Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 7-8, Pages: 536-539
https://doi.org/10.2298/SARH1108536M
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Silicotuberculosis and silicosis as occupational diseases: Report of two cases
Milovanović Aleksandar (Institut za medicinu rada Srbije, Medicinski fakultet, Beograd)
Nowak Dennis (Institut i poliklinika za medicinu rada, zaštitu životne sredine i socijalnu medicinu, Medicinski centar Univerziteta Ludvig Maksimilijans, Univerzitet u Minhenu, Minhen, Nemačka)
Milovanović Anđela (Klinika za fizikalnu medicinu i rehabilitaciju, Klinički centar Srbije, Beograd)
Hering Kurt G. (Rudarska bolnica, Medicinski centar, Vestfalija, Dortmund, Nemačka)
Kline Joel N. (Odeljenje za pulmologiju, intenzivnu negu i medicinu rada, Univerzitetska bolnica Univerziteta u Ajovi, Ajova Siti, Ajova, SAD;)
Kovalevskiy Evgeny (Istraživački institut za medicinu rada Ruske akademije medicinskih nauka, Moskva, Rusija)
Kundiev Ilich Yuriy (Institut za medicinu rada Akademije medicinskih nauka Ukrajine, Kijev, Ukrajina)
Peruničić Bogoljub (Institut za medicinu rada Srbije, Medicinski fakultet, Beograd)
Popević Martin (Institut za medicinu rada Srbije, Medicinski fakultet, Beograd)
Šuštran Branka (Institut za medicinu rada Srbije, Medicinski fakultet, Beograd)
Nenadović Milutin (Specijalna bolnica za psihijatrijske bolesti „Dr Laza Lazarević”, Beograd)
Introduction. Silicosis, the most prevalent of the pneumoconioses, is caused
by inhalation of crystalline silica particles. Silica-exposed workers are at
increased risk for tuberculosis and other mycobacterium-related diseases. The
risk of a patient with silicosis developing tuberculosis is higher (2.8 to 39
fold higher, depending on the severity of silicosis) than that found in
healthy controls. Outline of Cases. The first patient was a 52-year-old male
who was admitted in 2002 for the second time with dyspnoea, wheezing and
fatigue over the last 11 years. He had worked in an iron smelting factory and
was exposed to silica dust for 20 years. First hospitalization chest
radiography showed bilateral pleural adhesions, diffuse lung fibrosis with
signs of a specific lung process. Second hospitalization chest radiography
showed bilateral massive irregular, non-homogenous calcified changes in the
upper and middle parts of lungs. The patient died due to respiratory failure
and chronic pulmonary heart in 2007. The main causes of his death were
silicotuberculosis and chronic obstructive pulmonary disease. The second
patient was a 50-year-old male who was admitted in 2005 for the second time
with chest tightness, dyspnoea, wheezing and fatigue over the last 10 years.
He had worked in an iron smelting factory and was exposed to silica dust for
30 years. First hospitalization chest radiography showed diffuse lung
fibrosis and small nodular opacities. The patient was diagnosed with
silicosis, small opacities sized level p/q, and profusion level 2/3. Second
hospitalization chest radiography and CT showed diffuse lung fibrosis and
small nodular opacities predominantly in the upper lobes. The patient was
recognized as having an occupational disease, and received early retirement
due to disability. Conclusion. In low-income countries, new cases of
silicosis and associated lung cancer, chronic obstructive pulmonary disease
and tuberculosis are likely to be seen for decades because necessary
reduction of silica use will take time to be achieved.
Keywords: silica dust, silicosis, silicotuberculosis, occupational disease, fatal outcome
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