Silicosis natural history, complications and prognosis: Difference between revisions
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Tuberculosis: association between silicosis and TB has been known for a long time, but more recent findings show that exposure to silica, without silicosis, may also predispose individuals to TB <ref name="pmid7952577">{{cite journal| author=Cowie RL| title=The epidemiology of tuberculosis in gold miners with silicosis. | journal=Am J Respir Crit Care Med | year= 1994 | volume= 150 | issue= 5 Pt 1 | pages= 1460-2 | pmid=7952577 | doi=10.1164/ajrccm.150.5.7952577 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7952577 }} </ref>The increased risk of both pulmonary and extra-pulmonary TB is lifelong even if exposure ceases<ref name="pmid9816385">{{cite journal| author=Hnizdo E, Murray J| title=Risk of pulmonary tuberculosis relative to silicosis and exposure to silica dust in South African gold miners. | journal=Occup Environ Med | year= 1998 | volume= 55 | issue= 7 | pages= 496-502 | pmid=9816385 | doi= | pmc=PMC1757613 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9816385 }} </ref>. the risk increases with severity of silicosis . acute and accelerated silicosis . Pulmonary TB rates can be extremely high in silica-exposed groups with high background population TB and HIV rates. In many instances, it is the chest radiograph rather than clinical features that gives the first indication of TB in the presence of silicosis. | Tuberculosis: association between silicosis and TB has been known for a long time, but more recent findings show that exposure to silica, without silicosis, may also predispose individuals to TB <ref name="pmid7952577">{{cite journal| author=Cowie RL| title=The epidemiology of tuberculosis in gold miners with silicosis. | journal=Am J Respir Crit Care Med | year= 1994 | volume= 150 | issue= 5 Pt 1 | pages= 1460-2 | pmid=7952577 | doi=10.1164/ajrccm.150.5.7952577 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7952577 }} </ref>The increased risk of both pulmonary and extra-pulmonary TB is lifelong even if exposure ceases<ref name="pmid9816385">{{cite journal| author=Hnizdo E, Murray J| title=Risk of pulmonary tuberculosis relative to silicosis and exposure to silica dust in South African gold miners. | journal=Occup Environ Med | year= 1998 | volume= 55 | issue= 7 | pages= 496-502 | pmid=9816385 | doi= | pmc=PMC1757613 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9816385 }} </ref>. the risk increases with severity of silicosis . acute and accelerated silicosis . Pulmonary TB rates can be extremely high in silica-exposed groups with high background population TB and HIV rates. In many instances, it is the chest radiograph rather than clinical features that gives the first indication of TB in the presence of silicosis. | ||
Treatment for latent TB infection in people with silicosis (especially those with HIV infection) is recommended.<ref name="pmid9032226">{{cite journal| author=| title=Adverse effects of crystalline silica exposure. American Thoracic Society Committee of the Scientific Assembly on Environmental and Occupational Health. | journal=Am J Respir Crit Care Med | year= 1997 | volume= 155 | issue= 2 | pages= 761-8 | pmid=9032226 | doi=10.1164/ajrccm.155.2.9032226 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9032226 }} </ref> Screening for latent TB , tuberculin skin tests are used to diagnose latent TB, after which a 9-month course of INH is recommended, | Treatment for latent TB infection in people with silicosis (especially those with HIV infection) is recommended.<ref name="pmid9032226">{{cite journal| author=| title=Adverse effects of crystalline silica exposure. American Thoracic Society Committee of the Scientific Assembly on Environmental and Occupational Health. | journal=Am J Respir Crit Care Med | year= 1997 | volume= 155 | issue= 2 | pages= 761-8 | pmid=9032226 | doi=10.1164/ajrccm.155.2.9032226 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9032226 }} </ref> Screening for latent TB , tuberculin skin tests are used to diagnose latent TB, after which a 9-month course of INH is recommended, | ||
for active tuberculosis : Direct impairment of macrophage function by crystalline silica and poor drug penetration into silicotic lung nodules have resulted in high (>20%) treatment failure and relapse rates for patients with silicosis who are receiving chemotherapy for tuberculosis (6). This fi nding has prompted prolonged and more aggressive treatment of tuberculosis for such persons | |||
Mycosis: | |||
Insofar as silica dust impairs cellular defense, silica-exposed workers (without silicosis) may be at increased risk for fungal infections, as they are for mycobacterial infections | |||
Aspergillosis was the most common mycosis among persons with pneumoconiosis. Aspergillosis is a known complication in patients with underlying pulmonary disease, such as pulmonary tuberculosis and pneumoconiosis (2), in which silica-impaired macrophages are incapable of targeting inhaled conidia Measures to protect silica-exposed workers with coexposure to fungi include reducing silica exposure; wetting soil and bird droppings to suppress fungal-contaminated dust; maintaining good personal hygiene; and, in areas with endemic inhaled fungi, using enclosed operator cabs with high-effi ciency particulate air fi ltration or personal respiratory protection for particulates | |||
==References== | ==References== | ||
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Please help WikiDoc by adding content here. It's easy! Click here to learn about editing. complications Tuberculosis: association between silicosis and TB has been known for a long time, but more recent findings show that exposure to silica, without silicosis, may also predispose individuals to TB [1]The increased risk of both pulmonary and extra-pulmonary TB is lifelong even if exposure ceases[2]. the risk increases with severity of silicosis . acute and accelerated silicosis . Pulmonary TB rates can be extremely high in silica-exposed groups with high background population TB and HIV rates. In many instances, it is the chest radiograph rather than clinical features that gives the first indication of TB in the presence of silicosis. Treatment for latent TB infection in people with silicosis (especially those with HIV infection) is recommended.[3] Screening for latent TB , tuberculin skin tests are used to diagnose latent TB, after which a 9-month course of INH is recommended, for active tuberculosis : Direct impairment of macrophage function by crystalline silica and poor drug penetration into silicotic lung nodules have resulted in high (>20%) treatment failure and relapse rates for patients with silicosis who are receiving chemotherapy for tuberculosis (6). This fi nding has prompted prolonged and more aggressive treatment of tuberculosis for such persons
Mycosis:
Insofar as silica dust impairs cellular defense, silica-exposed workers (without silicosis) may be at increased risk for fungal infections, as they are for mycobacterial infections
Aspergillosis was the most common mycosis among persons with pneumoconiosis. Aspergillosis is a known complication in patients with underlying pulmonary disease, such as pulmonary tuberculosis and pneumoconiosis (2), in which silica-impaired macrophages are incapable of targeting inhaled conidia Measures to protect silica-exposed workers with coexposure to fungi include reducing silica exposure; wetting soil and bird droppings to suppress fungal-contaminated dust; maintaining good personal hygiene; and, in areas with endemic inhaled fungi, using enclosed operator cabs with high-effi ciency particulate air fi ltration or personal respiratory protection for particulates
References
- ↑ Cowie RL (1994). "The epidemiology of tuberculosis in gold miners with silicosis". Am J Respir Crit Care Med. 150 (5 Pt 1): 1460–2. doi:10.1164/ajrccm.150.5.7952577. PMID 7952577.
- ↑ Hnizdo E, Murray J (1998). "Risk of pulmonary tuberculosis relative to silicosis and exposure to silica dust in South African gold miners". Occup Environ Med. 55 (7): 496–502. PMC 1757613. PMID 9816385.
- ↑ "Adverse effects of crystalline silica exposure. American Thoracic Society Committee of the Scientific Assembly on Environmental and Occupational Health". Am J Respir Crit Care Med. 155 (2): 761–8. 1997. doi:10.1164/ajrccm.155.2.9032226. PMID 9032226.