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Edit to just link the article rather than my silly speculation about particle sizes and types:

Reference: https://onlinelibrary.wiley.com/doi/epdf/10.1111/resp.14625

"The qualitative comparison of in vitro responses between the categories of particles we examined revealed some interesting patterns. Firstly, the ES dusts were the most potent stimulus in inducing cytotoxicity and pro-inflammatory responses in epithelial cells while the standard silica sample was particularly toxic to macrophages. All particles (ES, BM,NS and standard silica) showed some potential to promote IL-8 (CXCL8) and TNF-α production in macrophages, as well as IL-1β, with the exception of natural stone. These observations are consistent with our overarching hypothesis that particle characteristics are key drivers of the lung cell response and, therefore, the risk of disease. In more in-depth analyses with a focus on ES dusts, we found that the quartz concentration was significantly associated with the inflammatory response in macrophages. This is an important observation as there has been consistent rhetoric regarding the crystalline silica content of ES being the key driver of the high disease prevalence. 7,39Indeed, crystalline silica has been shown to be related to the dose-dependent macrophage accumulation response,40aggravated inflammatory cell infiltration, thickened alveolar walls and enhanced expression of collagens. 41However, the relationship between quartz and the macrophage inflammatory response was not the sole driver of the cellular responses we observed."




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