MDCT Findings of Denim-Sandblasting-Induced Silicosis: a cross-sectional study

Cihan Akgul Ozmen,Hasan Nazaroglu,Levent Akyildiz,Gungor Ates,Tekin Yildiz,Senem Senturk,Aylin Hasanefendioglu Bayrak

doi:10.1186/1476-069x-9-17

Abstract

BackgroundDenim sandblasting is as a novel cause of silicosis in Turkey, with reports of a recent increase in cases and fatal outcomes. We aimed to describe the radiological features of patients exposed to silica during denim sandblasting and define factors related to the development of silicosis.MethodsSixty consecutive men with a history of exposure to silica during denim sandblasting were recruited. All CT examinations were performed using a 64-row multi-detector CT (MDCT). The nodules were qualitatively and semi-quantitatively analyzed by grading nodular profusion (NP) on CT images.ResultsSilicosis was diagnosed radiologically in 73.3% of patients (44 of 60). The latency period (the time between initial exposure and radiological imaging) and duration of silica exposure was longer in patients diagnosed with silicosis than in those without silicosis (p < 0.05). Nodules were present in all cases with centrilobular type as the commonest (63.6%). All cases of silicosis were clinically classified as accelerated and 11.4% had progressive massive fibrosis (PMF). Mild NP lesions were the most prevalent in all six zones of the lung. The NP score was significantly correlated with the duration of silica exposure, the latency period, presence of PMF, and pleural thickening. Enlarged lymphadenopathy was present in 45.5% of patients.ConclusionsThe duration of exposure and the latency period are important for development of silicosis in denim sandblasters. MDCT is a useful tool in detecting findings of silicosis in workers who has silica exposure.

Highlights

Denim sandblasting is as a novel cause of silicosis in Turkey, with reports of a recent increase in cases and fatal outcomes
The receiver operating characteristic (ROC) curve analysis of duration of exposure to denim sandblasting and the latency period for development of radiological silicosis showed that the areas under the curve (AUC) were 0.703 and 0.683, respectively (Figure 1)
Denim sandblasting is a novel cause of silicosis that has recently been reported in Turkey; there are few reports in the literature on CT detection of accelerated [4] and acute silicosis [10,14] caused by denim sandblast

Summary

Introduction

Denim sandblasting is as a novel cause of silicosis in Turkey, with reports of a recent increase in cases and fatal outcomes. We aimed to describe the radiological features of patients exposed to silica during denim sandblasting and define factors related to the development of silicosis. Silicosis is an incurable lung disease caused by the inhalation of dust containing free crystalline silica. Silicosis occurs in two distinct clinical forms: acute silicosis, known as silicoproteinosis, and classic or chronic silicosis. Acute silicosis occurs following exposure to a large quantity of silica, most frequently as a result of sandblasting. Classic or chronic silicosis is characterized by the development of nodular infiltrative lung disease [2] and occurs following long-term exposure (i.e., 10-20 years) to a low concentration of silica dust.

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