Clinical Hospital, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.
Faculty of Medicine of the Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.
Occup Med (Lond). 2022 Aug 16;72(6):394-402. doi: 10.1093/occmed/kqac034.
Uncontrolled occupational exposure to silica is still frequent in Brazil, with several recent records in the state of Minas Gerais. However, few national studies have addressed silica-related diseases other than silicosis.
To describe the occurrence of the main non-malignant silica-related diseases: silicosis, tuberculosis (TB), chronic obstructive pulmonary disease (COPD), and autoimmune diseases in a specialized outpatient clinic.
Case series study of 1525 patients exposed to silica, seen between 1984 and 2021, with descriptive findings of clinical and occupational data from the first medical evaluation.
Medians of age and exposure time were 47 and 15 years, respectively, and 97% of patients were male. The prevalence of silicosis was 44%, of which 27% had large opacities. The main occupational sectors were underground gold mining (28%), precious and semi-precious stone work (20%), and artisanal mining (9%). Spirometries were abnormal in 55%, with obstructive disorder being the most common finding. COPD (25%), active TB or sequelae (12%), and connective tissue diseases (6%) were diagnosed in patients with and without silicosis.
The percentage of silicosis appears to be alarming, even considering the biases of selective referrals. The patients were relatively young and already had a functional impact, caused not only by silicosis but by one or more silica-related diseases. COPD, TB, and connective tissue diseases proved to be frequent, leading to the need for specifics protocols to investigate them in individuals exposed to silica. By adopting strategies to combat silicosis, the prevention of other silica-related diseases is concomitantly promoted.
巴西仍频繁发生无法控制的职业性矽尘暴露，米纳斯吉拉斯州近期有几例记录。然而，除矽肺外，很少有全国性研究涉及矽尘相关疾病。
描述专门门诊中矽尘相关的主要非恶性疾病（矽肺、肺结核、慢性阻塞性肺疾病和自身免疫性疾病）的发生情况。
对 1984 年至 2021 年间就诊的 1525 名接触矽尘的患者进行病例系列研究，对首次医疗评估的临床和职业数据进行描述性分析。
患者年龄和暴露时间的中位数分别为 47 岁和 15 年，97%为男性。矽肺患病率为 44%，其中 27%为大阴影。主要职业领域为地下金矿开采（28%）、宝石和半宝石加工（20%）和个体采矿（9%）。55%的患者肺功能检查异常，以阻塞性障碍最为常见。矽肺患者中有 25%、无矽肺患者中有 12%被诊断为活动性肺结核或后遗症、6%被诊断为结缔组织疾病。
即使考虑到选择性转诊的偏倚，矽肺的比例似乎也令人担忧。患者相对年轻，已经出现功能障碍，不仅由矽肺引起，还由一种或多种矽尘相关疾病引起。COPD、肺结核和结缔组织疾病的发病率较高，需要制定专门的方案来对接触矽尘的个体进行调查。通过采取控制矽肺的策略，同时促进预防其他矽尘相关疾病。
