The Case for Autoantibody Screening in Stone Benchtop Workers.

Occupational silica exposure is a recognised cause of respiratory diseases such as silicosis, with increasing evidence linking it to systemic autoimmune diseases. We report a case of a 40-year-old stone benchtop fabricator diagnosed with complicated silicosis through a screening program. He was initially asymptomatic apart from Raynaud's phenomenon but had an elevated antinuclear antibody (ANA) titre. Over time, he developed progressive autoimmune disease with multisystem involvement and respiratory decline. This case highlights the potential for silica exposure to trigger severe autoimmune disease and the importance of proactive autoimmune screening in high-risk occupational groups. ANA positivity in otherwise asymptomatic individuals may signal underlying or future autoimmune disease. Clinicians should maintain a high index of suspicion for autoimmune conditions in workers exposed to silica, as early detection offers the potential to mitigate long-term morbidity through earlier intervention.