Rupani Mihir P
Clinical Epidemiology (Division of Health Sciences), ICMR - National Institute of Occupational Health (NIOH), Indian Council of Medical Research, Meghaninagar, Ahmedabad city, 380016, Gujarat, India.
J Occup Med Toxicol. 2023 Jul 11;18(1):11. doi: 10.1186/s12995-023-00379-1.
Silicosis has been one of the most serious occupational public health problems worldwide for many decades. The global burden of silicosis is largely unknown, although it is thought to be more prevalent in low and medium-income countries. Individual studies among workers exposed to silica dust in various industries, however, reveal a high prevalence of silicosis in India. This paper is an updated review of the novel challenges and opportunities for silicosis prevention and control in India.
The unregulated informal sector employs workers on contractual appointment thereby insulating the employers from legislative provisions. Due to a lack of awareness of the serious health risks and low-income levels, symptomatic workers tend to disregard the symptoms and continue working in dusty environments. To prevent any future dust exposure, the workers must be moved to an alternative job in the same factory where they will not be exposed to silica dust. Government regulatory bodies, on the other hand, must guarantee that factory owners relocate workers to another vocation as soon as they exhibit signs of silicosis. Technological advances such as artificial intelligence and machine learning might assist industries in implementing effective and cost-saving dust control measures. A surveillance system needs to be established for the early detection and tracking of all patients with silicosis. A pneumoconiosis elimination program encompassing health promotion, personal protection, diagnostic criteria, preventive measures, symptomatic management, prevention of silica dust exposure, treatment, and rehabilitation is felt important for wider adoption.
Silica dust exposure and its consequences are fully preventable, with the benefits of prevention considerably outweighing the benefits of treating patients with silicosis. A comprehensive national health program on silicosis within the public health system would strengthen surveillance, notification, and management of workers exposed to silica dust in India.
几十年来,矽肺病一直是全球最严重的职业公共卫生问题之一。尽管人们认为矽肺病在低收入和中等收入国家更为普遍,但全球矽肺病负担在很大程度上仍不为人知。然而,对各行业接触二氧化硅粉尘工人的个别研究表明,印度矽肺病患病率很高。本文是对印度矽肺病预防和控制面临的新挑战与机遇的最新综述。
不受监管的非正规部门以合同制雇佣工人,从而使雇主免受立法规定的约束。由于对严重健康风险缺乏认识且收入水平较低,有症状的工人往往忽视症状,继续在多尘环境中工作。为防止未来接触粉尘,必须将工人调至同一工厂内不会接触二氧化硅粉尘的其他工作岗位。另一方面,政府监管机构必须确保工厂主一旦发现工人出现矽肺病症状,就将其调至另一职业。人工智能和机器学习等技术进步可能有助于各行业实施有效且节省成本的粉尘控制措施。需要建立一个监测系统,以便早期发现和跟踪所有矽肺病患者。人们认为,一项涵盖健康促进、个人防护、诊断标准、预防措施、症状管理、防止接触二氧化硅粉尘、治疗和康复的尘肺病消除计划对于更广泛的采用很重要。
接触二氧化硅粉尘及其后果是完全可以预防的,预防的益处大大超过治疗矽肺病患者的益处。公共卫生系统内一项关于矽肺病的全面国家健康计划将加强对印度接触二氧化硅粉尘工人的监测、报告和管理。