Abstract
ObjectiveSilicosis is one of the common occupational lung diseases caused by crystalline silica respiration. Pneumothorax is one of the most common and morbid complications of silicosis involving lung pleura. It is commonly seen unilaterally in chronic silicosis and can often be lethal. The purpose of this study is to report secondary spontaneous pneumothorax (SSP) in critically ill patients with silicosis.MethodsA cross-sectional study was done between January 2019 and June 2019 at Sawai Man Singh (SMS) Medical College in Jaipur, India. A cohort of 50 patients with dyspnea and a history of silicosis were studied. A chest X-ray and sputum for acid fast bacilli were checked on all suspected cases.ResultsThe present study showed that the mean age of patients was 38.7 years, all silicosis patients had dyspnea, and 96% of patients had severe chest pain. The results of chest X-rays concluded the evidence of silicosis. Bilateral pneumothorax was seen in three cases, right-sided pneumothorax in eight cases, and left-sided pneumothorax in 11 cases. The rate of pneumothorax incidence in silicosis patients was about 44%, which is higher than the current evidence. Six patients were managed conservatively with oxygen and bronchodilators, and 16 patients underwent through tube thoracostomy.ConclusionThis study highlights the importance of considering spontaneous pneumothorax in patients who are presenting with shortness of breath and/or chest pain especially with a known history of silicosis, as the timely diagnosis can alter the management of this morbid condition which carries a high mortality rate if left untreated, compromising the lung expansion, venous return, cardiac output, oxygenation and eventually leading to death.
Highlights
Silicosis is an occupational lung illness due to the inhalation of crystalline silica
The present study showed that the mean age of patients was 38.7 years, all silicosis patients had dyspnea, and 96% of patients had severe chest pain
The rate of pneumothorax incidence in silicosis patients was about 44%, which is higher than the current evidence
Summary
Silicosis is an occupational lung illness due to the inhalation of crystalline silica. The International Agency for Research on Cancer (IARC) has listed crystalline silica as a “group 1” carcinogenic agent [1]. This typically occurs in the lungs after decades of silica exposure, and it transforms progressively into nodular fibrosing pneumoconiosis [2]. Workers are exposed to high silica concentrations, causing dysfunction of lungs due to the fibrogenic process. The occurrence of silicosis disease is certainly among those with silica exposure, posing a critical health problem in these populations, especially in low-income communities [4]
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