Silicosis in sandblasters of shipyard versus silicosis in stone carvers in Brazil: A comparison of imaging findings, lung function variables and cardiopulmonary exercise testing parameters

Abstract

ObjectivesTo compare imaging findings, lung function variables and cardiopulmonary exercise testing (CPET) results between Brazilian sandblasters of shipyard and stone carvers with silicosis. MethodsOf the 41 patients, 25 subjects were sandblasters and 16 were stone carvers, with median ages of 52 and 46.4 years, respectively. All of the patients underwent pulmonary function tests (PFTs) and CPET. Chest radiographs were classified according to the International Labour Organization recommendations. The following parameters were examined through the use of high-resolution computerized tomography (HRCT): nodules, progressive massive fibrosis (PMF), emphysema, and intrathoracic lymph node enlargement. ResultsLarge opacities on chest radiography were observed in 76% of sandblasters and only 18.7% of stone carvers. Using HRCT, PMF was identified in 92% of sandblasters and only 43.7% of stone carvers. Although carbon monoxide diffusing capacity results were significantly different between the sandblasters and stone carvers, these differences were more pronounced in the CPET results. While 92% of sandblasters failed to reach at least 80% of their predicted peak oxygen uptake (VO2), this was observed for only 43.7% of stone carvers. A breathing reserve of less than 25% was observed in 40.5% of sandblasters but not in any of the stone carvers. ConclusionIn silicosis, imaging findings, lung function and CPET results are strongly influenced by the type of exposure to silica dust. Additionally, CPET abnormalities are more pronounced compared to measurements taken at rest.