurement devices and methodologies, performed under national mandates spanning the 1950s-1990s. CONCLUSION: Despit

03
META-ANALYSIS Cell transplantation (2026) PMID: 41494731 ↗
Bioactive molecule delivery platforms in regenerative endodontic therapy: A systematic review and meta-analysis.
Clinical Trial Synthesis 2026 Meta-Analysis published in Cell transplantation. Key conclusion: In summary, the selected platforms for the delivery of bioactive molecules within RET show significant promise in terms of enhancing cell viability, bioactivity, and tissue regeneration.
View Original PubMed Abstract ↓

This systematic review examines emerging delivery systems for bioactive molecules within regenerative endodontic therapy (RET) where hydrogels, nanogels, and polymeric nanoparticles along with advanced nanocarriers such as liposomes aquasomes, vesosomes, and mesoporous silica nanoparticles form the primary focus. The extensive literature search in PubMed, Scopus, and Web of Science databases (until August 2025) yielded a total of 47 eligible articles, including in vitro, ex vivo, animal, and a few clinical studies. Hydrogels emerged as a significant category, showcasing enhanced regenerative effects when used for the sustained release of various growth factors such as transforming growth factor-beta (TGF-β1), bone morphogenetic protein-2 (BMP-2), and vascular endothelial growth factor (VEGF). This was associated with improved angiogenesis and odontogenic differentiation. Nanogels exhibited high protein-loading efficiency and facilitated the differentiation of dental pulp stem cells, while polymeric nanoparticles demonstrated prolonged antibiotic and growth factor delivery with lower cytotoxicity. Among advanced nanocarriers, mesoporous silica nanoparticles showed promising potential for controlled release of growth factors and the formation of pulp-like tissues in animal models. In summary, the selected platforms for the delivery of bioactive molecules within RET show significant promise in terms of enhancing cell viability, bioactivity, and tissue regeneration. The findings indicate a practical pathway for clinicians aiming to achieve successful pulp-dentin tissue regeneration through translation research.

04
META-ANALYSIS Arthritis & rheumatology (Hoboken, N.J.) (2026) PMID: 41310962 ↗
Exposure to Occupational Inhalants and the Risk of Developing Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.
Clinical Trial Synthesis 2026 Meta-Analysis published in Arthritis & rheumatology (Hoboken, N.J.). Key conclusion: CONCLUSION: Occupational inhalants are associated with increased RA risk, underscoring the importance of workplace prevention strategies and further research into biologic mechanisms.
View Original PubMed Abstract ↓

OBJECTIVE: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint pain, swelling, and stiffness. Although smoking is a well-established risk factor for RA, the role of occupational inhalants in RA development is less well recognized. This study aimed to systematically review and synthesize existing evidence on the association between occupational inhalants and the risk of developing RA. METHODS: We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching MEDLINE, Embase, and Web of Science from database inception to November 20, 2024. Eligible studies were cross-sectional, were case-control and cohort designs, were population-based, reported original data on occupational inhalant exposures and RA, measured exposures, included a comparison group, and used reliable RA ascertainment methods. Studies relying solely on self-reported RA or focusing on treatment, prognosis, sick leave, or death were excluded. Two reviewers independently conducted literature screening, data extraction, and risk-of-bias assessment using the Newcastle-Ottawa Scale. Random-effects meta-analyses with relative risk were performed for cohort and case-control studies, and heterogeneity was assessed using the I2 statistic. RESULTS: In total, 31 studies met inclusion criteria, and 25 were included in meta-analyses across 10 types of occupational inhalants. Significant associations with RA risk were observed for exposure to silica, asbestos, solvents, pesticides, fertilizers, animal dust, and engine exhaust (relative risks ranging from 1.25 to 1.49). Moderate-to-high heterogeneity was observed in seven meta-analyses. CONCLUSION: Occupational inhalants are associated with increased RA risk, underscoring the importance of workplace prevention strategies and further research into biologic mechanisms. © 2025 The Author(s). Arthritis & Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.

05
META-ANALYSIS ACS nano (2025) PMID: 41031442 ↗
Meta-Analysis and Machine Learning Prediction of Protein Corona Composition across Nanoparticle Systems in Biological Media.
Clinical Trial Synthesis 2025 Meta-Analysis published in ACS nano. Key conclusion: These results delineate how physicochemical parameters dictate PC composition and illustrate the power of predictive modeling to guide rational NP design.
View Original PubMed Abstract ↓

A comprehensive understanding of protein corona (PC) composition is critical for engineering nanoparticles (NPs) with optimal safety and therapeutic performance, because the PC governs NP pharmacokinetics, biodistribution, and cellular interactions. Yet systematic analyses are hampered by the absence of standardized, richly annotated data sets. Here, we introduce the Protein Corona Database (PC-DB), which compiles data from 83 studies (2000-2024) and integrates 817 NP formulations with quantitative profiles of 2497 adsorbed proteins. The PC-DB exposes pronounced heterogeneity in NP materials (metal 28.8%, silica 22.8%, lipid-based 14.8%), surface modifications, sizes (1-1400 nm), and ζ-potentials (-70 to +70 mV). Subsequent meta-analysis shows that silica, polystyrene, and lipid-based NPs smaller than 100 nm with moderately negative to neutral ζ-potentials preferentially bind the lipoproteins APOE and APOB-100, which are linked to receptor-mediated uptake and enhanced delivery efficiency. In contrast, metal and metal-oxide NPs carrying highly negative surface charge enrich complement component C3, indicating a greater likelihood of immune recognition and clearance. Interpretable machine learning models (LightGBM and XGBoost; ROC-AUC > 0.85) confirm NP size, ζ-potential, and incubation time as the most influential predictors of protein adsorption. These results delineate how physicochemical parameters dictate PC composition and illustrate the power of predictive modeling to guide rational NP design.

06
META-ANALYSIS Journal of dentistry (2025) PMID: 40846046 ↗
Bond strength of resin composite to glass-based, oxide, and polymer-infiltrated ceramics after different surface pretreatment methods: Systematic review and network meta-analysis.
Clinical Trial Synthesis 2025 Meta-Analysis published in Journal of dentistry. Key conclusion: CONCLUSIONS: Different surface pretreatment protocols are required for different types of ceramic substrates to achieve optimal bond strength to resin composite.
View Original PubMed Abstract ↓

OBJECTIVE: To assess the impact of different surface pretreatment protocols on the repair bond strength of resin composite to different ceramics. STUDY SELECTION: Laboratory studies reporting (micro-)tensile bond strength of resin composite to full contour/monolithic ceramics following different surface pretreatment methods. SOURCES: Electronic databases (MEDLINE via PubMed, EMBASE via Ovid, Web of Science, and Scopus) were searched in October 2024. DATA: A total of 32 sources reporting on 31 studies were entered in frequentist network meta-analyses (glass-based ceramics: 21 studies, polymer-infiltrated ceramics: 11 studies, oxide ceramics: two studies). Various surface pretreatment methods for glass-based and polymer-infiltrated ceramics were compared to the application of an adhesive only (control group), and P-scores were used to rank their efficacy. For glass-based ceramics, highest bond strengths were achieved following hydrofluoric acid etching + silane (multi-)primer + adhesive (+24.37 MPa, 95 %-CI: 13.18-35.56; P-score: 0.92) followed by silica coating + silane (multi-)primer + adhesive (+20.58 MPa, 95 %-CI: 8.25-32.92; P-score: 0.74). Regarding polymer-infiltrated ceramics, diamond bur roughening + silane (multi-)primer + adhesive (+13.15 MPa, 95 %-CI: 4.97-21.33; P-score: 0.86), silica coating + silane (multi-)primer + adhesive (+11.52 MPa, 95 %-CI: 1.64-21.39; P-score: 0.78), and hydrofluoric acid etching + silane (multi-)primer + adhesive (+11.36 MPa, 95 %-CI: 3.38-19.33, P-score: 0.78) were most effective. On oxide ceramics, no surface pretreatment increased bond strength compared to the application of a silane (multi-)primer and an adhesive. CONCLUSIONS: Different surface pretreatment protocols are required for different types of ceramic substrates to achieve optimal bond strength to resin composite. CLINICAL SIGNIFICANCE: Depending on the type of ceramic substrate the appropriate pretreatment method must be employed to optimise the repair bond strength between ceramic and resin composite.

07
SYSTEMATIC REVIEW Journal of Zhejiang University. Science. B (2025) PMID: 40722243 ↗
EGCG as a therapeutic agent: a systematic review of recent advances and challenges in nanocarrier strategies.
Clinical Trial Synthesis 2025 Systematic Review published in Journal of Zhejiang University. Science. B. Key conclusion: Notably, the pharmacological activities of EGCG-loaded nanoparticles, such as antioxidative, anti-inflammatory, anticancer, and antimicrobial effects, are significantly enhanced compared to those of free EGCG.
View Original PubMed Abstract ↓

Epigallocatechin-3-gallate (EGCG), a bioactive polyphenol abundant in green tea, has garnered significant attention for its diverse therapeutic applications, ranging from antioxidant and anti-inflammatory effects to potential anticancer properties. Despite its immense promise, the practical utilization of EGCG in therapeutic settings as a medication has been hampered by inherent limitations of this drug, including poor bioavailability, instability, and rapid degradation. This review comprehensively explores the current challenges associated with the application of EGCG and evaluates the potential of nanoparticle-based formulations in addressing these limitations. Nanoparticles, with their unique physicochemical properties, offer a platform for the enhanced stability, bioavailability, and targeted delivery of EGCG. Various nanoparticle strategies, including polymeric nanoparticle, micelle, lipid-based nanocarrier, metal nanoparticle, and silica nanoparticle, are currently employed to enhance EGCG stability and pharmacological activity. This review concludes that the particle sizes of most of these formulated nanocarriers fall within 300 nm and their encapsulation efficiency ranges from 51% to 97%. Notably, the pharmacological activities of EGCG-loaded nanoparticles, such as antioxidative, anti-inflammatory, anticancer, and antimicrobial effects, are significantly enhanced compared to those of free EGCG. By critically analyzing the existing literature and highlighting recent advancements, this article provides valuable insights into the promising prospects of nanoparticle-mediated EGCG formulations, paving the way for the development of more effective and clinically viable therapeutic strategies. Publisher: 表没食子儿茶素-3-没食子酸酯(EGCG)作为绿茶中富含的生物活性多酚,因其具有广泛的治疗应用而备受关注,包括抗氧化、抗炎作用以及潜在的抗癌特性。尽管前景广阔,但EGCG作为药物的实际应用一直受限于其固有的缺陷,包括生物利用度低、不稳定性和易降解等问题。本综述全面探讨了EGCG应用中当前存在的挑战,并评估了基于纳米颗粒的制剂在解决这些限制方面的潜力。凭借独特的理化性质,纳米颗粒为提高EGCG的稳定性、生物利用度和靶向递送提供了平台。目前采用的纳米颗粒策略包括聚合物纳米粒、胶束、脂质纳米载体、金属纳米粒和二氧化硅纳米粒等,这些策略显著增强了EGCG的稳定性与药理活性。本综述指出,大多数纳米载体的粒径分布在300 nm以内,其包封率介于51%至97%之间。值得注意的是,与游离EGCG相比,负载EGCG的纳米颗粒在抗氧化、抗炎、抗癌和抗菌等药理活性方面均有显著提升。通过系统分析现有文献并重点评述最新进展,本文为纳米颗粒介导的EGCG制剂提供了前瞻性见解,为开发更有效且具临床可行性的治疗策略奠定了基础。. 表没食子儿茶素

08
META-ANALYSIS BMC public health (2025) PMID: 40604719 ↗
The association between occupational silica exposure and leukemia: a systematic review and meta-analysis of cohort studies.
Clinical Trial Synthesis 2025 Meta-Analysis published in BMC public health. Key conclusion: The present study based on cohort studies provide no evidence that occupational exposure to silica does increase the risk of leukemia.
View Original PubMed Abstract ↓

Respirable crystalline silica is a proven lung carcinogen, but there is limited information of the carcinogenic effects of silica on non-respiratory organs. We aimed to systematically review cohort studies and conduct a meta-analysis to explore the relationship between occupational exposure to silica and the risk of leukemia development. We performed an exhaustive search across three databases (PubMed, Embase, and Web of Science) to identify pertinent cohort studies published since 1987. After removing duplicates and excluding irrelevant studies, 22 studies were included in our analysis. We utilized fixed-effects models in the implementation of our meta-analysis. The combined relative risk of leukemia associated with occupational silica exposure was determined to be 1.11 (95% CI: 0.93-1.33), with no significant differences observed across various industries, geographic regions, exposure periods, or study quality estimates. The present study based on cohort studies provide no evidence that occupational exposure to silica does increase the risk of leukemia. © 2025. The Author(s).

09
META-ANALYSIS Thorax (2025) PMID: 40518258 ↗
Inhalational exposures associated with risk of interstitial lung disease: a systematic review and meta-analysis.
Clinical Trial Synthesis 2025 Meta-Analysis published in Thorax involving n = 116 participants (OR 1.69). Key conclusion: Future work should investigate novel occupational exposures associated with ILD, characterise the gene-environment interaction and develop preventative strategies.
View Original PubMed Abstract ↓

RATIONALE: Inhalational exposures are associated with risk of developing interstitial lung disease (ILD), yet the relationship between specific exposures and ILD is poorly characterised. OBJECTIVE: Identify inhalational exposures associated with ILD and estimate the effects of exposures on ILD risk. METHODS: MEDLINE and EMBASE databases were searched from 1990 to 2022 to identify inhalational exposures associated with ILD diagnosis. ILDs where causality is well-established (hypersensitivity pneumonitis, pneumoconiosis) and sarcoidosis were excluded. Two independent reviewers screened abstracts with full-text review and data extraction of eligible studies. Where possible, data were pooled and multilevel meta-analysis was specified using a random effects model. Sources of heterogeneity and risk of bias were assessed. MAIN RESULTS: 96 studies were included in the systematic review, representing 40 819 116 subjects (295 167 had ILD, 40 523 949 controls). For the meta-analysis, 54 studies were included (40 490 793 subjects: 273 899 ILD, 40 216 894 controls). Exposures associated with significantly increased ILD risk included smoking (OR 1.69, 95% CI 1.47 to 1.94), organic exposures (OR 1.56, 95% CI 1.12 to 2.16), metals (OR 1.52, 95% CI 1.07 to 2.16), dust (OR 1.45, 95% CI 1.20 to 1.76) and asbestos (OR 1.53, 95% CI 1.08 to 2.15). Silica and fumes had positive associations with ILD that trended towards significance. CONCLUSIONS: This systematic review and multilevel meta-analysis is the first to comprehensively assess the effect of inhalational exposures on overall risk of ILD, with multiple putative exposures identified. Future work should investigate novel occupational exposures associated with ILD, characterise the gene-environment interaction and develop preventative strategies. PROSPERO REGISTRATION NUMBER: CRD42022292908. © Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.

10
META-ANALYSIS Journal of autoimmunity (2025) PMID: 40418862 ↗
Association between occupational and environmental dust exposure and autoimmune diseases: A systematic review and meta-analysis.
Clinical Trial Synthesis 2025 Meta-Analysis published in Journal of autoimmunity (OR 1.36). Key conclusion: Targeted interventions, such as improved ventilation systems and personal protective equipment (PPE), should be prioritized.
View Original PubMed Abstract ↓

BACKGROUND: Occupational and environmental dust exposure is often overlooked, presenting significant public health concerns. Recent studies suggest it may increase the risk of autoimmune diseases. However, previous research has primarily focused on specific diseases or dust types, leaving the broader relationship unclear. A comprehensive meta-analysis are needed to clarify this connection. METHODS: We systematically searched PubMed and Google Scholar up to October 2023, following PRISMA guidelines. Study quality was assessed using standard tools, and a random-effects model was used to estimate pooled odds ratio (OR) and 95 % confidence interval (CI), with subgroup analyses by dust type and disease category. RESULTS: From 90 initial records, 19 studies were included. Dust exposure was significantly associated with increased autoimmune disease risk (OR 1.36, 95 % CI 1.13-1.59). Both occupational (OR 1.18, 95 % CI 1.11-1.26) and environmental dust exposure (OR 1.12, 95 % CI 1.04-1.20) were linked to higher risk. Subgroup analysis showed a strong association between silica exposure and connective tissue diseases, particularly granulomatosis with polyangiitis (OR 5.75, 95 % CI 2.79-8.71). Sensitivity analysis confirmed the findings, though publication bias was noted. CONCLUSION: Our findings highlight a significant association between dust exposure and autoimmune disease risk, underscoring the need for stricter occupational safety measures and environmental regulations. Targeted interventions, such as improved ventilation systems and personal protective equipment (PPE), should be prioritized. Future research should focus on elucidating underlying mechanisms to inform prevention and treatment strategies.

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