Abstract
IntroductionCo-existence of silicosis and tuberculosis is known as silico-tuberculosis. This article review the frequency of silicosis and tuberculosis in workers who exposed to silica and evaluate influencing factors that may increase the risk of silico-tuberculosis.MethodsAn analytical cross-sectional study was performed in silica exposed workers in central province of Iran during 2011-2012. Sampling method was un-randomized and considering all workers who at least 6 months exposed to silica. The study was done via questionnaire, clinical examination, spirometry, chest x-ray and tuberculosis investigations.ResultsA total of 3121 workers were included in the study, the mean age of participants was 43.1±12.4 years, and mean employment duration 14.9±6.8 years. Prevalence of TB in silica-exposed workers without silicosis was 172 cases per 100 000 people and prevalence in silicosis cases was 917 cases per 100 000 people. Incidence of TB in silica-exposed workers without silicosis was 69 cases per 100 000 people and incidence in silicosis cases was 459 cases per 100 000 people. The frequency of LTBI/TB was higher in age over thirty years old (P = 0.02), in workers with employment duration over 10 years (P = 0.004), in workers with exposure duration over 5 years (P = 0.03) and smokers with over 5 pack-years (P = 0.01).ConclusionExposure to silica causes a renewed multiplication of bacilli in the healing TB lesions. Prevalence of pulmonary tuberculosis in Silicosis is more common when compared to prevalence in general population, hence all should use prophylactic measures Intensification of work place.
Highlights
IntroductionThis article review the frequency of silicosis and tuberculosis in workers who exposed to silica and evaluate influencing factors that may increase the risk of silico-tuberculosis
Co-existence of silicosis and tuberculosis is known as silico-tuberculosis
1) LTBI (Latent Tuberculosis Infection) defined by positive results for PPD, Chest radiograph is typically normal, no sign of active TB, negative smear and culture results; 2) No LTBI and no TB defined as negative PPD results, chest radiographs showing no sign of previous or active TB disease, and negative smear and culture results; 3) Past TB defined as positive PPD results, chest radiographs showing signs of previous TB, negative smear and culture results; 4) Active TB defined as chest radiographs showing signs of active TB and/or positive smear results and/or positive culture results
Summary
This article review the frequency of silicosis and tuberculosis in workers who exposed to silica and evaluate influencing factors that may increase the risk of silico-tuberculosis. Tuberculosis (TB) is one of the most important infectious diseases in the world in terms of morbidity and mortality and in year of 2012 its prevalence and incidence rate in Iran were 33(13-61) and 21(15-28) per 100 000 population respectively [5]. In a prospective study in 2000 miners, showed that the risk of developing pulmonary tuberculosis is proportional to the severity of the silicosis and the intensity of the exposure and workers with the highest cumulative exposure to dust were 3.2 times more likely to develop tuberculosis than were those with the lowest loads. In another study observed a mean duration of 6.8 years between the diagnosis of silicosis and the onset of tuberculosis [9]
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