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SILICA EXPOSURE. Dr. Nurhan KÖKSAL Kahramanmaraş Sütçü İmam University Medical Faculty, Department of Pulmonary Medicine. SILICA EXPOSURE. Silicosis is preventable but non curable disease . I mprovement of workplace conditions constitutes the main frame for prevention .
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SILICA EXPOSURE Dr. Nurhan KÖKSAL Kahramanmaraş Sütçü İmam University Medical Faculty, Department of Pulmonary Medicine
SILICA EXPOSURE • Silicosis is preventable but noncurabledisease. • Improvement of workplace conditions constitutes the main frameforprevention.
SILICA EXPOSURE In door exposure • Coalmines, • Gemstonemines, • Tunnelconstruction, • Barrageconstruction, • Exposure in workplace; • Sandblasting, • Stone cutting, • Marbelworkers, • Dentaltechnicians, • Ceramicsandfoundryworketc.
SILICA EXPOSURE Out door Exposure • Quarrying (stone cutting, stone grinding,…), • Construction workers (cement workers, plasterer,…), • Masonry, marbel workers, • Heavy construction engine operators (digger, buldozer, drill…), • Ceramist, farming,…
SILICA • Mainstructureformingsilica (silicondioxide or SiO2) is quartz. • It is found in common rocks such as granite, sandstone, limestone. • Itis the principle component of sand.
SILICA Silica content of minerals • Limestone 1 - 20 % • Granite 20 - 70 % • Sandstone 50 - 100% • Shale 5 - 20 % • Coal 0 - 10 %
WHAT MAKES SILICA? • Silicosis, trend increase in tuberculosis, lungcancer… • it is in the respirablerange: small enough to get into the air sacs (alveoli) --basically less than 10 microns in size. • it is present in high enough concentrations.
SILICOSIS Severity of DiseaseDepends on: • Dust Concentration, • Percent of free silica, • Duration of exposure, • Size of particles (respirable??)
TYPES of SILICOSIS • 1. AcuteSilicosis(can cause symptoms within a few weeks to 4 or 5 years) • 2.AcceleratedSilicosis(develops 5 - 15 years after start of exposure) • 3. ChronicSilicosis(occurs after 15 - 45 years of exposure )
ACUTE SILICOSIS • Occurs where silica concentrations are very high. • Can cause symptoms within a few weeks to 4 or 5 years. • Rapidly fatal.
ACCELERATED SILICOSIS • High concentrations of silica. • Develops 5 - 10 years after start of exposure. • May lead to massive fibrosis and death.
CHRONIC SILICOSIS • Most common form, • Occurs after 15 - 45 years of exposure, • No need to contact the high concentration of particles, • Inhaleddustscausesscarring, • Scarringcausesmassivefibrosis.
Silicotuberculosis Egg shell calcification
DIAGNOSIS OF SILICOSIS • Abnormal chest X-ray (or chest CT scan) consistent with silicosis, • History of significant exposure to silica dust, • Medical evaluation to exclude other possible causes of abnormal chest x-ray, • Pulmonary function tests are helpful to gauge severity of impairment, but NOT for diagnosis. • Lung biopsy rarely indicated.
HISTORY OF WORK AND JOB • To establish cause-effect relationship between duration and intensity of exposure to silica particles, • If necessary, place conditions must be seenon workplace.
DENIM SANDBLASTING • Withtheprocessthatbeganupontwo acute silicosis diagnosed in our country in 2004,todaywehave an idea aboutonlyvisibleface of theiceberg.
DENIM SANDBLASTING • Akgun M and his colleagues study; • Studied 157 cases, the average age of 23thatworked as sandblaster in Bingol'sTaşlıçay andToklular village between1991 and 2006. • Chest X ray of 145 caseperformedaccordingto İLO classification. • Determined 77 varying degrees of symptoms associated with silicosis. Eur Respir J 2008;32:1295-1303
DENIM SANDBLASTING EurRespir J 2008;32:1295-1303
DENIM SANDBLASTING • Known size of the problem • Approximately 600 silicosiscasesdueto denim sandblasting, • Deathsover 50, between 15-30 ages.
TEFLON SANDBLASTING • In our country,Kahramanmaraş city is leader in the production of aluminum and steel kitchen equipment. • Totally 16 (14 acute, two accelerated silicosis) case of silicosis. • 3 cases (ages 18, 22 and 26), death from respiratory failure. ERS Kongresi 2009, Berlin
SILICOSIS IN CERAMIC WORKERS • In a study in Manisa, 365 exposure to silica and ceramic of workers; • Glazing, glaze preparation in the foundry department, that exposure to dust. • Total of 24 cases of silicosis thatexposure time ranging between one and 21 years, were identified(6,57%). • In a studyÇımrın A. andcolleaguesalso found that silicosis were 6,02% in ceramic factory workers. Şakar A ve ark. Tuberk ve Toraks 2005;53:148-55 Çımrın A ve ark. Tuberk ve Toraks 1999;47:456-62
SILICOSIS IN OTHER PROFESSIONS Glass production and processing Foundry work
SILICOSIS IN OTHER PROFESSIONS Cement productıon Trucks, shovels, dozer operator Dental technician, manufacturer of cable ... ... the list goes on and on.
STUDY METHOD • Agricultural workers breathing through the many organic and inorganic powders to suffer. • Between the years 1994-1995 autopsies were made 112 people killed for various reasons, (53 agricultural workers), and lungs were examined. • The biopsy specimens taken fromtop and bottom ofthe left lung sagittal plan, including mainbronchussections.
Autopsies were performed within 12-24 hours after death. 112 males in the 16-73 age range, Different diameters taken from different areas in the bronchi and lung parenchyma were examined histopathologically. Parenchymal lung samples were used for mineralogical analysis.Electron microscopy for this purpose and X-ray spectrometry was used. STUDY METHOD
OUTCOMES • Exposure to agricultural dust, regardless of age, and smoking, causes small airway disease and pneumoconiosis. • Thereisn’tany sensitive method for early diagnosis yet.
SILICOSIS IS A PREVENTABLE DISEASE • Measures to be taken in the workplace environment is essential. • Control of adequate dust / particulate in workplace environment, • Ensuring adequate respiratory protection, • Medical checks at certain intervals, • The protection of air quality in the workplace environment.
SILICOSIS IS A PREVENTABLE DISEASE In fact, the preamble ofwork: • The dust can be controlled, in construction as engineering • Crystalline silica training • Respiratory protection program • Work clothes, changing and washing facilities • Work environment, air-control program • Medical surveillance • Recording
OBSERVATION: WORKER IN WORKPLACE AND BUSINNESS ENVIRONMENT THANK YOU