Multiple case reports have shown that continuous exposure to silica increases the risk of positive ANCA.

Studies have confirmed the dose-related effects of silica exposure. A meta-analysis showed that silica exposure was positively associated with AAV. A case-control study suggested a 3.4-fold increased risk of ANCA serology positivity in individuals with occupational silica exposure.

Another study suggested that silica can induce the expression of MPO in the cell membrane of neutrophils and monocytes, causing ANCA-related autoimmune responses.

However, research on the relationship between sustained exposure to silica and severity of AAV remains inadequate.