Silica-associated lung disease in developing countries

Abstract

Purpose of reviewThere is a considerable burden of silica-associated lung diseases in the developing world. This review summarizes the epidemiology of these diseases, especially silicosis and silico-tuberculosis, mitigative efforts and treatment, especially in the context of developing countries.Recent findingsIn 2017, the highest incidence of silicosis was in China, India and Brazil among the developing countries. The prevalence of silicosis amongst exposed workers may vary from 4 to 55%; there is a risk of underestimation because of the ‘healthy worker effect’. The permissible exposure limit for respirable silica adopted by governments in developing countries remains higher than the proposed 0.025 mg/m3. Silica exposure in informal or unorganized industries is challenging, as it falls outside statutory controls. Recent efforts on regulation and compensation by various governments in developing countries are encouraging but need proper implementation on the ground. Biomarkers such as club cell protein 16 and imaging methods such as computed tomography may offer earlier and easier detection of silicosis. Advanced silicosis remains incurable; novel treatments such as antifibrotics agents may be potentially effective.SummarySilica-associated lung diseases are prevalent in developing countries. Efforts directed at preventing or minimizing exposure to respirable crystalline silica are required for mitigation.

30-Year Trends in the Disease Burden, Incidence, and Prevention of Pneumoconiosis

“…Overall, the ASIR of pneumoconiosis initially rose and then declined in response to an increase in SDI. When the SDI value reached or exceeded 0.7, a negative correlation was observed between the AAPC in ASIR for pneumoconiosis and the SDI (10). These findings indicate a relationship between higher SDI values and a decrease in pneumoconiosis incidence rate.…”

“…The socio-demographic index (SDI) segregates the world into five distinct regions: low, low-middle, middle, high-middle, and high. The incident cases of pneumoconiosis were observed to be most prevalent in the middle region, followed by the high-middle region (10). Overall, the ASIR of pneumoconiosis initially rose and then declined in response to an increase in SDI.…”

“…Given the global prevalence of industrial dust exposure, affecting millions of workers, pneumoconiosis consistently garners significant public health attention (5)(6). Despite targeted public health efforts, the disease remains the deadliest occupational disease, particularly in low-to middle-income countries and developing regions such as China (7)(8)(9)(10)(11). Data from the Global Burden of Disease research carried out by the Institute for Health Metrics and Evaluation (IHME) report the number of new cases rising from 60,055 in 2017 to 199,125 in 2019 (10).…”

“…Despite targeted public health efforts, the disease remains the deadliest occupational disease, particularly in low-to middle-income countries and developing regions such as China (7)(8)(9)(10)(11). Data from the Global Burden of Disease research carried out by the Institute for Health Metrics and Evaluation (IHME) report the number of new cases rising from 60,055 in 2017 to 199,125 in 2019 (10). In China alone, the former Ministry of Health (now known as National Health Commission of China, NHC) reported over 271,000 new cases between 2010 and 2022.…”

Editorial: Pulmonary sarcoidosis

“…The method has been found to help a great deal in differentiating sarcoidosis, especially from tuberculosis and lymphoma in patients with intrathoracic lymph node enlargement ( 4 , 19 , 20 ). One must also not forget that silicosis and lymphangitis carcinomatosis are close radiologic mimics of sarcoidosis, although they were outside the purview of the review as they are not granulomatous disorders ( 21 ).…”