Secondary prevention of silicosis and silico-tuberculosis by periodic screening of silica dust exposed workers using serum club cell protein 16 as a proxy marker.

BACKGROUND AND OBJECTIVES

Silicosis is a neglected and widely prevalent occupational disease in India and several other countries such as China, South Africa, Brazil, etc. It is an irreversible, incurable, and progressive disease with high morbidity and mortality, which is mostly caused by occupational exposure to silica dusts. Silicosis is usually detected at an advanced stage, when effective intervention is not possible. But early detection appears to be a cost-effective way to control it. There is a need for some suitable biomarker, which could detect silicosis at an early stage for further necessary intervention. This study aimed to estimate the lung damage in silicotic subjects and its relationship with serum CC16 as a proxy marker. The ultimate objective was to explore whether CC16 could be used as a screening tool for early detection of silicosis.

METHODOLOGY

Radiographs of 117 workers having radiological evidences of silicosis were evaluated in accordance with International Labour Organisation (ILO) Classification of chest radiographs and were categorized as mild, moderate, and severe lung damage using a lung damage scoring system, made for the purpose of this study. The concentration of CC16 in serum was determined by enzyme-linked immunosorbent assay.

RESULT

It was observed that serum CC16 values were significantly decreased in relation to increasing lung damage. The mean ± standard deviation (SD) serum CC16 value in mild lung damage group was 8.4 ± 0.87 ng/mL as compared to 4.0 ± 2.10 ng/mL in moderate and 0.7 ± 0.21 ng/mL in high lung damage groups. On the other hand, CC16 value of control (healthy) population was found to be 16.3 ± 3.8 ng/mL.

CONCLUSION

Result of the study concluded that serum CC16 might be used as a periodic screening tool for early detection of silicosis and for it's secondary prevention. It may be viewed as a new approach toward control of silicosis, and an appropriate policy may be adopted.