Reported occupational respiratory diseases in three Spanish regions.

BACKGROUND: In 2002, a voluntary registry of occupational respiratory diseases was initiated in the test phase in Asturias, Catalonia, and Navarre (Spain). Based on data from the fully implemented voluntary registry, we assessed the differences in the incidence and characteristics of the diseases reported in the three regions studied and compared them with those notified to the compulsory official system. METHODS: Physicians whose daily practice includes patients with occupational respiratory diseases were invited to participate. Newly diagnosed cases occurring during 2003 in the work force of the three regions studied were reported on a notification form every 2 months. Data from the compulsory official notification system were obtained from statistics on work-related diseases for possible disability benefits. RESULTS: Five hundred thirty-three new cases, representing a cumulative incidence of 183.52 (168.27-199.78) per million workers per year, were reported. The number of cases and the incidence, overall and for each disease, causes of the diseases, and the occupations varied considerably between regions. The number of cases reported to the voluntary system was more than threefold greater than the number reported to the compulsory official system. CONCLUSIONS: The compulsory scheme for reporting occupational respiratory diseases is seriously under-reporting in the three Spanish regions studied. Our voluntary surveillance program, which showed considerable differences in the characteristics and incidence of these diseases among the regions, appears to be more effective.

High prevalence and advanced silicosis in active granite workers: a dose-response analysis including FEV1.

OBJECTIVE: To evaluate silica exposure and respiratory disease in granite workers. METHODS: A cross-sectional study of 440 active granite workers. RESULTS: Seventy-seven (17.5%) have silicosis, complicated in 15 of them; 18 have an obstructive ventilatory defect and 73 had exceeded 3.5 mg/m-year of cumulative silica exposure. Percent predicted FEV1 have a significant negative relation with mg/m(3)-year (P < 0.001) with a trend toward dose-response excluding silicotics and controlling for tobacco. The odds ratio (95% confidence interval) of having a percent predicted FEV1 below 50th percentile is 1.18 (0.66 to 2.11) for nonexposed smokers, 1.47 (0.76 to 2.84) for exposed nonsmokers, and 2.07 (1.12 to 3.85) for exposed smokers, in comparison with the control group. CONCLUSIONS: This study suggests that silica induces functional alteration regardless of silicosis and, in all likelihood, synergistically with tobacco. Exposure levels must be controlled better in these workers and those with silicosis must be relocated to risk-free jobs or retired.

Efectos del polvo inhalado en los trabajadores de la industria de pizarras / The effects of dust inhalation on slate industry workers

FUNDAMENTO: La explotación de pizarras constituye un riesgo para desarrollar silicosis; es una industria en auge e implica a un creciente número de trabajadores. No se conocen las repercusiones sobre su salud respiratoria. SUJETOS Y MÉTODO: Estudio transversal en trabajadores en activo. Se valoraron las alteraciones radiológicas y funcionales, y su relación con los factores de riesgo. RESULTADOS: Se encontró una prevalencia de neumoconiosis del 2,1 por ciento. El valor del volumen espiratorio máximo en 1 s (VEMS) se relacionaba significativamente con el tabaquismo y con la existencia de nodulación de profusión 1/0 o mayor; estos factores de riesgo, aplicada una regresión múltiple, actúan de forma independiente. CONCLUSIONES: La industria de pizarras supone un riesgo de neumoconiosis y otras alteraciones respiratorias (AU)