Evaluación de la exposición al polvo de carbón y de sílice en sitios de minería subterránea en tres departamentos de Colombia / Evaluation of the exposure to coal dust and prevalence of pneumoconiosis in underground mining in three Colombian departments

Introducción. La neumoconiosis de mineros del carbón es una enfermedad crónica e irreversible que se considera un problema de salud pública. Objetivo. Estimar la prevalencia de neumoconiosis y sus factores asociados en mineros de carbón de Boyacá, Cundinamarca y Norte de Santander. Materiales y métodos. Se hizo un estudio de corte transversal en 476 mineros. Se les hizo valoración médica, se tomaron radiografías de tórax siguiendo los criterios de la Organización Internacional del Trabajo, así como espirometrías, y se identificaron los polimorfismos de la glutatión S-transferasa y de las enzimas de reparación. Las asociaciones entre las condiciones ocupacionales y de la empresa con la neumoconiosis, se estudiaron usando modelos de regresión de Cox. Resultados. En 31 empresas se hicieron 479 monitorizaciones ambientales y se evaluaron 476 trabajadores cuyo tiempo de trabajo fluctuaba entre 10 y 57 años. La prevalencia de la neumoconiosis fue de 33,8 % (IC95% 27,0-41,3). En el modelo de regresión multivariado de Cox, con tiempo de riesgo constante para la neumoconiosis, esta se asoció significativamente con el trabajo en empresas medianas (razón de prevalencias, RP=2,00; IC95% 0,995- 2,690; p=0,052), con un nivel alto de exposición al polvo de carbón según el índice de exposición (RP=2,055; IC95% 1,043-4,048; p=0,038), y una antigüedad de 25 años o más (para 25,0 a 29,9 años: RP=2,199; IC95% 1,449-3,338; p=0,001). Conclusiones. La prevalencia de la neumoconiosis fue muy alta y se asoció a la exposición a altos niveles de polvo de carbón, a una exposición laboral mayor o igual a 25 años y al trabajo en empresas medianas.

Introduction: Coal workers' pneumoconiosis is a chronic and irreversible disease representing a public health problem. Objective: To estimate the prevalence of pneumoconiosis and its associated factors among underground coal miners in the Colombian departments of Boyacá, Cundinamarca and Norte de Santander. Materials and methods: We conducted a cross-sectional study of 476 miners to measure the prevalence of pneumoconiosis and its associated factors such as coal dust and silica levels, as well as the occupational conditions. The medical assessment and a chest x-ray were performed according to the International Labor Organization criteria, along with spirometry and the identification of glutathione S-transferase and repair enzyme polymorphisms. The associations were explored using Cox regression models. Results: We performed a total of 479 environmental monitoring sessions in 31 companies and we evaluated 476 workers with 10 to 57 years of mining work experience. The prevalence of pneumoconiosis was 33.8% (95% CI: 27.0 - 41.3%). In the Cox multivariate regression model with a constant risk time, pneumoconiosis was significantly associated with working in medium-sized companies (PR=2.00, 95% CI: 0.995 - 2.690; p=0.052), the level of severe exposure to coal dust (PR=2.055, 95% CI: 1.043 - 4.048; p=0.038), and working in underground mining for 25 years or more (for those with 25.0-29.9 years: PR=2.199, 95% CI: 1.449 - 3.338; p=0.001). Conclusions: The prevalence of pneumoconiosis was very high and was found to be associated with severe exposure to coal dust, work exposure for 25 years or more and working in medium-sized enterprises.

Percepción de riesgo de exposición ocupacional a sílice: construcción y validación de un cuestionario en Chile / Risk perception of occupational exposure to silica: construction and validation of a questionnaire in Chile

Resumen: Introducción: La silicosis es una enfermedad pulmonar progresiva, irreversible, pero potencialmente prevenible. Conocer la percepción de riesgo en trabajadores expuestos a sílice es necesario para intervenir y reducir la incidencia de silicosis y otras enfermedades relacionadas. El objetivo de este estudio fue validar un Cuestionario de Percepción de Riesgo de Exposición Ocupacional a Sílice (CuPREOS) en trabajadores expuestos, en distintas actividades laborales en Temuco, Chile. Material y método: Una etapa de exploración con enfoque fenomenológico/ naturalista permitió conformar categorías de primer y segundo orden, que concluyó en una primera versión del instrumento. Una segunda etapa incluyó análisis factorial exploratorio y confirmatorio. Resultados: Se develaron dos dimensiones subyacentes: a) evidencia de riesgo, en la que el trabajador manifiesta evaluar señales de alarma y b) ausencia de riesgo, en la que sopesa aspectos que contrarrestan las anteriores. Ambas configuran la estructura conceptual que conforma el CuPREOS de 9 ítems/preguntas, con una confiabilidad de 0.84 (alfa Cronbach). Los indicadores del análisis confirmatorio revelan un buen ajuste del mode lo. Discusión: la percepción de riesgo es un constructo que involucra complejidades sociales y culturales, su medición debe ser sencilla y práctica; su conocimiento permitiría decisiones más efectivas en pre vención e intervención.

Abstract: Introduction: Silicosis is a progressive lung disease, irreversible, but potentially preventable. Knowing the perception of risk in workers exposed to silica is necessary to intervene and reduce the incidence of silicosis and other related diseases. The objective of this study was to validate a Questionnaire of risk perception of occupational expo sure to silica (CuPREOS) in exposed workers, in different work activities in Temuco, Chile. Material and method: A stage of explo ration with phenomenological/naturalist approach allowed to create categories of first and second order, which ended in a first version of the instrument. The second stage included exploratory and con firmatory factor analysis. Results: two underlying dimensions were revealed: a) evidence of risk, in which worker states to evaluate signals of alarm and b) absence of risk, in which he weighs aspects that counteract the previous ones. Both set up the conceptual frame work that sustain the CuPREOS of 9 items/questions, with a reliabil ity of 0.84 (Cronbach alfa). The confirmatory analysis indicators show a good fit of the model. Discussion: the perception of risk is a construct involving social and cultural complexities, its measurement should be simple and practical; its knowledge would enable more effective decision-making in prevention and intervention.

Comparative analysis on inter-laboratory detection of free silica indust in Guangdong Province,2012-2015 / 中国职业医学

OBJECTIVE: To evaluate the technical level and ability of the detection of free silica in dust in occupational health technical service institutions of Guangdong Province through inter-laboratory comparison. METHODS: The interlaboratory detection of free silica in dust in 55,61,58 and 66 occupational health technical service institutions were carried out and compared in 2012-2015. The results were statistically analyzed by four points robust statistical technique,and the relative deviation between the laboratory test results and the Median of them was used as the auxiliary evaluation index of the laboratory's technical ability. RESULTS: The stable coefficient of variation(CV) of samples with free silica content > 20. 00% was less than 5. 00%,and the stable CV of samples with free silica content ≤20. 00% was more than5. 00%. The qualified rate in 2012-2015 were 89. 09%,81. 97%,77. 59% and 81. 82%,respectively. There was no statistical difference(P > 0. 05) in the annual reference between private and non-private institutions compared to the qualified rate in 2012-2015. There was no statistical difference(P > 0. 05) in the qualified rate of the institutions in the Pearl River Delta region and in the non-triangular regions of the Pearl River Delta in 2012-2015. CONCLUSION: Comparison of the detection technology service ability in the detection of free silica in dust should be conducted to improve its technical service quality.

A Case of Silicosis and Pneumothorax in a Workplace Producing Dental Porcerlain / 대한산업의학회지

BACKGROUND: Silicosis is more likely to occur in people working in the mining industry. However, workers suffering from silicosis have recently been reported frequently in other areas. We present a case of silicosis occuring in a 43-year-old man who had worked for 20 years in a workplace producing dental porcelain. CASE: The man was admitted to the emergency room with acute chest pain caused by pneumothorax. Chest X-ray indicated numerous small opacities spread over the whole lung field and a large opacity in the right middle lung field. According to ILO classification, the shape of the small opacities was t/s, the profusion rate was 2/3 and the large opacity was classified into the B category. Following this diagnosis of silicosis, the patient's medical history and work exposure history were examined. According to his medical history, he had undergone closed thoracostomy in 2006 because he had suffered pneumothorax twice (in 2005 and 2006) and his smoking history was 7 pack years. In particular, he had been exposed to silica dust for 20 years in his workplace. CONCLUSION: Despite the absence of any specific risk factor that caused pneumothorax, the patient suffered this condition three times. All clinical results and the progress of his physical symptoms, including radiologic findings from chest X-ray and computed tomography, clearly supported the diagnosis of silicosis. Except for exposure to silica dust in the workplace, no other risk factors causing silicosis were found. Therefore, he was finally diagnosed as having silicosis caused by exposure to silica dust in the workplace and followed by pneumothorax.