Exposure to respirable crystalline silica (RCS) reportedly induces chronic lung injury. We investigated the association between RCS exposure and two biomarkers of the effect, plasma club cell protein 16 (CC16) and heme oxygenase-1 (HO-1) levels, in stone-carving workers. Fifty-seven exposed workers (EWs) and 20 unexposed workers (UWs) were enrolled onto the study. Cumulative exposure to RCS was individually estimated using a filter-based gravimetric method. The plasma CC16 and HO-1 levels were determined using commercial kits. The 8-h time-weighted average for RCS concentration in the EW was significantly greater than this concentration in the UW (p < 0.001). The health risk characterization for RCS exposure expressed as a hazard quotient (HQ) indicated that crystalline silica might be a risk factor where there is chronic exposure (HQ = 4.48). The EW group presented a significant decrease in CC16 and an increase in HO-1 levels in comparison to the UW group (p < 0.001). In addition, we found a significant association between RCS concentration and plasma CC16 only. Therefore, our findings representing a significant decrease in CC16 in the plasma of stone-carving workers and this biological marker were significantly associated with RCS concentration. Our data indicated that CC16 might be a suitable biomarker to use to predict the health risk to stone-carving workers of exposure to RCS.
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