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Original research
Volume-based tomography for the diagnosis of incipient silicosis in former gold miners
  1. Ana Paula Scalia Carneiro1,
  2. Leandro Liberino da Silva2,
  3. Francisco das Chagas Lima Silva3,
  4. Kurt Georg Hering4,
  5. Eduardo Algranti5
  1. 1 Regional Reference Centre on Workers' Health, Clinical Hospital, UFMG, Belo Horizonte, MG, Brazil
  2. 2 Center for Diagnosis and Treatment, Santa Casa BH, Belo Horizonte, Minas Gerais, Brazil
  3. 3 Center of Research and Postgraduate Courses, Santa Casa de Misericórdia de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
  4. 4 Department of Radiology, Klinikum Dortmund gGmbH, Dortmund, Germany
  5. 5 Division of Applied Research, Fundacentro, Sao Paulo, Brazil
  1. Correspondence to Dr Ana Paula Scalia Carneiro, Regional Reference Centre on Workers' Health, Clinical Hospital, UFMG, Belo Horizonte, MG, Brazil; anapaula.scalia{at}gmail.com

Abstract

Objective To evaluate silicosis diagnosed through CT, with integration of clinical-occupational data, in silica-exposed workers presenting chest X-rays within International Labor Organization (ILO) category 0.

Methods Cross-sectional study with 339 former gold miners, with comparable exposures and X-rays classified as ILO subcategory 0/0 (n=285) and 0/1 (n=54) were submitted to volume-based CT. The findings were classified according to the International Classification of HRCT CT for Occupational and Environmental Respiratory Diseases.

Results A profusion degree of round opacities (RO)>1 was found in 22.4% (76/339) of the CT exams. After integrating the CT findings with clinical and occupational data, silicosis was diagnosed as follows: 43/285 (15.1%) and 14/54 (25.9%) in workers whose X-rays had been classified as 0/0 and 0/1, respectively. There was an upward trend towards longer exposures, reaching 38.9% when working more than 10 years underground and classified as 0/1 (p=0019). Those with presence of RO whose final diagnosis was not silicosis were mainly cases of tuberculosis or ‘indeterminate nodules’. Emphysema was found in 65/339 (19.1%), only 5 being detected in the X-ray.

Conclusion Volume-based CT proved to be useful in the investigation of silicosis among individuals with a relevant exposure to silica, capturing diagnoses that had not been identified on X-rays. A response gradient of silicosis was showed by CT even in this population with ILO category 0 radiographs. It can be indicated based on quantitative and/or qualitative criteria of occupational exposure, especially considering the possibilities of low CT dosage.

  • Silicosis
  • Miners
  • Respiratory System
  • Clinical medicine
  • Occupational Health

Data availability statement

All data relevant to the study are included in the article.

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Data availability statement

All data relevant to the study are included in the article.

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Footnotes

  • Collaborators Acknowledgements: We would like to thank the radiologists Dr Maria Luiza Bernardes Silva for all CT scan readings and Dr Fabiano Prado for reading the 80 CT scans that were part of the agreement assessment.

  • Contributors APSC made substantial contributions to the conception and design of the work; on acquisition, analysis and interpretation of data;drafting the work, revising it critically for important intellectual content. She gave her final approval of the version to be published and is the guarantor of the paper. LLS made substantial contributions to the study design, data acquisition, analysis and interpretation, drafting the work and revising it critically for important intellectual content. He gave his final approval of the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. FdCLS made contributions to the study design; on data acquisition, analysis and interpretation of data and for drafting the work. He gave his final approval of the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. KGH made substantial contributions to interpretation of data; for drafting the work and revising it critically for important intellectual content; gave his final approval of the version to be published; and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. EA made substantial contributions to the analysis and interpretation of data and drafting the work or revising it critically for important intellectual content. He gave his final approval of the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.