Nadir Öziş Türkan, Şafak Alıcı Nur, Alıcı İbrahim Onur, Ergün Dilek, Avcı Emine, Hoca Nevin Taci, Yılmaz Ömer Hınç
Department of Pulmonology, Ankara Occupational Diseases Hospital, Ankara, Turkey.
Department of Occupational Medicine, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, İzmir, Turkey.
Turk Thorac J. 2021 Jan;22(1):50-56. doi: 10.5152/TurkThoracJ.2021.19151. Epub 2021 Jan 1.
This study aimed to review the risk factors for silicosis together with survival analysis and a perspective for lung transplantation with data from a single center.
We reviewed the medical records of denim sandblasters who were referred to our center between January 2006 and December 2011 and evaluated 219 patients with a history of denim sandblasting with a minimum follow-up period of 5 years until 2016. We analyzed several personal and occupational features, together with functional and radiologic data.
Of the 219 denim sandblasters, 107 (49%) had been diagnosed with silicosis. In the logistic regression analysis, the duration of exposure was the only independent risk factor for the development of silicosis, indicating a 9% increased risk of silicosis for every month of exposure (p<0.001; odds ratio 1.09; 95% confidence interval 1.050-1.132). Of the patients, 7 (3%) died. A forced expiratory volume in the first second of <44% and a forced vital capacity of <47% were associated with an increased risk of mortality. Mortality was significantly higher in the international labor office category 3 patients, and 5-year survival rates of patients with A, B, and C lung opacities were 88%, 67%, and 25%, respectively.
Silicosis still kills young workers. Severe radiologic involvement and decreased lung volumes are related to mortality, and lung transplantation is the only therapeutic option.
本研究旨在通过生存分析以及利用单中心数据对肺移植前景进行展望，回顾矽肺病的风险因素。
我们回顾了2006年1月至2011年12月间转诊至本中心的牛仔布喷砂机操作工的病历，并评估了219例有牛仔布喷砂病史的患者，其最短随访期为5年，直至2016年。我们分析了多项个人和职业特征，以及功能和放射学数据。
在219名牛仔布喷砂机操作工中，107例（49%）被诊断为矽肺病。在逻辑回归分析中，接触时长是矽肺病发生的唯一独立风险因素，表明每接触一个月，患矽肺病的风险增加9%（p<0.001；比值比1.09；95%置信区间1.050 - 1.132）。患者中有7例（3%）死亡。第一秒用力呼气量<44%和用力肺活量<47%与死亡风险增加相关。国际劳工组织3类患者的死亡率显著更高，A、B、C级肺部混浊患者的5年生存率分别为88%、67%和25%。
矽肺病仍会导致年轻工人死亡。严重的放射学病变和肺容积减小与死亡率相关，肺移植是唯一的治疗选择。
