Volume-based tomography for the diagnosis of incipient silicosis in former gold miners

Carneiro, Ana Paula Scalia; Silva, Leandro Liberino da; Silva, Francisco das Chagas Lima; Hering, K. G.; Algranti, Eduardo

doi:10.1136/oemed-2021-107922

Cited by 3 publications

(1 citation statement)

References 34 publications

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“…Chest radiography is not sufficiently sensitive in detecting early disease. In a Brazilian study, using volumetric CT along with clinical and occupational data, silicosis was diagnosed in 15.1 and 25.9% of workers whose chest radiographs had been classified as ILO category 0/0 and 0/1, respectively [86]. Recently, club cell protein 16 (CC16), the most abundant protein in normal airway secretions secreted by airway club cells, has been investigated as a biomarker for the early detection of silicosis [87 ▪▪ ].…”

Section: Introductionmentioning

confidence: 99%

Silica-associated lung disease in developing countries

Dhooria

Sehgal

Agarwal

2022

Current Opinion in Pulmonary Medicine

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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.

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Section: Introductionmentioning

confidence: 99%

Silica-associated lung disease in developing countries

Dhooria

Sehgal

Agarwal

2022

Current Opinion in Pulmonary Medicine

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Non-malignant silica-related diseases in a specialized outpatient clinic

Carneiro

Teixeira

Silveira

et al. 2022

Occupational Medicine

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Background Uncontrolled occupational exposure to silica is still frequent in Brazil, with several recent records in the state of Minas Gerais. However, few national studies have addressed silica-related diseases other than silicosis. Aims To describe the occurrence of the main non-malignant silica-related diseases: silicosis, tuberculosis (TB), chronic obstructive pulmonary disease (COPD), and autoimmune diseases in a specialized outpatient clinic. Methods Case series study of 1525 patients exposed to silica, seen between 1984 and 2021, with descriptive findings of clinical and occupational data from the first medical evaluation. Results Medians of age and exposure time were 47 and 15 years, respectively, and 97% of patients were male. The prevalence of silicosis was 44%, of which 27% had large opacities. The main occupational sectors were underground gold mining (28%), precious and semi-precious stone work (20%), and artisanal mining (9%). Spirometries were abnormal in 55%, with obstructive disorder being the most common finding. COPD (25%), active TB or sequelae (12%), and connective tissue diseases (6%) were diagnosed in patients with and without silicosis. Conclusions The percentage of silicosis appears to be alarming, even considering the biases of selective referrals. The patients were relatively young and already had a functional impact, caused not only by silicosis but by one or more silica-related diseases. COPD, TB, and connective tissue diseases proved to be frequent, leading to the need for specifics protocols to investigate them in individuals exposed to silica. By adopting strategies to combat silicosis, the prevention of other silica-related diseases is concomitantly promoted.

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Chest x‐ray has low sensitivity to detect silicosis in artificial stone benchtop industry workers

Hoy,

Jones,

Newbigin

et al. 2024

Respirology

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Background and ObjectiveChest x‐ray (CXR) remains a core component of health monitoring guidelines for workers at risk of exposure to crystalline silica. There has however been a lack of evidence regarding the sensitivity of CXR to detect silicosis in artificial stone benchtop industry workers.MethodsPaired CXR and high‐resolution computed tomography (HRCT) images were acquired from 110 artificial stone benchtop industry workers. Blinded to the clinical diagnosis, each CXR and HRCT was independently read by two thoracic radiologists from a panel of seven, in accordance with International Labour Office (ILO) methodology for CXR and International Classification of HRCT for Occupational and Environmental Respiratory Diseases. Accuracy of screening positive (ILO major category 1, 2 or 3) and negative (ILO major category 0) CXRs were compared with identification of radiological features of silicosis on HRCT.ResultsCXR was positive for silicosis in 27/110 (24.5%) workers and HRCT in 40/110 (36.4%). Of the 83 with a negative CXR (ILO category 0), 15 (18.1%) had silicosis on HRCT. All 11 workers with ILO category 2 or 3 CXRs had silicosis on HRCT. In 99 workers ILO category 0 or 1 CXRs, the sensitivity of screening positive CXR compared to silicosis identified by HRCT was 48% (95%CI 29–68) and specificity 97% (90–100).ConclusionCompared to HRCT, sensitivity of CXR was low but specificity was high. Reliance on CXR for health monitoring would provide false reassurance for many workers, delay management and underestimate the prevalence of silicosis in the artificial stone benchtop industry.

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Volume-based tomography for the diagnosis of incipient silicosis in former gold miners

Cited by 3 publications

References 34 publications

Silica-associated lung disease in developing countries

Silica-associated lung disease in developing countries

Non-malignant silica-related diseases in a specialized outpatient clinic

Chest x‐ray has low sensitivity to detect silicosis in artificial stone benchtop industry workers

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