Citation: Begvarfaj, E.; Greco, E.; Armone Caruso, A.; Masieri, S.; Ciofalo, A.; Velardita, C.; Cavaliere, C. Effects of the Silica Dust on the Nasal Mucosa of Ceramic Workers. Sustainability 2022, 14, 12556. https://doi.org/10.3390/ su141912556 Academic Editor: Hyo Sun Jung Received: 29 August 2022 Accepted: 30 September 2022 Published: 2 October 2022 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). sustainability Article Effects of the Silica Dust on the Nasal Mucosa of Ceramic Workers Elona Begvarfaj 1, * , Emilio Greco 2 , Arturo Armone Caruso 3 , Simonetta Masieri 4 , Andrea Ciofalo 1 , Carmelita Velardita 5 and Carlo Cavaliere 1 1 Department of Sense Organs, Sapienza University, 00185 Rome, Italy 2 Department of Research, Link Campus University, 00165 Rome, Italy 3 ENT Department, AIAS, Afragola, 80021 Naples, Italy 4 Department of Oral and Maxillofacial Sciences, Sapienza University, 00185 Rome, Italy 5 Unità Locale Socio Sanitaria (ULSS) 2, Marca Trevigiana, 31015 Treviso, Italy * Correspondence: ebegvarfaj@yahoo.it Abstract: Background. Adverse health effects due to occupational exposures are a global public health concern and have been studied for many years. Ceramic workers are occupationally exposed to a wide range of toxic substances as they manage clay (silico-aluminous feldspar mixed with sodium, potassium salts and iron oxide). The objective of this study was to assess the presence of any inflammation or alteration of the nasal mucosa of ceramic workers by nasal cytology. Materials and methods. Twenty-eight ceramic workers from Caltagirone (Italy) were enrolled. Nasal symptoms, atopy, health habits and workplace features were assessed by a special questionnaire, and nasal mucosa health was evaluated by nasal cytology. Results. The cytological study of the nasal mucosa revealed the constant presence of abundant, thick and filamentous mucus, as well as a reorganization of the nasal cellularity with a prevalence of muciparous hyperplasia and metaplasia in the study group, and only in a lesser extent for the subjects with some protective environmental measures. Conclusions. The ceramic workers showed chronic inflammatory rhinitis on nasal cytology, with a remodelling of the nasal mucosa and thick mucus. Nasal cytology may be a helpful tool either for the health surveillance of the ceramic workers, or for the screening of any pathology of the upper airways. Keywords: nasal cytology; ceramic workers; silicosis; upper airways; inflammation; occupational rhinitis; occupational health; quality of life; social health 1. Background Adverse health effects due to occupational exposures are a global public health concern and have been studied for many years. A high incidence of silicosis and other pulmonary diseases in the ceramic working population has been reported from Japanese researchers in the early decades of the last century [1,2]. It is well documented that workers engaged in pottery-related industries are at great risk for pulmonary diseases, lead and other metal poisoning, as well as other toxic reactions caused by occupational exposure to clays, glazes and furnace emissions [3]. Some reports indicate that 1.7 million workers in the United States [4] and over 3 million workers in Europe [5] are exposed to crystalline silica. Silicosis is a well-known consequence of exposure to silica dust, and long-term expo- sure to crystalline silica has also been associated with the risk of developing lung cancer, pulmonary tuberculosis and other airway diseases [6–8]. On the other hand, glaze or crystallinity, enamel and colours randomly used for decorations, may play a direct irri- tating action on airway epithelial cells. Since 1997, crystalline silica has been classified as a human carcinogen by the International Agency for Research on Cancer (IARC) [9], and a worldwide series of risk assessments has been conducted for respirable silica dust exposure, especially for low levels of exposure [10–13]. Although advances in occupational Sustainability 2022, 14, 12556. https://doi.org/10.3390/su141912556 https://www.mdpi.com/journal/sustainability