Epidemiological characteristics of pneumoconiosis deaths in a certain area from 1961 to 2020 / 中华劳动卫生职业病杂志

Objective: To investigate the epidemiological characteristics of pneumoconiosis deaths in Putuo District of Shanghai, and to provide evidence for prevention and management of pneumoconiosis in the future. Methods: In June 2021, the data of 263 patients with pneumoconiosis who died from January 1961 to December 2020 in Putuo District of Shanghai were retrospectively analyzed. Trend χ(2) test, analysis of variance and Spearman rank correlation methods were used to analyze the basic information, age of exposure to dust, promotion period, course of disease and direct cause of death of patients with pneumoconiosis. Results: Among the 263 cases of pneumoconiosis patients who died in Putuo District of Shanghai from 1961 to 2020, 260 cases (98.86%) were male. The main types of pneumoconiosis were foundry worker pneumoconiosis (53.23%, 140/263) and silicosis (43.73%, 115/263). The main types of pneumoconiosis were sand cleaner (36.50%, 96/263). The age of onset was (53.42±10.13) years old, the age of death was (76.14±9.12) years old, and the age of exposure to dust was (20.91±8.99) years. The duration of dust exposure was negatively correlated with the duration of disease (r(s)=-0.24, P<0.001). With the increase of pneumoconiosis stage, the mortality of silicosis and foundry worker pneumoconiosis also showed an increasing trend (χ(2)(trend)=4.22, 3.87, P=0.040, 0.049). 31.94% (84/263) of pneumoconiosis patients died directly from pneumoconiosis, ranking first among the direct causes of death. Conclusion: The death cases of pneumoconiosis in Putuo District of Shanghai are mainly foundry worker pneumoconiosis and silicosis, and pneumoconiosis is the main cause of death.

Analysis of disease burden of occupational pneumoconiosis in Gansu Province from 2010 to 2020 / 中华劳动卫生职业病杂志

Objective: Through comparative analysis of the disease burden of occupational pneumoconiosis in Gansu Province from 2010 to 2020, the main influencing factors are screened, and scientific basis is provided for rational allocation of limited health resources, precise management and policy implementation. Methods: In August 2021, survey and collect information on surviving occupational pneumoconiosis patients and dead occupational pneumoconiosis patients diagnosed in Gansu Province from 2010 to 2020, and analyze and calculate indicators such as morbidity, mortality, and disability adjusted of life years (DALY). Analyzing the influencing factors of disease burden usirrg multiple linear regression. Results: From 2010 to 2020, the average annual incidence of occupational pneumoconiosis in Gansu Province was 0.9992/100000, the average annual mortality was 0.897/100000, the cumulative case fatality rate was 25.75%, and the cumulative DALY was 28932.96 person-years. The first stage of occupational pneumoconiosis was the highest among DALY loss (19920.14 person-years), and the DALY loss was positively correlated with the stage of occupational pneumoconiosis. Among occupational pneumoconiosis in Gansu Province, silicosis (13753.66 person-years) and coal worker's pneumoconiosis (13414.73 person-years) caused the highest disease burden, followed by cement pneumoconiosis and asbestos lung. Period, length of service, type of disease, and region are all influencing factors of DALY loss (P<0.05). Conclusion: From 2010 to 2020, the DALY losses caused by occupational pneumoconiosis in Gansu Province showed a fluctuating decrease, with the composition of DALY mainly changing from the loss of life years due to premature death to the loss of years due to injury and disability.

Analysis of the prevalence and social security situation of pneumoconiosis in non-coal mine industry in Jiangsu Province / 中华劳动卫生职业病杂志

Objective: To understand the social security situation of current cases of pneumoconiosis in non-coal mine industries in Jiangsu Province, and to provide reference for the treatment and security work of pneumoconiosis patients. Methods: From January to October 2020, a follow-up survey was conducted on 4038 cases of pneumoconiosis in non-coal mine industries of the province from October 1949 to December 2019. The age, type of pneumoconiosis, industry type, and social security status of the patients were collected. Namely, work-related injury insurance, employer compensation, basic medical insurance for urban and rural residents, major illness insurance, etc. SPSS 19.0 was used for statistical description and analysis. Results: The cases of pneumoconiosis in non-coal mine industries in Jiangsu Province ranged in age from 36 to 105 (70.78±8.43) years old, and had been exposed to dust for 1 to 55 (19.27±9.29) years. Silicosis was the main form (3875 cases, 95.96%), and non-metallic mining and dressing industry was the main form (2618 cases, 64.83%). A total of 3991 cases (98.84%) of pneumoconiosis patients enjoyed social security, most of them were urban and rural residents with basic medical insurance (3624 cases, 89.75%), but there were still 47 patients without any social security. 15 cases (0.37%) enjoyed the subsistence allowance, with the monthly allowance amount ranging from 104 to 3960 yuan, with the average amount of 954.87 yuan/month. Conclusion: In Jiangsu Province, the proportion of pneumoconiosis patients in non-coal mine industries enjoying social security is relatively high, but there are still patients who do not enjoy any social security, and the difference in the amount of subsistence allowance is slightly larger. It is necessary to further improve the medical security of pneumoconiosis patients and improve their quality of life.

Investigation on diagnosis of pneumoconiosis in non-coal mining industry in Jiangsu Province / 中华劳动卫生职业病杂志

Objective: To understand the incidence of pneumoconiosis in the non-coal mining industry in Jiangsu Province, and provide reference for the prevention and control of pneumoconiosis in the non-coal mining industry. Methods: The data of 7019 newly diagnosed pneumoconiosis patients in non-coal mining industry in Jiangsu Province from January 1956 to December 2019 were collected through the Jiangsu Province Pneumoconiosis Follow-up Network Report System, including the gender of the pneumoconiosis patients, the name of the employer and the location, the industry classification of the employer, the duration of dust exposure in dust exposure, the name of occupational pneumoconiosis disease, the date of diagnosis of pneumoconiosis, etc. The collected case data of patients with pneumoconiosis were entered into the statistical software, and the characteristics of the patients' diagnosis time, region and industry were analyzed. Results: The number of confirmed pneumoconiosis patients in the non-coal mining industry in Jiangsu Province was mostly in 2007 (395 cases) , concentrated in Wuxi City (40.96%, 2875/7019) and Suzhou City (27.72%, 1946/7019) . The industries to which the patients belonged were mainly non-metallic mining and dressing (60.95%, 4278/7019) , and the most common type of pneumoconiosis was silicosis (96.40%, 6766/7019) . The patients were mainly stageⅠpneumoconiosis (61.33%, 4305/7019) . There were statistically significant differences in the mean age of diagnosis and the average duration of dust exposure among patients with different pneumoconiosis stages (P<0.01) . The differences in the average diagnosis age and the average duration of dust exposure of patients with different types of pneumoconiosis were statistically significant (P<0.05) , the mean age of diagnosis and the average duration of dust exposure of electric welders were the smallest, which were (44.92±7.74) years old and (17.38±10.15) years, respectively. Conclusion: The regional and industry distribution characteristics of new pneumoconiosis patients in the non-coal mining industry in Jiangsu Province are obvious, and attention should be paid to the treatment of pneumoconiosis patients with young diagnosed age and short duration of dust exposure, as well as the personal protection and health protection of front-line workers such as electric welders who are exposed to productive dust in a short period of time.

Analysis of incidence characteristics and trend of pneumoconiosis in Ningbo City from 1967 to 2019 / 中华劳动卫生职业病杂志

Objective: To understand the incidence of pneumoconiosis in Ningbo city from 1967 to 2019, and to analyze the distribution characteristics and change trend of pneumoconiosis. Methods: In February 2021, the data of pneumoconiosis patients in Ningbo city from 1967 to 2019 were sorted out. The data from 1967 to 1987 were from historical case files of Zhejiang Center for Disease Control and Prevention, the data from 1988 to 2005 were from the historical case files of Ningbo Center for Disease Control and Prevention, and the data from 2006 to 2019 were from the pneumoconiosis report card in China Disease Prevention and Control Information System; Followed up and supplement relevant information, including basic information, basic information of employers and information related to pneumoconiosis diagnosis, and comprehensively analyze the composition and development trend, population characteristics and industry characteristics of pneumoconiosis. Results: From 1967 to 2019, a total of 1715 cases of pneumoconiosis were reported in Ningbo City, including 1254 cases of stageⅠpneumoconiosis, 258 cases of stageⅡpneumoconiosis, 172 cases of stage Ⅲpneumoconiosis. 1202 cases of silicosis (70.09%) , 296 cases of asbestosis (17.26%) , 40 cases of welder's pneumoconiosis (2.33%) , 32 cases of graphite pneumoconiosis (1.87%) were reported. There were 1296 male cases (75.57%) and 419 female cases (24.43%) were reported. Silicosis (91.15%, 1102/1209) and welder's pneumoconiosis (100.00%, 40/40) were the most common pneumoconiosis in males, while asbestosis (90.24%, 268/297) and graphite pneumoconiosis (87.50%, 28/32) were the most common pneumoconiosis in females. The average age was (49.71±10.90) years old and the average length of service was (10.98±6.96) years. The top three reported pneumoconiosis cases were construction industry (336 cases, 19.59%) , ferrous metal smelting and rolling industry (317 cases, 18.48%) and non-metallic mineral products industry (315 cases, 18.37%) . The top three reported pneumoconiosis cases were 414 cases (24.14%) in Ninghai County, 294 cases (17.14%) in Yuyao City and 272 cases (15.86%) in Yinzhou District. Conclusion: With the development of industries in Ningbo City, government departments should strengthen supervision and management of enterprises involving silica dust and welding fume to curb the high incidence of pneumoconiosis.

Analysis on epidemiological characteristics of pneumoconiosis in Qinghai Province from 2011 to 2020 / 中华劳动卫生职业病杂志

Objective: To analyze the epidemiological characteristics of pneumoconiosis in Qinghai Province from 2011 to 2020, and to provide a basis for the formulation of prevention and control strategy. Methods: In April 2021 , the cases of pneumoconiosis were monitored by the Occupational Disease and Health Hazard Factors Monitoring Information System in Qinghai Province from 2011 to 2020. The distribution of pneumoconiosis, the composition of diseases and the working years exposed to dust were analyzed. Results: All 1026 cases of pneumoconiosis were newly diagnosed in Qinghai Province from 2011 to 2020, silicosis and coal worker pneumoconiosis were the main diseases (78.36% ,804/1026). Stage Ⅰ pneumoconiosis were 484 (47.17%,484/1026) cases. 359 (34.99%,359/1026) cases, 315 (30.70%,315/1026) cases and 252 (24.56%, 252/1026) cases had been diagnosed respectively in Xining City, Haidong City and Haixi Prefecture; 628 (61.21%,628/1026) cases and 418 (40.74%, 418/1026) cases engaged in mining industry and large-sized enterprise, respectively. The working years exposed to dust in silicosis cases were shorter than that in coal worker pneumoconiosis and other pneumoconiosis (P <0.05). Conclusion: The pneumoconiosis area and industry focus in Qinghai Province is obvious. The supervision and adninistration of small and micro scale employers should be strengthened to protect the health rights and interests of workers, especially for the key area and industry.

The epidemiological characteristics of pneumoconiosis in Qingyuan City from 1949 to 2018 / 中华劳动卫生职业病杂志

Objective: In order to find out the prevalence and death of pneumoconiosis in Qingyuan City, to explore the regularity of pneumoconiosis and lay a foundation for the prevention and management of pneumoconiosis. Methods: In August to December 2019, the basic data of pneumoconiosis from 1949 to 2018 were obtained through the monitoring of death causes of residents, occupational disease management system, Guangdong population information system and other means. The reported cases of pneumoconiosis were followed up, and retrospective investigation was conducted to analyze the basic conditions, the length of service exposed to dust, the time of diagnosis, the type of disease, the stage and the combined status of tuberculosis of pneumoconiosis cases. Results: From 1949 to 2018, a total of 466 cases of new pneumoconiosis were reported in Qingyuan City, including 325 cases of death (69.74%) , 114 cases of survival (24.46%) and 27 cases of loss of follow-up (5.80%) . The cases were mainly concentrated in the age group of 40-89 years (80.04%, 373/466) . There were 411 male cases (88.20%) and 7 female cases (1.50%) . The median length of service exposed to dust was 10.7 (6.0, 16.0) years. The diagnosis time of pneumoconiosis cases was mainly from 1949 to 1986 (68.67%, 320/466) , and the death cases were mainly from 1949 to 1986 (82.77%, 269/325) . Silicosis was the main type of pneumoconiosis (398 cases, 85.41%) . 200 cases (42.92%) were diagnosed as stage I pneumoconiosis, 185 cases (39.69%) were stage II pneumoconiosis, 81 cases (17.38%) were stage III pneumoconiosis at the first diagnosis. 102 cases (21.89%) were pneumoconiosis with tuberculosis. The proportion of death and lost follow-up cases diagnosed as stage I pneumoconiosis for the first time was significantly lower than that of survival cases, and the proportion diagnosed as stage II pneumoconiosis and the complication rate of tuberculosis were significantly higher than those of survival cases (χ(2)=15.48, 11.29, 32.73, P<0.001) . Conclusion: Pneumoconiosis in Qingyuan City is mainly silicosis. The number of new cases has been increasing in the past decade, and the prevention and control situation is still severe. The comprehensive prevention and treatment of silica dust should be included in the focus of supervision of government functional departments.

La silicosis: ¿un problema de salud pública prioritario para Chile? / Silicosis: a relevant public health issue in Chile?

Work related diseases and common diseases are covered by separated health systems in Chile. Chilean Ministry of Health focuses on common diseases, making work related diseases almost absent from public health policies. In this article current national and international information about the magnitude and impact of silicosis is reviewed. Although the quality of the national information is suboptimal, it is possible to estimate in several hundreds of thousands the number of workers exposed to silica dust, tens of thousands those under medical surveillance and thousands those currently affected by the disease. Albeit, additional efforts need to be made to estimate the burden of this disease on the Chilean population, information gathered in this article suggests that it is a relevant public health issue, deserving more importance among public policies in our country.

Las enfermedades comunes y laborales son atendidas en distintos sistemas de aseguramiento de la salud en Chile. Las políticas públicas emanadas del Ministerio de Salud se enfocan en las enfermedades comunes, relegando a un rol secundario a aquellas ocasionadas por la actividad laboral de las personas. En este artículo, los autores revisan información actualizada tanto nacional como internacional con el fin de determinar si la silicosis constituye un problema de salud relevante. Aunque la calidad de la información nacional no es óptima, su revisión permite estimar que son cientos de miles los trabajadores expuestos a sílice cristalina, que hay varias decenas de miles bajo vigilancia médica y que son más de mil los portadores de la enfermedad. Si bien es necesario hacer mayores esfuerzos para estimar la carga que esta patología representa para la sociedad chilena, la información recopilada indica que constituye un problema de salud pública relevante que debiera tener mayor protagonismo en las políticas públicas de nuestro país.

Efeito do derivado N-acilidrazônico LASSBio-897 sobre a resposta inflamatória pulmonar na asma e silicose experimentais / Effect of the N-acylhydrazone derivative LASSBio-897 on pulmonary inflammatory response in experimental asthma and silicosis

Doenças pulmonares crônicas, como a asma e a silicose, são caracterizadas por inflamação das vias aéreas e fibrose que levam à marcada deterioração da função pulmonar. O objetivo da presente tese é investigar o impacto das propriedades anti-inflamatórias e antifibróticas do composto LASSBio-897 na asma e silicose experimental. Utilizaram-se metodologias diversas, incluindo a quantificação da reatividade de vias aéreas por pletismografia barométrica, além da quantificação do teor tecidual de mediadores inflamatórios por ELISA e do infiltrado celular pulmonar com técnicas de histologia e imunohistoquímica. Foram ainda quantificados a produção de citocinas por fibroblastos e macrófagos “in vitro”. O tratamento oral profilático com LASSBio-897 (2 e 5 mg/kg) preveniu a instalação do quadro de hiper-reatividade brônquica, o infiltrado celular e a geração de citocinas pró-inflamatórias em modelos de asma aguda em camundongos. Por outro lado, o tratamento mostrou-se inativo quando feito após a instalação da resposta asmática. Resultados mais promissores foram obtidos na condição da silicose experimental, onde o tratamento oral terapêutico com LASSBio-897 (2 e 5 mg/kg) claramente inibiu o comprometimento da função pulmonar, o processo inflamatório e a fibrose observados induzidos pela exposição à sílica. O composto não interferiu com a atividade de mastócitos e células epiteliais estimuladas com sílica “in vitro”. No entanto, a administração de LASSBio-897 reduziu a expressão de F4/80 e alfa-SMA no tecido pulmonar de animais silicóticos, evidenciando assim sua atividade sobre macrófagos e miofibroblastos, respectivamente. Ensaios “in vitro” confirmaram esse efeito, uma vez que o composto reduziu a liberação de TNF-alfa por macrófagos alveolares estimulados com sílica e inibiu a proliferação e produção de colágeno induzida por IL-13 em fibroblastos pulmonares oriundos de animais silicóticos...

Chronic lung diseases such as asthma and silicosis are characterized by airwayinflammation and fibrosis leading to marked deterioration of lung function. The aim of this thesis is to investigate the effect of compound LASSBio-897 onexperimental asthma and silicosis. Various pathological parameters wereassessed, including airway hyper-reactivity by barometric plethysmography,lung tissue content of inflammatory mediators by ELISA and cellular infiltrationusing histology and immunohistochemistry techniques. Cytokine generationfrom fibroblasts and macrophages in vitro was also quantified. Oral prophylactictreatment with LASSBio-897 (2 and 5 mg/kg) prevented airway bronchial hyperreactivity,leukocyte recruitment and cytokine generation in a model of acuteasthma in mice. However, this treatment was inactive when performed afterinstallation of the asthmatic response. More promising results were obtained inthe experimental silicosis condition, where the LASSBio-897 therapeutictreatment (2 and 5 mg/kg, oral) clearly inhibited airway hyper-reactivity, as wellas inflammation and peribronchial fibrosis induced by silica particles.Furthermore, LASSBio-897 did not interfere with mast cells and epithelial cellsactivity after silica stimulation in vitro. However, LASSBio-897 clearly reducedF4/80 and alfa-SMA expression in the lung of silicotic mice, showing its inhibitoryeffect on macrophages and myofibroblasts, respectively. In vitro assaysconfirmed this effect, since the compound reduced TNF-alfa release by analveolar macrophage cell lineage after silica exposure, and inhibitedproliferation and collagen production induced by IL-13 in lung fibroblastsrecovered from silicotic mice...

Silicose em ex-mineiros de extração de cobre / Silicosis among former copper mine workers

Introdução: Existe escassez de estudos brasileiros analisando o efeito da exposição contínua à sílica em ex-trabalhadores de minas de cobre. Os achados radiográficos produzidos pela silicose têm recebido atenção médica especial. O objetivo deste estudo foi caracterizar clínica e radiologicamente a silicose em ex-mineiros de extração de cobre. Métodos: Estudo transversal, com 100 ex-mineiros de extração de cobre. Os dados foram coletados através de entrevista pessoal, dados clínicos ocupacionais e exames radiológicos. Na entrevista foi verificada a idade, sexo e o tempo de trabalho na extração de cobre. Os pacientes que já haviam realizado exame radiológico de tórax trouxeram estes para comparação. Os ex-mineiros assinaram um termo de consentimento para a realização dos exames radiológicos os quais foram aplicados pelo radiologista que os interpretou. Resultados: Entre os 100 ex-mineiros 35% são portadores de silicose, 11% apresentaram alterações pulmonares que podem ter outras causas, como tuberculose, enfisema e doença broncopulmonar obstrutiva crônica e 54% não apresentaram nenhuma alteração pulmonar. Conclusão: A alta frequência de silicose encontrada reforça a recomendação de suspender a exposição à sílica tão logo se tenha uma radiografia sugestiva da doença

Introduction: There is scarcity of Brazilian studies analyzing the effect of continuous exposure to silica in former workers of copper mines. The radiographic images produced by silicosis have received special medical attention. The aim of this study was to characterize clinical and radiological silicosis in former copper mine workers. Methods: Cross-sectional study of 100 ex-copper miners. Data were collected through personal interview, occupational clinical data, and radiological examinations. In the interviews we recorded age, gender and working time on the extraction of copper. Patients who had previously undergone chest X-rays have brought these for comparison. The ex-miners signed a consent form to be submitted to Xrays, which was applied by the same radiologist that interpreted them. Results: Among the 100 ex-miners 35% are diagnosed with silicosis, 11% had lung abnormalities that may have other causes such as tuberculosis, emphysema and chronic obstructive pulmonary disease, and 54% had no pulmonary change. Conclusion: The high incidence of silicosis found reinforces the recommendation to suspend silica exposure as soon as there is a radiograph suggestive of the disease

Silicose: exposição ocupacional e medidas preventivas / Silicosis: occupational exposure and preventive measures

A silicose é uma doença crônica e incapacitante com altas taxas de mortalidade e morbidade tornando-se uma preocupação não só no território nacional mas a n´vel internacional. A silicose é a pneumoconiose mais antiga e mesmo assim, medidas preventivas e tecnologia disponível nas indústrias não são suficientes para diminuir sua incidência. Mesmo com desenvolvimento de sistemas legislativos mais eficientes e conscientes, surtos de silicose aguda continuam a ocorrer em indústrias mesmo nos países mais desenvolvidos. Uma vez estabelecida a doença é irreversível tendo como única alternativa evitar a progressão da doença e o surgimento de complicações . Este trabalho foi realizado através de uma extensa revisão da literatura nacional e internacional, utilizando livros texto e artigos publicados nas principais revistas médicas com o objetivo de conhecer melhor a doença e sua epidemiologia, diferentes apresentações e possíveis formas de manejo terapêutico.

A silicose e o perfil dos lapidários de pedras semipreciosas em Joaquim Felício, Minas Gerais, Brasil / Silicosis among semiprecious gem cutters in Joaquim Felício, Minas Gerais State, Brazil

Para conhecer a prevalência de silicose, descrever os perfis clínico, epidemiológico e ocupacional, e estudar as condições de trabalho das oficinas de lapidação, realizou-se estudo transversal de setenta lapidários de pedras semipreciosas de Joaquim Felício, Minas Gerais, Brasil, de abril a dezembro de 2002. Utilizaram-se história ocupacional com questionário respiratório, radiografia de tórax e espirometria. A prevalência de silicose foi de 7,1 por cento. Todos eram do sexo masculino, com média de idade de 21,5 anos e tempo médio de exposição à sílica de 7,1 anos. Todos pertenciam ao setor da economia informal e trabalhavam em oficinas pequenas e rudimentares, sendo o maquinário improvisado e havendo maciça exposição à sílica. Segundo a Classificação Radiológica da Organização Internacional do Trabalho, dos cinco casos de silicose, quatro foram classificados na categoria 1, e um na 3. A silicose em lapidários constitui um sério problema de saúde pública que requer esforços para minimização do risco de adoecimento, por meio da ação de equipes multidisciplinares provenientes de instituições governamentais e não-governamentais, com inserção ativa dos trabalhadores.

A cross-sectional study was performed to determine the prevalence of silicosis among semiprecious gem cutters (n = 70) and describe their clinical, epidemiological, and occupational profiles in Joaquim Felício, Minas Gerais State, Brazil, from April to December 2002. Occupational history was used with a respiratory questionnaire, chest x-ray, and spirometry. Silicosis prevalence was 7.1 percent. All affected individuals were men, with a mean age of 21.5 and mean exposure to silica of 7.1 years. All belonged to the informal economy and had been working at small and rudimentary workshops, using improvised lathes, with intense exposure to silica dust. According to the ILO Radiological Classification, four of the five cases of silicosis were classified as grade 1 and one as grade 3. Silicosis among gem cutters constitutes a serious public health problem that requires efforts to minimize risk through work by multidisciplinary teams from government agencies and nongovernmental organizations, with active participation by the workers themselves.

Exposição ocupacional e ocorrência de pneumoconioses na região de Campinas (SP) Brasil, 1978-2003 / Occupational exposure and occurrence of pneumoconioses in Campinas, Brazil, 1978-2003

OBJETIVO: Desenvolver e consolidar uma ampla base de dados acerca da ocorrência das pneumoconioses numa região industrializada do Brasil, com especial referência às atividades mais freqüentemente relacionadas a essas doenças. MÉTODOS: Numa avaliação retrospectiva observacional, coletaram-se dados referentes à casuística ambulatorial das pneumoconioses no Hospital das Clínicas da Universidade Estadual de Campinas, entre o período de 1978 e 2003. Incluíram-se os indivíduos com diagnóstico de pneumoconiose, com base no histórico ocupacional e no radiograma do tórax, segundo recomendações da Organização Internacional do Trabalho, de 1980 e 2000, com anormalidades compatíveis com comprometimento intersticial do parênquima pulmonar. RESULTADOS: Foram identificados 1.147 casos de pneumoconiose (1.075 homens e 72 mulheres), sendo 1.061 casos (92,5 por cento) de silicose, 51 (4,45 por cento) de pneumoconiose por poeira mista, 15 (1,31 por cento) de asbestose, 13 (1,13 por cento) de pneumoconiose por rocha fosfática e 7 (0,61 por cento) de outras pneumoconioses (por carvão, grafite e metais duros). As alterações radiológicas com profusão 1/0, 1/1 e 1/2 e as pequenas opacidades regulares p, q e r foram as mais freqüentes, tendo sido identificados 192 casos (16,74 por cento) com grandes opacidades. Observou-se redução pronunciada da ocorrência dos casos a partir da década de 1990; adicionalmente, o tempo de exposição foi caracteristicamente mais breve do que o observado em série norte-americana. CONCLUSÕES: Os dados do presente estudo estabelecem uma ampla base de dados para a investigação da ocorrência de pneumoconioses numa região industrializada brasileira, tornando factível a realização de estudos de seguimento e a elaboração de políticas de saúde relacionadas aos agravos respiratórios ocupacionais.

OBJECTIVE: To develop and consolidate a comprehensive database on the occurrence of pneumoconioses in an industrialized region of Brazil, with a special focus on the activities most frequently related to these diseases. METHODS: A retrospective, observational study was conducted in order to gather data on cases of pneumoconioses treated at the outpatient clinic of the State University at Campinas Hospital das Clínicas between 1978 and 2003. Individuals diagnosed with pneumoconiosis, based on their occupational history and on chest X-ray findings of abnormalities consistent with interstitial lung disease involving the parenchyma, in accordance with the 1980 and 2000 recommendations of the International Labour Organization, were included in the study. RESULTS: A total of 1147 cases of pneumoconiosis were identified (1075 in males and 72 in females): 1061 cases of silicosis (92.5 percent); 51 cases of mixed-dust pneumoconiosis (4.45 percent); 15 cases of asbestosis (1.31 percent); 13 cases of phosphate rock-related pneumoconiosis (1.13 percent); and 7 cases of other types of pneumoconiosis (0.6 percent), including those related to exposure to coal, graphite and hard metals. The most common chest X-ray findings were 1/0, 1/1 or 1/2 profusion and small regular opacities (p, q or r), although 192 patients (16.74 percent) presented large opacities. There has been a substantial decline in the occurrence of the disease since the 1990s, and the duration of exposure was typically shorter than that observed in a study conducted in the United States. CONCLUSIONS: Our findings have been compiled into a comprehensive database for the investigation of pneumoconiosis in an industrialized area of Brazil. These data make it possible to conduct follow-up studies and develop health policies related to occupational respiratory disorders.

Exposição ocupacional à sílica e silicose entre trabalhadores de marmorarias, no município de São Paulo / Occupational exposure to silica and silicosis among sheds workers in São Paulo

No Brasil encontram-se em crescimento os índices de prevalência das doenças crônicas causadas pela exposição dos trabalhadores à poeiras minerais, sendo a silicose a pneumoconiose de maior prevalência, realizou-se estudo com objetivo de estimar o risco de silicose e propor ações preventivas.Métodos: Realizou-se estudo transversal em 27 marmorarias, no município de São Paulo que executavam o beneficiamento final de rochas ornamentais, que inclui: a) avaliação da exposição à poeiras e à sílica cristalina respirável por meio de coleta de amostras de ar, análise química por gravimetria e difração de Raios X e acumulação das exposições estimadas por função conforme história ocupacional; b) aplicação de questionário de sintomas respiratórios e avaliação médica, espirometria e radiografia do tórax; c) correlação dos resultados de exposição acumulada, com achados clínicos e radiológicos por meio de análises estatísticas; d) levantamento de informações sobre os processos de trabalho e alternativas de controle. Resultados: Os acabadores possuíam a maior exposição, concentração de 0,36 mg m3 (IC 95 por cento 0,32 a 0,47) para granitos e de 0,19 mg m3 (IC 95 por cento 0,16 a 0,23) para a mistura de matérias primas. Para estimativa de exposição acumulada à sílica cristalina respirável de 0,56 mg m3 anos existiu risco de OD = 1,2 (IC 95 por cento 1,02 a 1,40) de o trabalhador exposto apresentar classificação radiológica alterada, profusão maior ou igual 1, em relação a um trabalhador não exposto, com tempo médio de exposição de 19,9 ( mais ou menos 13,0) anos.A população possuía baixo nível de escolaridade e de renda familiar com média de idade 35,8 ( mais ou menos 11,6) anos.

Las silicosis aceleradas / The accelerated silicosis

Se revisaron las historias clínicas de 67 pacientes con diagnóstico de silicosis. Los 37 primeros tienen el tipo de silicosis acelerada (grupo A) y los segundos, silicosis crónica (grupo C). De los del primer grupo fallecieron 9, con los que se conformó otro que se estudió aparte (grupo B). Todos fueron objeto de estudios clínicos, radiológicos, funcionales y broncoscópicos. El conjunto de ellos, considerados en promedio, demostraron que la enfermedad era más grave en el grupo B que en el grupo A, a pesar de su juventud y menor exposición. Los del grupo A tenían una situación de gravedad importante, aunque menor que los del B. El grupo C tenía lesiones irreversibles y autoevolutivas de tal naturaleza que sugieren cronicidad y agravamientos a plazos más prolongados. De los de la enfermedad acelerada falleció el 25 por ciento. Desde el punto de vista epidemiológico se destaca el predominio de oficios como arenador y minero. Se verificó asociación estadísticamente significativa entre: 1) el oficio de arenador y el diagnóstico de silicosis acelerada; Odd Ratio 149.8, IC 95 por ciento (16.4 < OR < 6303.0). 2) diagnóstico de silicosis crónica con el oficio de minero, OR 26.4, IC 95 por ciento (5.7 < OR 158.3). 3) la posibilidad de morir y el antecedente de arenado (concentración de sílice en el medio ambiente laboral)...

Silicose em artesãos de pedras ornamentais no Município de Petrópolis / Silicosis in stone carvers from the city of Petrópolis

O achado de fibrose pulmonar maciça em um artesão de pedras ornamentais no Município de Petrópolis, RJ, motivou uma investigação sobre a prevalência de silicose naquela população. No período de janeiro de 2000 a junho de 2002, um estudo transversal foi conduzido, sendo os trabalhadores avaliados com história clínica e ocupacional, radiografias de tórax, tomografias computadorizadas de alta resolução, espirometria, medidas de volumes pulmonares e capacidade de difusão. Foram analisadas amostras do ar ambiente e implantado um programa educacional. A prevalência de silicose foi de 53,7 por cento, num total de 42 trabalhadores avaliados. Dois casos de silicotuberculose foram diagnosticados. Conclui-se que a exposição a altos níveis de sílica respirável estava associada a elevada prevalência de silicose / The finding of pulmonary massive fibrosis in a stone carver from the City of Petrópolis, motivated an investigation of the prevalence of silicosis in this group. IN the period between January 2000 and June 2002, a cross-sectional study was carried out. The workers were evaluated with clinical and occupational history, chest radiographs, high-resolution computed tomography, spirometry, and lung volumes and carbon monoxide diffusion capacity measurements. Air samples were analyzed and an educational program was implemented. The prevalence of silicosis was 53.7 per cent, in 42 workers. Two cases of silicotuberculosis were diagnosed. It is concluded that exposure to high levels of respirable silica was associated with an increased prevalence of silicosis...

Co-morbidade na silicose / Silicosis co morbidity

Em estudo retrospectivo de 168 casos de pacientes portadores de silicose, representando 42,4 por cento (168/396), atendidos no HUAP e INSS de Niterói entre 1985 e 1995, foram encontradas as seguintes entidades associadas: tuberculose pulmonar, DPOC, cor pulmonale, infecções respiratórias agudas, outras tuberculoses, fibroses pulmonares não-classificadas, outras pneumoconioses, sinusite crônica, outras pneumopatias não-classificadas, sarcoidose, micoses pulmonares, esclerodermia, câncer de pulmão e proteinose alveolar. A comparação dos dois qüinqüênios mostrou um crescimento no percentual da silicose de 43,4 por cento (73/168) para 56,5 por cento (95/168), com aumento da ocorrência de tuberculose, que passou de 31,5 por cento para 42,1 por cento e redução da incidência de DPOC de 41,0 por cento (30/73) para 38,9 por cento (37/95)

Silicose em cavadores de poços da regiäo de Ibiapaba(CE): da descoberta ao controle / Silicosis among PIT diggers in the region of Ibiapaba, state of Ceará, Brazil: from detection to control

A ocorrência de silicose em cavadores de poços foi descoberta em 1984. Em 1988, foi evidenciado um foco da doença na regiäo da Ibiapaba, Estado do Ceará (Brasil). O presente estudo teve por objetivos: 1) apresentar a intervençäo educativa preventiva primária (IEPP) criada, segundo o método de conscientizaçäo crítica de Paulo Freire, e aplicada aos cavadores de poços e seus familiares; 2) conhecer o papel dessas medidas no aprendizado sobre silicose e nas mudanças de atitude promovidas na prática dessa atividade na regiäo da Ibiapaba. Dos 1.202 cavadores de poços da regiäo, 687 de cinco municípios selecionados para o estudo foram submetidos à IEPP e, destes, 283 participaram do estudo do papel da IEPP no controle da silicose. Todos eram homens, com idades variando de 18 a 78 anos; 115 eram silicóticos, 122 näo silicóticos e 46 ignoravam o diagnóstico. Os resultados mostraram que a IEPP promoveu apresendizado sólido sobre a relaçäo entre cavar poços e silicose, independentemente dos indivíduos serem ou näo portadores da doença, induzindo a maioria deles (85,8 por cento) a abandonarem a atividade. A IEPP foi capaz de promover a conscientizaçäo do problema nos cavadores de poços, interrompendo o ciclo epidemiológico da silicose na regiäo da Ibiapaba.

Doenças profissionais causadas por poeiras: "silicose" / Diseases caused by dust: \"silicosis\"

No presente trabalho o autor faz uma revisão bibliográfica da literatura médica e análise das publicações científicas sobe a silicose existente nos últimos anos, tendo em vista ser a mesma, uma das afecções mais relevantes entre as pneumoconioses. É apresentada uma revisão sobre a doença, suas manifestações respiratórias e complicações, sua epidemiologia,estudo clínico, exames complementares e correlações radiológicas e fucionais, demonstrando ser essencial uma boa história ocpacional e radilógica de bom padrão, para que se proceda o diagnóstico. Destaca a importância da prevenção, e, principalmente, o tratamento.

Silicosis and pulmonary tuberculosis in stone-grinding factories in Saraburi, Thailand.

The stone-grinding industry is well known to place its workforce at higher risk for silicosis. In addition, workers who are exposed to silica fibers are at a higher risk for pulmonary tuberculosis. This study was conducted to determine the prevalence levels of silicosis and pulmonary tuberculosis among workers in 33 factories in 3 subdistricts of Saraburi, Thailand and the associated risk factors. Thirty-one of the factories (93.9%) had amounts of either total dust or respirable dust exceeding threshold limit values with the average levels of total dust and respirable dust of 24.3 +/- 34.6 and 2.4 +/- 1.6 mg/m3 respectively. Radiologic patterns indicated that 61 workers (9.0%) had silicosis and 13 workers (1.9%) had pulmonary tuberculosis. The prevalence of silicosis and pulmonary tuberculosis was significantly associated with years of work. This study demonstrated the need for developing and supporting potential primary preventive intervention, periodic medical screening as a part of a medical surveillance system and a national occupational medical services program.