Pneumoconiosis in different sectors and their differences in Turkey.

Tuberk Toraks 2016 Dec;64(4):275-282

Department of Chest Diseases, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

Introduction: Pneumoconiosis which is one of the ancient diseases, still affects many workers throughout the world despite "existing" control programs. We add data from a single center reviewing risk factors for pneumoconiosis; evaluate functional and radiological findings in different sectors.

Materials And Methods: We reviewed medical records of patients diagnosed with pneumoconiosis who were admitted to our center between the years 2013 and 2015. Several personal and occupational features, together with functional and radiologic data, were collected.

Result: 60 were young males. Twenty-four of the cases (39.3%) worked at dental technician, 24 cases (39.3%) were ceramic workers, 5 cases (8.2%) were sandblasters, 2 cases (3.3%) were welders, 3 cases (4.9%) were miners, and 3 cases (4.9%) were marble cutters. The sectors in which the exposure started at the earliest ages were dental technicians and sandblasters, while the shortest working time was in sandblasting. The dental technicians were younger than the ceramic workers at the age of diagnosis (Kruskall-Wallis p= 0.003). The exposure time of the sandblasters was significantly shorter, especially than the ceramic workers (Kruskall-Wallis p= 0.002). The cases have been referred to us with pneumoconiosis suspicion based on the radiographic findings in the PA chest roentgenogram performed during the periodic examinations at their work place; but unlike other studies, in our study, following the HRCT assessment, cases which did not present any visible pathology in the re-evaluation of their PA chest roentgenogram, but had HRCT findings have been diagnosed as pneumoconiosis. Among the 44 cases in which micro-nodules had been detected at their HRCT, 15 of them had been previously classified as profusion of small opacities 0/1 according to their PA chest roentgenogram findings. It has been seen that the HRCT findings differ among sectors. Ceramics workers and sandblasters had significantly more micro-nodules, while dental technicians had significantly more mediastinal lymphadenopathies (Chi square, p= 0.004 and p= 0.007 respectively). When the relationship between the existence of big opacities and complaints was studied, statistically significant weight loss was detected in cases which had C opacities (chi square p= 0.01). Statistically significant FEV1 decrease was observed in cases which had weight loss (independent samples t-test p= 0.046). It has been observed that when the profusion of small opacities increased, while there was no statistically significant functional status change in non-smokers, a significant functional impairment was observed in smokers.

Conclusions: Pneumoconiosis still exists in Turkey. Even a short exposure time as 2 years can cause pneumoconiosis. Workers in different sectors had different functional, radiological properties and smoking can affect the diseases' course. There are serious limitations related to the surveillance of both the workplace environment and the employees' health in Turkey. Without institutional preventive measures, personal protection and surveillance examinations, occupational hazards will continue to cause premature deaths. Pneumoconiosis in different sectors is a prototype of uncontrolled industry in the developing world.

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Source
December 2016

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