Department of Occupational Medicine, İstanbul Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.
Department of Public Health, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey.
Balkan Med J. 2021 Nov;38(6):374-381. doi: 10.5152/balkanmedj.2021.21208.
Deaths due to epidemics of silicosis still continue to be reported both in developing and developed countries, and silica exposure from different sectors remains an important occupational health concern.
To identify characteristics of silicosis cases by focusing on a developing country and evaluate the frequency of and factors related to premature deaths and also reveal preventable causes of premature deaths in silicosis.
Retrospective cohort.
We reviewed the records of 9769 patients who were diagnosed with occupational diseases in İstanbul Occupational Diseases Hospital between 2006 and 2017. According to International Classification of Diseases (ICD)-10 codes, 1473 silicosis cases were detected. The sociodemographic characteristics, job characteristics, comorbidities, serological, functional, and radiological data, and follow-up time were obtained from the medical records. Mortality data were gathered from The National Death Notification System of Ministry of Health.
The study examined 9769 cases diagnosed with an occupational disease, and 15.0% (n = 1473) of them were diagnosed with silicosis. The median age of silicosis patients was 40.0 years, and 26.9% of them were child labor when they started to work in dusty industries. Child labor was mostly seen among dental technicians (57.7%), denim sandblasters (46.4%), and miners (37.0%). In the follow-up period, 26.3% of Teflon sandblasters, 11.1% of coal miners, 8.6% of denim sandblasters had died before their average life expectancy, and the years of loss of life was 26.0 ± 11.6 years all over the group. Premature death was associated with occupation [hazard ratio (Teflon sandblasting): 3.93, CI: 1.43-10.78; hazard ratio (marble production): 4.4, CI: 1.02-19.21]; large opacities in posterior anterior chest X-ray [hazard ratio: 2.14, CI: 1.18-3.86]; tuberculosis [hazard ratio: 2.60, CI: 1.42- 4.76]; and reduction in forced vital capacity (forced vital capacity% ≤80) during diagnosis [hazard ratio: 4.43, CI: 2.22-8.83].
More than a quarter of silicosis cases are those who start working in dusty industries at an early age. Factors associated with premature death in patients with silicosis are patient occupation, large opacities on chest X-ray, tuberculosis, and pulmonary function loss at diagnosis.
发展中国家和发达国家仍不断报告因矽肺引起的死亡病例，不同行业的矽尘暴露仍然是一个重要的职业健康问题。
通过关注一个发展中国家，确定矽肺病例的特征，评估早逝的频率和相关因素，并揭示矽肺早逝的可预防原因。
回顾性队列研究。
我们回顾了 2006 年至 2017 年间在伊斯坦布尔职业病医院诊断为职业病的 9769 名患者的记录。根据国际疾病分类（ICD-10）代码，发现 1473 例矽肺病例。从病历中获取社会人口统计学特征、职业特征、合并症、血清学、功能和影像学数据以及随访时间。死亡率数据来自卫生部国家死亡通知系统。
本研究共检查了 9769 例诊断为职业病的病例，其中 15.0%（n=1473）诊断为矽肺。矽肺患者的中位年龄为 40.0 岁，26.9%的人在开始在粉尘行业工作时是童工。童工主要见于牙科技工（57.7%）、牛仔喷砂工（46.4%）和矿工（37.0%）。在随访期间，特氟龙喷砂工中有 26.3%、煤矿工人中有 11.1%、牛仔喷砂工中有 8.6%在平均预期寿命之前死亡，整个组的生命损失年数为 26.0±11.6 年。过早死亡与职业相关[特氟龙喷砂（hazard ratio：3.93，CI：1.43-10.78）；大理石生产（hazard ratio：4.4，CI：1.02-19.21]；后前位胸片大阴影[危险比：2.14，CI：1.18-3.86]；肺结核[危险比：2.60，CI：1.42-4.76]；诊断时用力肺活量降低（用力肺活量%≤80）[危险比：4.43，CI：2.22-8.83]。
超过四分之一的矽肺病例是在早期开始在粉尘行业工作的人。矽肺患者早逝的相关因素是患者的职业、胸片上的大阴影、肺结核和诊断时的肺功能丧失。
