Pylica krzemowa – Rokowania, prognozy i postęp choroby

Pylica krzemowa
Rokowania, prognozy i postęp choroby

Pylica krzemowa to nieuleczalna, postępująca choroba płuc o nieodwracalnym charakterze, której rozwój może trwać nawet po zaprzestaniu ekspozycji na pył krzemionkowy. Rokowanie zależy od wielu czynników, takich jak wiek, historia palenia, polimorfizmy genetyczne (np. TNF-2, rs2076304 w genie desmoplakiny), długość ekspozycji (zwykle 15-20 lat, choć w 20% przypadków poniżej 10 lat), oraz forma kliniczna choroby (przewlekła, przyspieszona, ostra, guzowata). Szczególnie agresywna jest pylica z kamienia syntetycznego (ES), diagnozowana po 7-19 latach ekspozycji, często u młodych osób (mediana wieku 33-55 lat). Zaawansowane formy, takie jak masywne włóknienie postępujące (PMF), prowadzą do niewydolności oddechowej i wysokiej śmiertelności. Pylica krzemowa zwiększa 8-20-krotnie ryzyko zakażeń mykobakteryjnych, a współistnienie z gruźlicą (krzemico-gruźlica) podwaja ryzyko śmiertelności (HR=2,0; 95% CI: 1,4-3,0) i skraca medianę przeżycia do 16 miesięcy w porównaniu do 44 miesięcy u pacjentów z samą gruźlicą.

Wstęp do prognozy pylicy krzemowej
Modele predykcyjne w pylicy krzemowej
Czynniki prognostyczne w pylicy krzemowej

Czynniki genetyczne
Długość ekspozycji i latencja
Formy kliniczne i ich prognostyczne znaczenie

Pylica krzemowa i choroby współistniejące – wpływ na rokowanie

Zakażenia mykobakteryjne
Choroby autoimmunologiczne

Śmiertelność i długoterminowe rokowanie
Szczególne uwagi dla pylicy krzemowej z kamienia syntetycznego
Znaczenie prognozowania w praktyce klinicznej

Kolejne rozdziały

Wstęp do prognozy pylicy krzemowej

Pylica krzemowa jest nieuleczalną, postępującą chorobą płuc o nieodwracalnym charakterze, której przebieg może być kontynuowany nawet po zaprzestaniu ekspozycji na pył krzemionkowy.¹² Wszystkie strategie leczenia koncentrują się na opóźnieniu progresji choroby i kontroli wtórnych stanów medycznych.³ Prognoza pylicy krzemowej zależy od wielu czynników, w tym wieku w momencie diagnozy, historii palenia tytoniu, klinicznej progresji choroby, polimorfizmów genetycznych, chorób współistniejących oraz obecności guzkowatych zmian na radiogramach.⁴

Modele predykcyjne w pylicy krzemowej

Predykcja ryzyka pylicy krzemowej to podejście polegające na opracowaniu modeli statystycznych szacujących prawdopodobieństwo rozwoju choroby w odpowiednim okresie czasu (okres latencji). Modele te pomagają klinicystom identyfikować pracowników z podwyższonym ryzykiem pylicy, co umożliwia wcześniejsze poradnictwo w zakresie modyfikacji czynników ryzyka w celu jego zmniejszenia.⁵⁶

Badania wykazały, że możliwe jest opracowanie systemu punktacji ryzyka przy użyciu liniowej kombinacji predyktorów ważonych współczynnikami regresji Coxa z karą LASSO. Takie systemy wykazują dobrą dokładność z zakresem pola pod krzywą ROC (AUC) wynoszącym 83-96%.⁷⁸ Te nowe systemy punktacji zapewniają klinicystom naukowe wskazówki i wygodne podejście do identyfikacji pracowników wysokiego ryzyka w rutynowych konsultacjach, co ma istotne implikacje dla efektywności kosztowej.⁹¹⁰

Czynniki prognostyczne w pylicy krzemowej

Czynniki genetyczne

Polimorfizmy genetyczne odgrywają istotną rolę w rokowaniu pylicy krzemowej. Wykazano, że polimorfizmy czynnika martwicy nowotworów (TNF-2) oraz rs2076304 w genie desmoplakiny są związane ze zwiększonym ryzykiem śmiertelności.¹¹ Badania genetyczne mogą w przyszłości umożliwić bardziej precyzyjną stratyfikację ryzyka dla pacjentów z pylicą krzemową.

Długość ekspozycji i latencja

Długość ekspozycji na pył krzemionkowy stanowi istotny czynnik prognostyczny, choć o umiarkowanej zdolności predykcyjnej.¹² Badania wykazały, że pylica krzemowa zazwyczaj rozwija się po 15-20 latach ekspozycji zawodowej na respirabilną krzemionkę krystaliczną.¹³ Jednakże 20% osób z pylicą krzemową kwalifikującą się do odszkodowania miało staż pracy krótszy niż 10 lat; w prawie wszystkich tych przypadkach odstęp między ostatnią ekspozycją a roszczeniem wynosił 10 lat lub więcej.¹⁴

Warto zauważyć, że w przypadku pylicy krzemowej z kamienia syntetycznego (ES) choroba ma charakter przyspieszony i jest diagnozowana po 7-19 latach ekspozycji, często dotykając młodych osób (mediana wieku 33-55 lat).¹⁵

Formy kliniczne i ich prognostyczne znaczenie

Rokowanie w pylicy krzemowej zależy znacząco od formy klinicznej choroby:

Pylica krzemowa przewlekła – najczęstsza forma choroby, rozwijająca się po dekadach ekspozycji. Początkowo może być bezobjawowa, ale u wielu pacjentów ostatecznie rozwija się duszność wysiłkowa, która postępuje do duszności spoczynkowej.¹⁶ Część pacjentów z przewlekłą pylicą może rozwinąć masywne włóknienie postępujące (PMF).¹⁷
Pylica krzemowa przyspieszona – związana z ekspozycją w okresie od 5 do 15 lat, zazwyczaj 10 lat lub krócej. Choroba może postępować mimo zaprzestania ekspozycji na krzemionkę. Z przyspieszoną pylicą często współwystępują choroby autoimmunologiczne.¹⁸
Pylica krzemowa ostra – występuje po intensywnej ekspozycji na pył krzemionkowy w krótkim okresie (kilka miesięcy lub lat). U pacjentów obserwuje się szybkie postępowanie duszności, utratę wagi i zmęczenie z rozlanymi obustronnie trzeszczeniami.¹⁹ W rzadkich przypadkach osoby narażone na bardzo wysokie stężenia respirabilnej krzemionki krystalicznej mogą rozwinąć typowe objawy pylicy, a także gorączkę i utratę masy ciała w ciągu tygodni zamiast lat.²⁰
Pylica krzemowa guzowata (powikłana) – zaawansowana forma przewlekłej lub przyspieszonej pylicy, charakteryzująca się rozległymi masami włóknistymi, zazwyczaj w górnych strefach płuc. Powoduje ciężkie, przewlekłe objawy oddechowe.²¹ Retrakcje PMF mogą powodować zmiany rozedmowe w podstawnych regionach płuc. Pacjenci ci są podatni na rozwój hipoksycznej niewydolności oddechowej, zakażeń mykobakteryjnych i odmy opłucnowej. Przyczyną śmierci jest niezmiennie niewydolność oddechowa.²²

Pylica krzemowa i choroby współistniejące – wpływ na rokowanie

Zakażenia mykobakteryjne

U pacjentów z pylicą krzemową występuje 8-20-krotnie zwiększone ryzyko zakażeń mykobakteryjnych.²³ Ponieważ pylica krzemowa wpływa na układ odpornościowy, ekspozycja na krzemionkę zwiększa ryzyko zakażeń płuc, takich jak gruźlica.²⁴

Współistnienie gruźlicy i pylicy krzemowej (krzemico-gruźlica) znacząco pogarsza rokowanie. Analiza Kaplana-Meiera wykazała istotnie bardziej stromy spadek przeżywalności dla pacjentów z krzemico-gruźlicą (p≤0,001, test log-rank).²⁵ Krzemico-gruźlica wiązała się z dwukrotnie zwiększonym ryzykiem śmiertelności (HR=2,0, 95% CI: 1,4-3,0, p≤0,001, regresja proporcjonalnego hazardu Coxa).²⁶ Model logarytmiczno-normalny AFT wskazał, że pacjenci z krzemico-gruźlicą mieli tylko 36% mediany czasu przeżycia w porównaniu do pacjentów tylko z gruźlicą (16 vs. 44 miesiące).²⁷

Skumulowana krzywa przeżycia dla pacjentów z gruźlicą z pylicą krzemową wykazała wyraźny spadek w odstępach sześciomiesięcznych, w przeciwieństwie do pacjentów bez pylicy krzemowej.²⁸ Po skorygowaniu o współzmienne, modele AFT ujawniły, że mediana czasu przeżycia dla pacjentów z krzemico-gruźlicą była o 28 miesięcy krótsza niż w przypadku pacjentów z gruźlicą bez pylicy krzemowej.²⁹

Choroby autoimmunologiczne

Dowody epidemiologiczne potwierdzają zwiększone ryzyko rozwoju zaburzeń autoimmunologicznych, takich jak toczeń rumieniowaty układowy (SLE), twardzina układowa i reumatoidalne zapalenie stawów (RZS), w związku z zawodową ekspozycją na krystaliczny pył krzemionkowy.³⁰ Zaburzenia autoimmunologiczne mogą towarzyszyć przyspieszonej pylicy krzemowej. Dlatego ważne jest, aby badać dotknięte osoby, ponieważ leczenie i rokowanie mogą ulec zmianie.³¹

Śmiertelność i długoterminowe rokowanie

Pylica krzemowa, szczególnie jej zaawansowane formy, wiąże się z wysoką zachorowalnością i śmiertelnością, z wysokim odsetkiem przeszczepów płuc i zgonów.³² Szczególnie niekorzystne rokowanie dotyczy pacjentów z masywnym włóknieniem postępującym (PMF), które charakteryzuje się szybkim postępem do niewydolności sercowo-płucnej przy braku przeszczepu płuc.³³

Wśród 2 742 pacjentów z jednego z badań, 309 (11%) zmarło w ciągu 27 miesięcy.³⁴ Szczególnie niepokojące jest przyspieszenie śmiertelności w przypadku współistnienia pylicy krzemowej i gruźlicy, co podkreśla potrzebę ukierunkowanych, prowadzonych przez pracodawcę modeli opieki i wspólnych badań przesiewowych gruźlicy i pylicy krzemowej w ramach programów kontroli gruźlicy dla grup wysokiego ryzyka zawodowego.³⁵³⁶

Szczególne uwagi dla pylicy krzemowej z kamienia syntetycznego

Pylica krzemowa z kamienia syntetycznego (ES) została po raz pierwszy opisana na początku lat 2010. wśród pracowników produkujących blaty kuchenne z kamienia syntetycznego w Hiszpanii, Włoszech i Izraelu.³⁷ Ta forma pylicy ma charakter przyspieszony i jest diagnozowana po 7-19 latach ekspozycji, często dotykając młodych osób (mediana wieku 33-55 lat) z marginalizowanych lub imigranckich społeczności.³⁸

Biorąc pod uwagę wysoki poziom ekspozycji, pracownicy ES stoją w obliczu wyjątkowo wysokiego ryzyka progresji i ciężkości pylicy krzemowej, pomimo krótszego stażu pracy.³⁹ Powszechnie uznaje się, że trwająca ekspozycja przyspiesza progresję pylicy krzemowej.⁴⁰ Stosunkowo krótki okres latencji pylicy krzemowej ES skłonił biomédyczne nauki do rozważenia pylicy krzemowej ES jako nowej jednostki chorobowej i zbadania jej unikalnych mechanizmów.⁴¹

Znaczenie prognozowania w praktyce klinicznej

Opracowanie modeli predykcyjnych ryzyka dla pylicy krzemowej ma kluczowe znaczenie dla identyfikacji pracowników wysokiego ryzyka i wdrożenia odpowiednich strategii profilaktycznych. Te nowe ustalenia dostarczają naukowych dowodów, które pomagają klinicystom odróżnić pracowników wysokiego ryzyka od tych z niskim ryzykiem, dzięki czemu ukierunkowana profilaktyka może być stosowana w sposób efektywny kosztowo.⁴²⁴³

Pomimo braku możliwości leczenia pylicy krzemowej, wczesna identyfikacja osób zagrożonych może prowadzić do interwencji, które mogą spowolnić progresję choroby, w tym:

Eliminacja dalszej ekspozycji na pył krzemionkowy
Regularne monitorowanie funkcji płuc i radiologiczne
Wczesne leczenie powikłań, takich jak infekcje mykobakteryjne
Badania przesiewowe w kierunku chorób autoimmunologicznych
Rozważenie transplantacji płuc w zaawansowanych przypadkach

Należy pamiętać, że chociaż rozpoznanie pylicy krzemowej oznacza nieodwracalne zmiany w płucach, odpowiednie interwencje mogą znacząco wpłynąć na jakość życia i przeżycie pacjentów.⁴⁴⁴⁵

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Materiały źródłowe

#1 Prediction models and risk assessment for silicosis using a retrospective cohort study among workers exposed to silica in China
https://pmc.ncbi.nlm.nih.gov/articles/PMC4473532/
This study aims to develop a prognostic risk prediction model for the development of silicosis among workers exposed to silica dust in China. […] The score system was regarded as accurate given the range of AUCs (8396%). […] Silicosis is an incurable disease with irreversible progressive nature and all treatment strategies are relevant to postponing the progression and control of subsequent medical conditions. […] Risk prediction of silicosis is an approach of developing statistical models to estimate the probability of developing disease over an adequate time period (latency) that helps clinicians identify workers at higher risk of silicosis, which allows for an earlier counseling of risk factor modifications to decrease risk. […] Our results are thus the novel findings that provide scientific evidence to guide clinicians to differentiate workers at high risk from those at low risk so that targeted prevention can be applied cost efficiently.
#2 Silicosis | Health & Human Services
https://hhs.iowa.gov/epi-manual-guide-surveillance-investigation-and-reporting/environmental-disease/silicosis
Silicosis is an irreversible, progressive disease, especially if further ongoing exposure to respirable crystalline silica is not eliminated. […] Chronic silicosis is the most common form of the disorder and generally develops only after exposure over decades. Chronic silicosis is often asymptomatic, but many patients eventually develop dyspnea on exertion that progresses to dyspnea at rest. […] Acute silicosis and the rarer accelerated silicosis are caused by intense silica dust exposure over short periods (several months or years). Acute silicosis patients experience rapid progression of dyspnea, weight loss, and fatigue with diffuse bilateral crackles. […] Conglomerate (complicated) silicosis is the advanced form of chronic or accelerated silicosis and is characterized by widespread masses of fibrosis, typically in the upper lung zones. Conglomerate silicosis causes severe, chronic respiratory symptoms.
#3 Prediction models and risk assessment for silicosis using a retrospective cohort study among workers exposed to silica in China
https://pmc.ncbi.nlm.nih.gov/articles/PMC4473532/
This study aims to develop a prognostic risk prediction model for the development of silicosis among workers exposed to silica dust in China. […] The score system was regarded as accurate given the range of AUCs (8396%). […] Silicosis is an incurable disease with irreversible progressive nature and all treatment strategies are relevant to postponing the progression and control of subsequent medical conditions. […] Risk prediction of silicosis is an approach of developing statistical models to estimate the probability of developing disease over an adequate time period (latency) that helps clinicians identify workers at higher risk of silicosis, which allows for an earlier counseling of risk factor modifications to decrease risk. […] Our results are thus the novel findings that provide scientific evidence to guide clinicians to differentiate workers at high risk from those at low risk so that targeted prevention can be applied cost efficiently.
#4 Silicosis: Background, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/302027-overview
Previous studies of silicosis have shown that prognosis is dependent on various factors, including age at diagnosis, smoking history, clinical progression of disease, genetic polymorphisms, comorbid diseases, and conglomerate nodular disease on radiography. […] Genetic polymorphisms of tumor necrosis factor (TNF)-2 and rs2076304 in the desmoplakin gene have also been associated with an increased risk of mortality. […] Patients who had profound silica exposure over a relatively shorter time course may develop accelerated silicosis. This entity is typically related to an exposure history of 5 to 15 years, usually 10 years or less. […] Disease progression may continue despite cessation of silica exposure. Autoimmune diseases are associated with accelerated silicosis. […] Patients with chronic silicosis may be asymptomatic despite potentially decades of exposure to silica dust. A subset of these patients, however, may develop progressive massive fibrosis (PMF).
#5 Prediction models and risk assessment for silicosis using a retrospective cohort study among workers exposed to silica in China | Scientific Reports
https://www.nature.com/articles/srep11059
This study aims to develop a prognostic risk prediction model for the development of silicosis among workers exposed to silica dust in China. […] We developed a risk score system using a linear combination of the predictors weighted by the LASSO penalized Cox regression coefficients. […] The score system was regarded as accurate given the range of AUCs (8396%). […] This study developed a unique score system with a good internal validity, which provides scientific guidance to the clinicians to identify high-risk workers, thus has important cost efficient implications. […] Risk prediction of silicosis is an approach of developing statistical models to estimate the probability of developing disease over an adequate time period (latency) that helps clinicians identify workers at higher risk of silicosis, which allows for an earlier counseling of risk factor modifications to decrease risk.
#6 Prediction models and risk assessment for silicosis using a retrospective cohort study among workers exposed to silica in China
https://pmc.ncbi.nlm.nih.gov/articles/PMC4473532/
This study aims to develop a prognostic risk prediction model for the development of silicosis among workers exposed to silica dust in China. […] The score system was regarded as accurate given the range of AUCs (8396%). […] Silicosis is an incurable disease with irreversible progressive nature and all treatment strategies are relevant to postponing the progression and control of subsequent medical conditions. […] Risk prediction of silicosis is an approach of developing statistical models to estimate the probability of developing disease over an adequate time period (latency) that helps clinicians identify workers at higher risk of silicosis, which allows for an earlier counseling of risk factor modifications to decrease risk. […] Our results are thus the novel findings that provide scientific evidence to guide clinicians to differentiate workers at high risk from those at low risk so that targeted prevention can be applied cost efficiently.
#7 Prediction models and risk assessment for silicosis using a retrospective cohort study among workers exposed to silica in China | Scientific Reports
https://www.nature.com/articles/srep11059
This study aims to develop a prognostic risk prediction model for the development of silicosis among workers exposed to silica dust in China. […] We developed a risk score system using a linear combination of the predictors weighted by the LASSO penalized Cox regression coefficients. […] The score system was regarded as accurate given the range of AUCs (8396%). […] This study developed a unique score system with a good internal validity, which provides scientific guidance to the clinicians to identify high-risk workers, thus has important cost efficient implications. […] Risk prediction of silicosis is an approach of developing statistical models to estimate the probability of developing disease over an adequate time period (latency) that helps clinicians identify workers at higher risk of silicosis, which allows for an earlier counseling of risk factor modifications to decrease risk.
#8 Prediction models and risk assessment for silicosis using a retrospective cohort study among workers exposed to silica in China
https://pmc.ncbi.nlm.nih.gov/articles/PMC4473532/
This study aims to develop a prognostic risk prediction model for the development of silicosis among workers exposed to silica dust in China. […] The score system was regarded as accurate given the range of AUCs (8396%). […] Silicosis is an incurable disease with irreversible progressive nature and all treatment strategies are relevant to postponing the progression and control of subsequent medical conditions. […] Risk prediction of silicosis is an approach of developing statistical models to estimate the probability of developing disease over an adequate time period (latency) that helps clinicians identify workers at higher risk of silicosis, which allows for an earlier counseling of risk factor modifications to decrease risk. […] Our results are thus the novel findings that provide scientific evidence to guide clinicians to differentiate workers at high risk from those at low risk so that targeted prevention can be applied cost efficiently.
#9 Prediction models and risk assessment for silicosis using a retrospective cohort study among workers exposed to silica in China | Scientific Reports
https://www.nature.com/articles/srep11059
Our results are thus the novel findings that provide scientific evidence to guide clinicians to differentiate workers at high risk from those at low risk so that targeted prevention can be applied cost efficiently. […] We developed an unique score system for risk prediction of silicosis using shrinkage estimates with LASSO method in fitting Cox model that enables to adjust for models over fitting and avoid extreme predictions. […] This newly developed score system provides clinicians scientific guidance and convenient approaches to identify high-risk workers in routine consultation, thus has important cost efficient implications.
#10 Prediction models and risk assessment for silicosis using a retrospective cohort study among workers exposed to silica in China
https://pmc.ncbi.nlm.nih.gov/articles/PMC4473532/
We developed an unique score system for risk prediction of silicosis using shrinkage estimates with LASSO method in fitting Cox model that enables to adjust for models over fitting and avoid extreme predictions. […] This newly developed score system provides clinicians scientific guidance and convenient approaches to identify high-risk workers in routine consultation, thus has important cost efficient implications.
#11 Silicosis: Background, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/302027-overview
Previous studies of silicosis have shown that prognosis is dependent on various factors, including age at diagnosis, smoking history, clinical progression of disease, genetic polymorphisms, comorbid diseases, and conglomerate nodular disease on radiography. […] Genetic polymorphisms of tumor necrosis factor (TNF)-2 and rs2076304 in the desmoplakin gene have also been associated with an increased risk of mortality. […] Patients who had profound silica exposure over a relatively shorter time course may develop accelerated silicosis. This entity is typically related to an exposure history of 5 to 15 years, usually 10 years or less. […] Disease progression may continue despite cessation of silica exposure. Autoimmune diseases are associated with accelerated silicosis. […] Patients with chronic silicosis may be asymptomatic despite potentially decades of exposure to silica dust. A subset of these patients, however, may develop progressive massive fibrosis (PMF).
#12 The utility of length of mining service and latency in predicting silicosis among claimants to a compensation trust
https://repository.up.ac.za/handle/2263/88774
In conclusion, self-reported service length in the absence of an official service record could be accepted in claims with compatible clinical findings. Length of service offers, at best, moderate predictive capability for silicosis. […] Predictive accuracy was moderate, with significant potential misclassification. […] Twenty percent of claimants with compensable silicosis had a length of service 10 years; in almost all these claims, the interval between last exposure and the claim was 10 years or more. […] Relatively short service compensable silicosis, when combined with at least 10 years since last exposure, was not uncommon.
#13 Silica, Crystalline – Health Effects | Occupational Safety and Health Administration
http://www.osha.gov/silica-crystalline/health-effects
Breathing in very small („respirable”) crystalline silica particles, causes multiple diseases, including silicosis, an incurable lung disease that leads to disability and death. […] Silicosis typically occurs after 15â20 years of occupational exposure to respirable crystalline silica. […] There is no cure for silicosis. […] In rare instances, individuals exposed to very high concentrations of respirable crystalline silica can develop typical silicosis symptoms as well as fever and weight loss within weeks instead of years. […] Because silicosis affects the immune system, exposure to silica increases the risk of lung infections, such as tuberculosis.
#14 The utility of length of mining service and latency in predicting silicosis among claimants to a compensation trust
https://repository.up.ac.za/handle/2263/88774
In conclusion, self-reported service length in the absence of an official service record could be accepted in claims with compatible clinical findings. Length of service offers, at best, moderate predictive capability for silicosis. […] Predictive accuracy was moderate, with significant potential misclassification. […] Twenty percent of claimants with compensable silicosis had a length of service 10 years; in almost all these claims, the interval between last exposure and the claim was 10 years or more. […] Relatively short service compensable silicosis, when combined with at least 10 years since last exposure, was not uncommon.
#15 A review of silicosis and other silica-related diseases in the engineered stone countertop processing industry | Journal of Occupational Medicine and Toxicology | Full Text
https://occup-med.biomedcentral.com/articles/10.1186/s12995-025-00455-8
ES silicosis was first described in the early 2010s among ES countertop workers in Spain, Italy, and Israel. […] Silicosis from ES dust is accelerated and diagnosed after 7-19 years of exposure, often affecting young individuals (median age 33-55 years) from marginalized or immigrant communities. […] Morbidity and mortality are poor, with high rates of lung transplantation and death. […] The relatively short latency period of ES silicosis has prompted biomedical science to reconsider ES silicosis as a novel entity and explore its unique mechanisms. […] The current state of knowledge of the pathogenic mechanisms of ES silicosis is detailed at length in a recent review by Ramkissoon et al. and is beyond the scope of this review. […] Considering their high exposure level, ES workers face an exceptionally high risk of silicosis progression and severity despite shorter work tenures. […] It is widely accepted that ongoing exposure accelerates silicosis progression. […] PMF has a poor prognosis with rapid progression to cardiopulmonary failure in the absence of lung transplantation.
#16 Silicosis | Health & Human Services
https://hhs.iowa.gov/epi-manual-guide-surveillance-investigation-and-reporting/environmental-disease/silicosis
Silicosis is an irreversible, progressive disease, especially if further ongoing exposure to respirable crystalline silica is not eliminated. […] Chronic silicosis is the most common form of the disorder and generally develops only after exposure over decades. Chronic silicosis is often asymptomatic, but many patients eventually develop dyspnea on exertion that progresses to dyspnea at rest. […] Acute silicosis and the rarer accelerated silicosis are caused by intense silica dust exposure over short periods (several months or years). Acute silicosis patients experience rapid progression of dyspnea, weight loss, and fatigue with diffuse bilateral crackles. […] Conglomerate (complicated) silicosis is the advanced form of chronic or accelerated silicosis and is characterized by widespread masses of fibrosis, typically in the upper lung zones. Conglomerate silicosis causes severe, chronic respiratory symptoms.
#17 Silicosis: Background, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/302027-overview
Previous studies of silicosis have shown that prognosis is dependent on various factors, including age at diagnosis, smoking history, clinical progression of disease, genetic polymorphisms, comorbid diseases, and conglomerate nodular disease on radiography. […] Genetic polymorphisms of tumor necrosis factor (TNF)-2 and rs2076304 in the desmoplakin gene have also been associated with an increased risk of mortality. […] Patients who had profound silica exposure over a relatively shorter time course may develop accelerated silicosis. This entity is typically related to an exposure history of 5 to 15 years, usually 10 years or less. […] Disease progression may continue despite cessation of silica exposure. Autoimmune diseases are associated with accelerated silicosis. […] Patients with chronic silicosis may be asymptomatic despite potentially decades of exposure to silica dust. A subset of these patients, however, may develop progressive massive fibrosis (PMF).
#18 Silicosis: Background, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/302027-overview
Previous studies of silicosis have shown that prognosis is dependent on various factors, including age at diagnosis, smoking history, clinical progression of disease, genetic polymorphisms, comorbid diseases, and conglomerate nodular disease on radiography. […] Genetic polymorphisms of tumor necrosis factor (TNF)-2 and rs2076304 in the desmoplakin gene have also been associated with an increased risk of mortality. […] Patients who had profound silica exposure over a relatively shorter time course may develop accelerated silicosis. This entity is typically related to an exposure history of 5 to 15 years, usually 10 years or less. […] Disease progression may continue despite cessation of silica exposure. Autoimmune diseases are associated with accelerated silicosis. […] Patients with chronic silicosis may be asymptomatic despite potentially decades of exposure to silica dust. A subset of these patients, however, may develop progressive massive fibrosis (PMF).
#19 Silicosis | Health & Human Services
https://hhs.iowa.gov/epi-manual-guide-surveillance-investigation-and-reporting/environmental-disease/silicosis
Silicosis is an irreversible, progressive disease, especially if further ongoing exposure to respirable crystalline silica is not eliminated. […] Chronic silicosis is the most common form of the disorder and generally develops only after exposure over decades. Chronic silicosis is often asymptomatic, but many patients eventually develop dyspnea on exertion that progresses to dyspnea at rest. […] Acute silicosis and the rarer accelerated silicosis are caused by intense silica dust exposure over short periods (several months or years). Acute silicosis patients experience rapid progression of dyspnea, weight loss, and fatigue with diffuse bilateral crackles. […] Conglomerate (complicated) silicosis is the advanced form of chronic or accelerated silicosis and is characterized by widespread masses of fibrosis, typically in the upper lung zones. Conglomerate silicosis causes severe, chronic respiratory symptoms.
#20 Silica, Crystalline – Health Effects | Occupational Safety and Health Administration
http://www.osha.gov/silica-crystalline/health-effects
Breathing in very small („respirable”) crystalline silica particles, causes multiple diseases, including silicosis, an incurable lung disease that leads to disability and death. […] Silicosis typically occurs after 15â20 years of occupational exposure to respirable crystalline silica. […] There is no cure for silicosis. […] In rare instances, individuals exposed to very high concentrations of respirable crystalline silica can develop typical silicosis symptoms as well as fever and weight loss within weeks instead of years. […] Because silicosis affects the immune system, exposure to silica increases the risk of lung infections, such as tuberculosis.
#21 Silicosis | Health & Human Services
https://hhs.iowa.gov/epi-manual-guide-surveillance-investigation-and-reporting/environmental-disease/silicosis
Silicosis is an irreversible, progressive disease, especially if further ongoing exposure to respirable crystalline silica is not eliminated. […] Chronic silicosis is the most common form of the disorder and generally develops only after exposure over decades. Chronic silicosis is often asymptomatic, but many patients eventually develop dyspnea on exertion that progresses to dyspnea at rest. […] Acute silicosis and the rarer accelerated silicosis are caused by intense silica dust exposure over short periods (several months or years). Acute silicosis patients experience rapid progression of dyspnea, weight loss, and fatigue with diffuse bilateral crackles. […] Conglomerate (complicated) silicosis is the advanced form of chronic or accelerated silicosis and is characterized by widespread masses of fibrosis, typically in the upper lung zones. Conglomerate silicosis causes severe, chronic respiratory symptoms.
#22 Silicosis: Background, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/302027-overview
Retractions of PMF may cause emphysematous changes in the basilar lung regions. These patients are prone to develop hypoxic respiratory failure, mycobacterial infections, and pneumothoraces. Cause of death is invariably respiratory failure. […] There is an 8- to 20-fold increased risk of mycobacterial infections in patients with silicosis. […] Epidemiologic evidence supports the increased risk between occupational exposure to crystalline silica dust and the development of autoimmune disorders such as systemic lupus erythematosus (SLE), systemic sclerosis, and rheumatoid arthritis (RA). […] Autoimmune disorders may accompany accelerated silicosis. Thus, it is important to screen affected individuals, as treatment and prognosis may be altered.
#23 Silicosis: Background, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/302027-overview
Retractions of PMF may cause emphysematous changes in the basilar lung regions. These patients are prone to develop hypoxic respiratory failure, mycobacterial infections, and pneumothoraces. Cause of death is invariably respiratory failure. […] There is an 8- to 20-fold increased risk of mycobacterial infections in patients with silicosis. […] Epidemiologic evidence supports the increased risk between occupational exposure to crystalline silica dust and the development of autoimmune disorders such as systemic lupus erythematosus (SLE), systemic sclerosis, and rheumatoid arthritis (RA). […] Autoimmune disorders may accompany accelerated silicosis. Thus, it is important to screen affected individuals, as treatment and prognosis may be altered.
#24 Silica, Crystalline – Health Effects | Occupational Safety and Health Administration
http://www.osha.gov/silica-crystalline/health-effects
Breathing in very small („respirable”) crystalline silica particles, causes multiple diseases, including silicosis, an incurable lung disease that leads to disability and death. […] Silicosis typically occurs after 15â20 years of occupational exposure to respirable crystalline silica. […] There is no cure for silicosis. […] In rare instances, individuals exposed to very high concentrations of respirable crystalline silica can develop typical silicosis symptoms as well as fever and weight loss within weeks instead of years. […] Because silicosis affects the immune system, exposure to silica increases the risk of lung infections, such as tuberculosis.
#25 Survival analysis shows tuberculosis patients with silicosis experience earlier mortality and need employer-led care models in occupational settings in India | Scientific Reports
https://www.nature.com/articles/s41598-024-80367-5
Indias high tuberculosis (TB) burden is exacerbated by concurrent silicosis, which increases TB susceptibility and worsens treatment outcomes. […] Among the 2,742 patients, 309 (11%) died within 27 months. […] Kaplan-Meier analysis showed a significantly steeper survival decline for silico-tuberculosis patients (p0.001, log-rank test). […] Silico-tuberculosis was associated with a two-fold increased mortality risk (HR=2.0, 95% CI: 1.4-3.0, p0.001, Cox-proportional hazards regression). […] The lognormal AFT model indicated silico-tuberculosis patients had 36% of the median survival time compared to TB-only patients (16 vs. 44 months). […] These findings highlight significantly earlier mortality in silico-tuberculosis patients, underscoring the need for targeted, employer-led care models and TB-silicosis collaborative screening within Indias TB program for high-risk occupational groups.
#26 Survival analysis shows tuberculosis patients with silicosis experience earlier mortality and need employer-led care models in occupational settings in India | Scientific Reports
https://www.nature.com/articles/s41598-024-80367-5
Indias high tuberculosis (TB) burden is exacerbated by concurrent silicosis, which increases TB susceptibility and worsens treatment outcomes. […] Among the 2,742 patients, 309 (11%) died within 27 months. […] Kaplan-Meier analysis showed a significantly steeper survival decline for silico-tuberculosis patients (p0.001, log-rank test). […] Silico-tuberculosis was associated with a two-fold increased mortality risk (HR=2.0, 95% CI: 1.4-3.0, p0.001, Cox-proportional hazards regression). […] The lognormal AFT model indicated silico-tuberculosis patients had 36% of the median survival time compared to TB-only patients (16 vs. 44 months). […] These findings highlight significantly earlier mortality in silico-tuberculosis patients, underscoring the need for targeted, employer-led care models and TB-silicosis collaborative screening within Indias TB program for high-risk occupational groups.
#27 Survival analysis shows tuberculosis patients with silicosis experience earlier mortality and need employer-led care models in occupational settings in India | Scientific Reports
https://www.nature.com/articles/s41598-024-80367-5
Indias high tuberculosis (TB) burden is exacerbated by concurrent silicosis, which increases TB susceptibility and worsens treatment outcomes. […] Among the 2,742 patients, 309 (11%) died within 27 months. […] Kaplan-Meier analysis showed a significantly steeper survival decline for silico-tuberculosis patients (p0.001, log-rank test). […] Silico-tuberculosis was associated with a two-fold increased mortality risk (HR=2.0, 95% CI: 1.4-3.0, p0.001, Cox-proportional hazards regression). […] The lognormal AFT model indicated silico-tuberculosis patients had 36% of the median survival time compared to TB-only patients (16 vs. 44 months). […] These findings highlight significantly earlier mortality in silico-tuberculosis patients, underscoring the need for targeted, employer-led care models and TB-silicosis collaborative screening within Indias TB program for high-risk occupational groups.
#28 Survival analysis shows tuberculosis patients with silicosis experience earlier mortality and need employer-led care models in occupational settings in India | Scientific Reports
https://www.nature.com/articles/s41598-024-80367-5
The cumulative survival curve for TB patients with silicosis showed a pronounced decline at six-month intervals, in contrast to their counterparts without silicosis. […] Adjusted for covariates, the AFT models revealed that the median survival time for silico-tuberculosis patients was 28 months shorter than that of TB patients without silicosis. […] Our Cox proportional hazards model reveals that silico-tuberculosis patients have a twofold higher mortality risk than TB-only patients. […] These findings indicate that while hazard ratios are similar across studies, differences in occupational and healthcare contexts impact mortality and age of death. […] Our study reveals that patients with silico-tuberculosis experience significantly earlier mortality than those with TB alone, underscoring the need to prioritize silico-tuberculosis within Indias national TB program.
#29 Survival analysis shows tuberculosis patients with silicosis experience earlier mortality and need employer-led care models in occupational settings in India | Scientific Reports
https://www.nature.com/articles/s41598-024-80367-5
The cumulative survival curve for TB patients with silicosis showed a pronounced decline at six-month intervals, in contrast to their counterparts without silicosis. […] Adjusted for covariates, the AFT models revealed that the median survival time for silico-tuberculosis patients was 28 months shorter than that of TB patients without silicosis. […] Our Cox proportional hazards model reveals that silico-tuberculosis patients have a twofold higher mortality risk than TB-only patients. […] These findings indicate that while hazard ratios are similar across studies, differences in occupational and healthcare contexts impact mortality and age of death. […] Our study reveals that patients with silico-tuberculosis experience significantly earlier mortality than those with TB alone, underscoring the need to prioritize silico-tuberculosis within Indias national TB program.
#30 Silicosis: Background, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/302027-overview
Retractions of PMF may cause emphysematous changes in the basilar lung regions. These patients are prone to develop hypoxic respiratory failure, mycobacterial infections, and pneumothoraces. Cause of death is invariably respiratory failure. […] There is an 8- to 20-fold increased risk of mycobacterial infections in patients with silicosis. […] Epidemiologic evidence supports the increased risk between occupational exposure to crystalline silica dust and the development of autoimmune disorders such as systemic lupus erythematosus (SLE), systemic sclerosis, and rheumatoid arthritis (RA). […] Autoimmune disorders may accompany accelerated silicosis. Thus, it is important to screen affected individuals, as treatment and prognosis may be altered.
#31 Silicosis: Background, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/302027-overview
Retractions of PMF may cause emphysematous changes in the basilar lung regions. These patients are prone to develop hypoxic respiratory failure, mycobacterial infections, and pneumothoraces. Cause of death is invariably respiratory failure. […] There is an 8- to 20-fold increased risk of mycobacterial infections in patients with silicosis. […] Epidemiologic evidence supports the increased risk between occupational exposure to crystalline silica dust and the development of autoimmune disorders such as systemic lupus erythematosus (SLE), systemic sclerosis, and rheumatoid arthritis (RA). […] Autoimmune disorders may accompany accelerated silicosis. Thus, it is important to screen affected individuals, as treatment and prognosis may be altered.
#32 A review of silicosis and other silica-related diseases in the engineered stone countertop processing industry | Journal of Occupational Medicine and Toxicology | Full Text
https://occup-med.biomedcentral.com/articles/10.1186/s12995-025-00455-8
ES silicosis was first described in the early 2010s among ES countertop workers in Spain, Italy, and Israel. […] Silicosis from ES dust is accelerated and diagnosed after 7-19 years of exposure, often affecting young individuals (median age 33-55 years) from marginalized or immigrant communities. […] Morbidity and mortality are poor, with high rates of lung transplantation and death. […] The relatively short latency period of ES silicosis has prompted biomedical science to reconsider ES silicosis as a novel entity and explore its unique mechanisms. […] The current state of knowledge of the pathogenic mechanisms of ES silicosis is detailed at length in a recent review by Ramkissoon et al. and is beyond the scope of this review. […] Considering their high exposure level, ES workers face an exceptionally high risk of silicosis progression and severity despite shorter work tenures. […] It is widely accepted that ongoing exposure accelerates silicosis progression. […] PMF has a poor prognosis with rapid progression to cardiopulmonary failure in the absence of lung transplantation.
#33 A review of silicosis and other silica-related diseases in the engineered stone countertop processing industry | Journal of Occupational Medicine and Toxicology | Full Text
https://occup-med.biomedcentral.com/articles/10.1186/s12995-025-00455-8
ES silicosis was first described in the early 2010s among ES countertop workers in Spain, Italy, and Israel. […] Silicosis from ES dust is accelerated and diagnosed after 7-19 years of exposure, often affecting young individuals (median age 33-55 years) from marginalized or immigrant communities. […] Morbidity and mortality are poor, with high rates of lung transplantation and death. […] The relatively short latency period of ES silicosis has prompted biomedical science to reconsider ES silicosis as a novel entity and explore its unique mechanisms. […] The current state of knowledge of the pathogenic mechanisms of ES silicosis is detailed at length in a recent review by Ramkissoon et al. and is beyond the scope of this review. […] Considering their high exposure level, ES workers face an exceptionally high risk of silicosis progression and severity despite shorter work tenures. […] It is widely accepted that ongoing exposure accelerates silicosis progression. […] PMF has a poor prognosis with rapid progression to cardiopulmonary failure in the absence of lung transplantation.
#34 Survival analysis shows tuberculosis patients with silicosis experience earlier mortality and need employer-led care models in occupational settings in India | Scientific Reports
https://www.nature.com/articles/s41598-024-80367-5
Indias high tuberculosis (TB) burden is exacerbated by concurrent silicosis, which increases TB susceptibility and worsens treatment outcomes. […] Among the 2,742 patients, 309 (11%) died within 27 months. […] Kaplan-Meier analysis showed a significantly steeper survival decline for silico-tuberculosis patients (p0.001, log-rank test). […] Silico-tuberculosis was associated with a two-fold increased mortality risk (HR=2.0, 95% CI: 1.4-3.0, p0.001, Cox-proportional hazards regression). […] The lognormal AFT model indicated silico-tuberculosis patients had 36% of the median survival time compared to TB-only patients (16 vs. 44 months). […] These findings highlight significantly earlier mortality in silico-tuberculosis patients, underscoring the need for targeted, employer-led care models and TB-silicosis collaborative screening within Indias TB program for high-risk occupational groups.
#35 Survival analysis shows tuberculosis patients with silicosis experience earlier mortality and need employer-led care models in occupational settings in India | Scientific Reports
https://www.nature.com/articles/s41598-024-80367-5
Indias high tuberculosis (TB) burden is exacerbated by concurrent silicosis, which increases TB susceptibility and worsens treatment outcomes. […] Among the 2,742 patients, 309 (11%) died within 27 months. […] Kaplan-Meier analysis showed a significantly steeper survival decline for silico-tuberculosis patients (p0.001, log-rank test). […] Silico-tuberculosis was associated with a two-fold increased mortality risk (HR=2.0, 95% CI: 1.4-3.0, p0.001, Cox-proportional hazards regression). […] The lognormal AFT model indicated silico-tuberculosis patients had 36% of the median survival time compared to TB-only patients (16 vs. 44 months). […] These findings highlight significantly earlier mortality in silico-tuberculosis patients, underscoring the need for targeted, employer-led care models and TB-silicosis collaborative screening within Indias TB program for high-risk occupational groups.
#36 Survival analysis shows tuberculosis patients with silicosis experience earlier mortality and need employer-led care models in occupational settings in India | Scientific Reports
https://www.nature.com/articles/s41598-024-80367-5
The cumulative survival curve for TB patients with silicosis showed a pronounced decline at six-month intervals, in contrast to their counterparts without silicosis. […] Adjusted for covariates, the AFT models revealed that the median survival time for silico-tuberculosis patients was 28 months shorter than that of TB patients without silicosis. […] Our Cox proportional hazards model reveals that silico-tuberculosis patients have a twofold higher mortality risk than TB-only patients. […] These findings indicate that while hazard ratios are similar across studies, differences in occupational and healthcare contexts impact mortality and age of death. […] Our study reveals that patients with silico-tuberculosis experience significantly earlier mortality than those with TB alone, underscoring the need to prioritize silico-tuberculosis within Indias national TB program.
#37 A review of silicosis and other silica-related diseases in the engineered stone countertop processing industry | Journal of Occupational Medicine and Toxicology | Full Text
https://occup-med.biomedcentral.com/articles/10.1186/s12995-025-00455-8
ES silicosis was first described in the early 2010s among ES countertop workers in Spain, Italy, and Israel. […] Silicosis from ES dust is accelerated and diagnosed after 7-19 years of exposure, often affecting young individuals (median age 33-55 years) from marginalized or immigrant communities. […] Morbidity and mortality are poor, with high rates of lung transplantation and death. […] The relatively short latency period of ES silicosis has prompted biomedical science to reconsider ES silicosis as a novel entity and explore its unique mechanisms. […] The current state of knowledge of the pathogenic mechanisms of ES silicosis is detailed at length in a recent review by Ramkissoon et al. and is beyond the scope of this review. […] Considering their high exposure level, ES workers face an exceptionally high risk of silicosis progression and severity despite shorter work tenures. […] It is widely accepted that ongoing exposure accelerates silicosis progression. […] PMF has a poor prognosis with rapid progression to cardiopulmonary failure in the absence of lung transplantation.
#38 A review of silicosis and other silica-related diseases in the engineered stone countertop processing industry | Journal of Occupational Medicine and Toxicology | Full Text
https://occup-med.biomedcentral.com/articles/10.1186/s12995-025-00455-8
ES silicosis was first described in the early 2010s among ES countertop workers in Spain, Italy, and Israel. […] Silicosis from ES dust is accelerated and diagnosed after 7-19 years of exposure, often affecting young individuals (median age 33-55 years) from marginalized or immigrant communities. […] Morbidity and mortality are poor, with high rates of lung transplantation and death. […] The relatively short latency period of ES silicosis has prompted biomedical science to reconsider ES silicosis as a novel entity and explore its unique mechanisms. […] The current state of knowledge of the pathogenic mechanisms of ES silicosis is detailed at length in a recent review by Ramkissoon et al. and is beyond the scope of this review. […] Considering their high exposure level, ES workers face an exceptionally high risk of silicosis progression and severity despite shorter work tenures. […] It is widely accepted that ongoing exposure accelerates silicosis progression. […] PMF has a poor prognosis with rapid progression to cardiopulmonary failure in the absence of lung transplantation.
#39 A review of silicosis and other silica-related diseases in the engineered stone countertop processing industry | Journal of Occupational Medicine and Toxicology | Full Text
https://occup-med.biomedcentral.com/articles/10.1186/s12995-025-00455-8
ES silicosis was first described in the early 2010s among ES countertop workers in Spain, Italy, and Israel. […] Silicosis from ES dust is accelerated and diagnosed after 7-19 years of exposure, often affecting young individuals (median age 33-55 years) from marginalized or immigrant communities. […] Morbidity and mortality are poor, with high rates of lung transplantation and death. […] The relatively short latency period of ES silicosis has prompted biomedical science to reconsider ES silicosis as a novel entity and explore its unique mechanisms. […] The current state of knowledge of the pathogenic mechanisms of ES silicosis is detailed at length in a recent review by Ramkissoon et al. and is beyond the scope of this review. […] Considering their high exposure level, ES workers face an exceptionally high risk of silicosis progression and severity despite shorter work tenures. […] It is widely accepted that ongoing exposure accelerates silicosis progression. […] PMF has a poor prognosis with rapid progression to cardiopulmonary failure in the absence of lung transplantation.
#40 A review of silicosis and other silica-related diseases in the engineered stone countertop processing industry | Journal of Occupational Medicine and Toxicology | Full Text
https://occup-med.biomedcentral.com/articles/10.1186/s12995-025-00455-8
ES silicosis was first described in the early 2010s among ES countertop workers in Spain, Italy, and Israel. […] Silicosis from ES dust is accelerated and diagnosed after 7-19 years of exposure, often affecting young individuals (median age 33-55 years) from marginalized or immigrant communities. […] Morbidity and mortality are poor, with high rates of lung transplantation and death. […] The relatively short latency period of ES silicosis has prompted biomedical science to reconsider ES silicosis as a novel entity and explore its unique mechanisms. […] The current state of knowledge of the pathogenic mechanisms of ES silicosis is detailed at length in a recent review by Ramkissoon et al. and is beyond the scope of this review. […] Considering their high exposure level, ES workers face an exceptionally high risk of silicosis progression and severity despite shorter work tenures. […] It is widely accepted that ongoing exposure accelerates silicosis progression. […] PMF has a poor prognosis with rapid progression to cardiopulmonary failure in the absence of lung transplantation.
#41 A review of silicosis and other silica-related diseases in the engineered stone countertop processing industry | Journal of Occupational Medicine and Toxicology | Full Text
https://occup-med.biomedcentral.com/articles/10.1186/s12995-025-00455-8
ES silicosis was first described in the early 2010s among ES countertop workers in Spain, Italy, and Israel. […] Silicosis from ES dust is accelerated and diagnosed after 7-19 years of exposure, often affecting young individuals (median age 33-55 years) from marginalized or immigrant communities. […] Morbidity and mortality are poor, with high rates of lung transplantation and death. […] The relatively short latency period of ES silicosis has prompted biomedical science to reconsider ES silicosis as a novel entity and explore its unique mechanisms. […] The current state of knowledge of the pathogenic mechanisms of ES silicosis is detailed at length in a recent review by Ramkissoon et al. and is beyond the scope of this review. […] Considering their high exposure level, ES workers face an exceptionally high risk of silicosis progression and severity despite shorter work tenures. […] It is widely accepted that ongoing exposure accelerates silicosis progression. […] PMF has a poor prognosis with rapid progression to cardiopulmonary failure in the absence of lung transplantation.
#42 Prediction models and risk assessment for silicosis using a retrospective cohort study among workers exposed to silica in China | Scientific Reports
https://www.nature.com/articles/srep11059
Our results are thus the novel findings that provide scientific evidence to guide clinicians to differentiate workers at high risk from those at low risk so that targeted prevention can be applied cost efficiently. […] We developed an unique score system for risk prediction of silicosis using shrinkage estimates with LASSO method in fitting Cox model that enables to adjust for models over fitting and avoid extreme predictions. […] This newly developed score system provides clinicians scientific guidance and convenient approaches to identify high-risk workers in routine consultation, thus has important cost efficient implications.
#43 Prediction models and risk assessment for silicosis using a retrospective cohort study among workers exposed to silica in China
https://pmc.ncbi.nlm.nih.gov/articles/PMC4473532/
This study aims to develop a prognostic risk prediction model for the development of silicosis among workers exposed to silica dust in China. […] The score system was regarded as accurate given the range of AUCs (8396%). […] Silicosis is an incurable disease with irreversible progressive nature and all treatment strategies are relevant to postponing the progression and control of subsequent medical conditions. […] Risk prediction of silicosis is an approach of developing statistical models to estimate the probability of developing disease over an adequate time period (latency) that helps clinicians identify workers at higher risk of silicosis, which allows for an earlier counseling of risk factor modifications to decrease risk. […] Our results are thus the novel findings that provide scientific evidence to guide clinicians to differentiate workers at high risk from those at low risk so that targeted prevention can be applied cost efficiently.
#44 Prediction models and risk assessment for silicosis using a retrospective cohort study among workers exposed to silica in China
https://pmc.ncbi.nlm.nih.gov/articles/PMC4473532/
This study aims to develop a prognostic risk prediction model for the development of silicosis among workers exposed to silica dust in China. […] The score system was regarded as accurate given the range of AUCs (8396%). […] Silicosis is an incurable disease with irreversible progressive nature and all treatment strategies are relevant to postponing the progression and control of subsequent medical conditions. […] Risk prediction of silicosis is an approach of developing statistical models to estimate the probability of developing disease over an adequate time period (latency) that helps clinicians identify workers at higher risk of silicosis, which allows for an earlier counseling of risk factor modifications to decrease risk. […] Our results are thus the novel findings that provide scientific evidence to guide clinicians to differentiate workers at high risk from those at low risk so that targeted prevention can be applied cost efficiently.
#45 Silica, Crystalline – Health Effects | Occupational Safety and Health Administration
http://www.osha.gov/silica-crystalline/health-effects
Breathing in very small („respirable”) crystalline silica particles, causes multiple diseases, including silicosis, an incurable lung disease that leads to disability and death. […] Silicosis typically occurs after 15â20 years of occupational exposure to respirable crystalline silica. […] There is no cure for silicosis. […] In rare instances, individuals exposed to very high concentrations of respirable crystalline silica can develop typical silicosis symptoms as well as fever and weight loss within weeks instead of years. […] Because silicosis affects the immune system, exposure to silica increases the risk of lung infections, such as tuberculosis.