[A test of screening to predict lung cancer among dust-exposed tin miners with sputum imaging cytometry].

OBJECTIVE: To evaluate efficacy of sputum imaging cytometry in early diagnosis on lung cancer among tin miners exposed to dust and analyze possible risk factors related to lung cancer among tin miners. METHODS: From a cohort of tin miners in Guangxi Province, a total of 345 male tin miners higher than 45 years old and with high exposure to crystalline silica dust were randomly selected as the objects. Imaging cytometry was used to implement the sputum analysis for the screening on lung cancer according to the experience diagnostic standard. All objects were then followed up to the end of 2006. Clinical diagnosis of lung cancer was used as the golden standard to evaluate the efficacy of screening. RESULTS: From 1998 to 2006, 11 new cases were diagnosed as clinical lung cancer. Except of age and exposure to occupational hazards, smoking status (P = 0.0384) and mean smoking dose (P = 0.0078) were significantly associated with lung cancer, and the adjusted odds ratio of high level to the low was 18.21 (2.15 approximately 154.39). The sensitivity, specificity and Youden's index of the sputum imaging cytometry for the experience diagnosis were 27.3%, 83.9% and 11.2% respectively. According to the ROC curve analysis, area under ROC Curve (AUC) of C2.5 (the percentage when the DNA index ranged from 1.25 to 2.50) was 0.647 (0.525 approximately 0.768), with the optimal operating point (OOP) of 1.70%. Sensitivity, specificity, agreement rate, positive predictive value, negative predictive value and Youden's index for predicting lung cancers in high-exposure tin miners were found to be 72.7%, 62.3%, 62.6%, 6.0%, 98.6% and 35.0% respectively. CONCLUSION: Smoking is confirmed as an important risk factor of lung cancer in tin miners. The diagnostic efficiency can be improved if the diagnostic point of C2.5 is adjusted to 1.70%.

[Determination and analysis of silica particles surface alumino-silicate occlusion].

OBJECTIVE: To investigate the methods of determining aluminum silicate coated on the surface of silica particles and analyze the role of surface occlusion on development of silicosis. METHODS: Respirable dust samples were collected on filters using 2 L/min flow in tungsten mines and pottery factories of Jiangxi province, and tin mines of Guanxi province. Dust particles were analyzed by a multiple-voltage scanning electron microscopy-energy dispersive X-ray spectroscopy (MVSEM-EDS) using 20 KeV and 5 KeV electron beam accelerating voltages. Changes in the silicon to aluminum X-ray line intensity ratio between the two voltages are compared particle by particle. This provided an index that distinguishes a silica particle that was homogeneously aluminum-contaminated from a clay coated silica particle. RESULTS: The total of 3,982 dust particles from 47 dust samples of seven pottery factories, three tin mines and three tungsten mines were analyzed in this study. Significant difference of aluminum silicate coated on the surface of silica particle was shown between particles from pottery factories and tin mines. The average sample percentage of respirbale-sized silica particles alumino-silicate occlusion in the pottery factories (45%) was higher than that in the tin mines (18%) and tungsten mines (13%). CONCLUSION: Higher percentages silica particles alumino-silicate occlusion is observed in the pottery factories than that in metal mines. These surface analysis results help to understand differences in risk of silicosis when exposure is normalized to cumulative respirable surface silica dust.