Early Diagnosis and Development of Referral System for Silicosis among Sandstone Miners in Western India.

Introduction: Silicosis is the most common and oldest occupational lung disease. The disease has been an ancient one and has been recognized in India for the past around 100 years. However, despite its ubiquitous presence among various mine and quarry workers, there is no uniformly available referral system in India in general for workers having occupational dust exposure and respiratory symptoms. The current study involved the clinical assessment of those working in mines and quarries in Jodhpur, Rajasthan, Western India and explore the possibility of development of a referral system for symptomatic mine workers. Materials and Methods: Workers working in mines and quarries in Jodhpur district were clinically screened for symptoms related to silicosis after choosing the quarries randomly. Demographic information and detailed occupational history were recorded using a predesigned questionnaire. Duration of exposure and morbidity/ mortality details related to silicosis in the family were noted in detail. Respiratory symptom score was evaluated using a numeric score. The study was a cross-sectional one, and a 12-point respiratory symptom score based on predesigned questionnaire was constructed using the literature survey of silicosis symptoms. Results: A total of 435 mine/quarries workers (M: F = 432:3) working in sandstone belt of Jodhpur, Rajasthan, Western India were assessed clinically, and details of their symptoms were noted. Demographic information was as followed mean age = 36.44 ± 11.23 years and mean duration of dust exposure = 13.4 ± 9.6 years. A total of 96/435 workers were symptomatic (22%), and salient hypoxia was present in 113/435 (26%). Both groups of these workers were referred to nearby community health centers for further evaluation. Awareness levels among the workers were poor, as only 119/435 (27%) workers had some ideas about the silicosis prevention while working in mines and quarries. Regular wearing of masks while being on the field was observed in only 8% (35/435). Mine Worker Screening Camp approach was used for symptomatic workers and evaluation by a three-member clinical board was done in community health center in the vicinity of mining areas. Those suspected of having silicosis were referred to pneumoconiosis board for further evaluation. Conclusions: High frequency of symptomatic mine workers (22%) exposed chronically to occupational dust was found in sandstone mines and quarries of Jodhpur region. Awareness levels about silicosis prevention were poor. A referral system for those needing further evaluation has been demonstrated. [ABSTRACT FROM AUTHOR]