Many environmental and occupational substances such as vinyl chloride, epoxy resins, solvents, pesticides, paraffin/silicone and silica particles cause dysregulation of autoimmunity.

Silica-exposed patients suffer from silicosis  There are several typical pulmonary complications such as pulmonary tuberculosis, tuberculous pleurisy, pneumothorax, bronchiectasis and lung cancer.

In addition to these lung complications, it is well known that the condition of silicosis patients is often complicated with autoimmune diseases. The classical disease is known as Caplan’s syndrome, complicated with rheumatoid arthritis. Furthermore, other autoimmune diseases such as systemic sclerosis,systemic lupus erythematosus and anti-neutrophil cytoplasmic antibody (ANCA) positive vasculitis/nephritis have been reported in case reports and epidemiological investigations.