Introduction Occupational Health Unit of the Cluj-Napoca Emergency General County Hospital has a long and strong experience in diagnosing occupational lung disease and especially in diagnosing pneumoconiosis according to International Labour Organisation (ILO) classification. This study retrospectively searched for trends in characteristics of new silicosis cases reported by this unit over more than 35 years of activity.
Methods We reviewed medical records of all new cases of silicosis identified between 1980–1985 (93 subjects – group I), 2000–2005 (62 subjects – group II) and 2011–2016 (60 subjects, group III). We compared for each group their mean age at diagnosis, gender distribution, smoking habit, type of industry as source of exposure to mineral dust, radiological findings (according to ILO Classification of Radiographs of Pneumoconiosis), pulmonary function tests (PFT).
Results Mean age at diagnosis for the last group (57.15 years) compared to the other two (group I – 51.87 and group II – 52.24 years); sex distribution: females for the last two groups (16.12% group II and 5% group III compared to 0 cases in group I). The vast majority of patients in group I (97%) were from mining industry; in group II mining was represented by only 38% of patients, while foundries took the lead by 52% and some other industries were responsible for 10% cases, distribution remaining the same in group III (40% mining industry, 41.66% – foundries and 18.33% other industries). A slight increase in group III was found in smoking habit prevalence (58% – group I, 55% – group II and 65% – group III current or ex-smokers). The most important data regarded opacities profusion and size on radiographs and pulmonary function tests results. If in group I we found a fairly even distribution for profusions (23%–1, 26%–2, 16%–3), radiographs with axe symbol (13%) and with large opacities (22%), in group II and III profusion 1 was predominant (68% and 40%) and profusion 2 (19% and 36.66%) was also significant. On the other hand, in group I restrictive pattern at PFT was in the first place (42%) and obstructive pattern in group II (52%). In group III ventilatory defects were less frequent (28.33% obstructive and just 6.66% restrictive).
Conclusion Our results suggest significant changes in silicosis pattern in studied population. Age for first diagnosis tends to increase, radiological findings are less severe and pulmonary dysfunctions are less frequent. All these changes might be explained by a major shift in job exposure suggested by a decrease in mining activities and increase for other industries, especially foundries in our area of research.
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