Latent tuberculosis infection and infection-associated risk factors for miner workers with silicosis in eastern China.

OBJECTIVES: Silicosis people are at high risk of developing pulmonary tuberculosis. Whether silica exposure increases the likelihood of latent tuberculosis infection (LTBI) was not well understood, and potential factors involved in LTBI risk among silicosis people were not evaluated before. Thus, LTBI among silicosis people and potential risk factors for LTBI among silicosis people were evaluated in this study. METHODS: A cross-sectional study was undertaken for 130 miner workers with silicosis. The QFT-GIT was performed for LTBI detection. RESULTS: The LTBI was high to 31.6% (36/114) for silicosis participants, and 13.1% (13/99) had a history of tuberculosis. Drinking was associated with LTBI risk (OR = 6.92, 95%CI, 1.47-32.66, P = 0.015). Meanwhile, tunneling work was associated with an increased risk of LTBI compared with other mining occupations (OR = 3.91,95%CI,1.20-12.70, P = 0.024). CONCLUSIONS: The LTBI rate of silicosis participants was high and more than 10% had a history of tuberculosis. Drinking alcohol and tunneling were independent risk factors for LTBI in silicosis participants.

TB and interstitial lung disease: a systematic review and meta-analysis.

To determine the frequency of TB among patients with interstitial lung diseases (ILDs).We performed a comprehensive search in the PubMed/Medline, EMBASE and Scopus databases up to 1 August 2023 of studies reporting on the prevalence of TB among patients with ILDs.Twelve studies comprising 3,817 patients with ILD were found: the pooled prevalence of TB among ILD patients was 11.0% (95% CI 5.4-21.0). In the subgroup analysis, the TB rate among patients with silicosis and idiopathic pulmonary fibrosis (IPF) was respectively 35.6% (95% CI 32.6-38.8) and 4.4% (95% CI 3.6-5.3) (P = 0.00). The frequency of TB among ILD patients was higher in high TB burden countries than in low/intermediate-burden countries: 26.3%, 95% CI 17.7-37.3 vs. 4.9%, 95% CI 3.3-7.2; P = 0.00.This study shows the frequency of TB among ILD patients. The meta-analysis reveals a significantly increased prevalence of TB among ILD patients with silicosis compared to IPF, and among individuals in high TB burden countries than in those with low/intermediate burden. The study results can help physicians and policymakers make efficient decisions for prompt screening and anti-TB treatment initiation in ILD patients..

Dose-response relationship between lung function and chest imaging response to silica exposures in artificial stone manufacturing workers.

BACKGROUND: Occupational exposure to artificial stone, a popular material used for countertops, can cause accelerated silicosis, but the precise relationship between silica dose and disease development is unclear. OBJECTIVES: This study evaluated the impact of silica exposure on lung function and chest imaging in artificial stone manufacturing workers. METHODS: Questionnaire and spirometry assessments were administered to workers in two plants. A high-exposure subset underwent further evaluation, including chest CT and DLco. Weighting factors, assigned as proxies for silica exposure, were based on work tasks. Individual cumulative exposures were estimated using area concentration measurements and time spent in specific areas. Exposure-response associations were analyzed using linear and logistic regression models. RESULTS: Among 65 participants, the mean cumulative silica exposure was 3.61 mg/m3-year (range 0.0001 to 44.4). Each 1 mg/m3-year increase was associated with a 0.46% reduction in FVC, a 0.45% reduction in FEV1, and increased lung function abnormality risk (aOR = 1.27, 95% CI = 1.03-1.56). Weighting factors correlated with cumulative exposures (Spearman correlation = 0.59, p < 0.0001), and weighted tenure was associated with lung function abnormalities (aOR = 1.04, 95% CI = 1.01-1.09). Of 37 high-exposure workers, 19 underwent chest CT, with 12 (63%) showing abnormal opacities. Combining respiratory symptoms, lung function, and chest X-ray achieved 91.7% sensitivity and 75% specificity for predicting chest CT abnormalities. CONCLUSION: Lung function and chest CT abnormalities occur commonly in artificial stone workers. For high-exposure individuals, abnormalities on health screening could prompt further chest CT examination to facilitate early silicosis detection.

Lung cancer risk and occupational pulmonary fibrosis: systematic review and meta-analysis.

BACKGROUND: Molecular pathways found to be important in pulmonary fibrosis are also involved in cancer pathogenesis, suggesting common pathways in the development of pulmonary fibrosis and lung cancer. RESEARCH QUESTION: Is pulmonary fibrosis from exposure to occupational carcinogens an independent risk factor for lung cancer? STUDY DESIGN AND METHODS: A comprehensive search of PubMed, Embase, Web of Science and Cochrane databases with over 100 search terms regarding occupational hazards causing pulmonary fibrosis was conducted. After screening and extraction, quality of evidence and eligibility criteria for meta-analysis were assessed. Meta-analysis was performed using a random-effects model. RESULTS: 52 studies were identified for systematic review. Meta-analysis of subgroups identified silicosis as a risk factor for lung cancer when investigating odds ratios for silicosis in autopsy studies (OR 1.47, 95% CI 1.13-1.90) and for lung cancer mortality in patients with silicosis (OR 3.21, 95% CI 2.67-3.87). Only considering studies with an adjustment for smoking as a confounder identified a significant increase in lung cancer risk (OR 1.58, 95% CI 1.34-1.87). However, due to a lack of studies including cumulative exposure, no adjustments could be included. In a qualitative review, no definitive conclusion could be reached for asbestosis and silicosis as independent risk factors for lung cancer, partly because the studies did not take cumulative exposure into account. INTERPRETATION: This systematic review confirms the current knowledge regarding asbestosis and silicosis, indicating a higher risk of lung cancer in exposed individuals compared to exposed workers without fibrosis. These individuals should be monitored for lung cancer, especially when asbestosis or silicosis is present.

Burden of silica-attributed pneumoconiosis and tracheal, bronchus & lung cancer for global and countries in the national program for the elimination of silicosis, 1990-2019: a comparative study.

BACKGROUND: In industries worldwide, crystalline silica is pervasive and poses risks of pneumoconiosis and respiratory malignancies, with the latter being a knowledge gap in disease burden research that this study aims to address. By integrating both diseases, we also seek to provide an in-depth depiction of the silica-attributed disease burden. METHODS: Data from the Global Burden of Disease 2019 were extracted to analyze the disease burden due to silica exposure. The trends of age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) from 1990 to 2019, as well as the age-specific number and rate of deaths and disability-adjusted life years (DALYs) in 1990 and 2019, were presented using GraphPad Prism software. The average annual percentage changes (AAPCs) on ASMR and ASDR were calculated using joinpoint regression models. RESULTS: The global trends of disease burden due to silica exposure from 1990 to 2019 showed a significant decrease, with AAPCs on ASMR and ASDR of -1.22 (-1.38, -1.06) and - 1.18 (-1.30, -1.05), respectively. Vietnam was an exception with an unprecedented climb in ASMR and ASDR in general over the years. The age-specific deaths and DALYs mainly peaked in the age group 60-64. In comparison to 1990, the number of deaths and DALYs became higher after 45 years old in 2019, while their rates stayed consistently lower in 2019. Males experienced an elevated age-specific burden than females. China's general age-standardized burden of pneumoconiosis and tracheal, bronchus & lung (TBL) cancer ranked at the forefront, along with the highest burden of pneumoconiosis in Chilean males and South African females, as well as the prominent burden of TBL cancer in Turkish males, Thai females, and overall Vietnamese. The age-specific burden of TBL cancer surpassed that of pneumoconiosis, and a delay was presented in the pneumoconiosis pinnacle burden compared to the TBL cancer. Besides, the burden of pneumoconiosis indicated a sluggish growth trend with advancing age. CONCLUSION: Our research highlights the cruciality of continuous enhancements in occupational health legislation for countries seriously suffering from industrial silica pollution and the necessity of prioritizing preventive measures for male workers and elderly retirees.

Health Screening Strategies for Artisanal and Small-Scale Miners for Tuberculosis, Human Immunodeficiency Virus and Silicosis: A Case of the USAID-Supported Kunda Nqob'iTB Project in Zimbabwe.

Artisanal and small-scale mining is characterized by excessive exposure to physical, chemical, ergonomic, psychosocial and biological hazards. There is a high burden of tuberculosis (TB), human immunodeficiency virus (HIV) infections and silicosis among artisanal and small-scale miners (ASMs). The aim of this project report is to describe lessons learned from strategies implemented to reach ASMs with screening services for TB, HIV and silicosis in Zimbabwe through the Kunda-Nqob'i TB (KNTB) project supported by the United States Agency for International Development (USAID). The intervention package for screening ASMs for TB, HIV and silicosis included service provision through two occupational health clinics at two provincial hospitals and a mobile workplace-based screening (WBS) facility at the mining sites. From 1 October 2020 to 30 September 2023, 10,668 ASMs were screened, with a high number of cases of silicosis (21%) and TB (7.4%). There was a high burden of HIV (30%) in ASMs attending the occupational health clinics. The two occupational health clinics screened 3453 ASMs, while the mobile WBS activities screened 7215 ASMs during the period. A total of 370 healthcare workers (doctors/clinical officers, nurses, environmental health technicians and district tuberculosis and Leprosy control officers) were trained on TB and the fundamental diagnostic principles of silicosis. The KNTB project has been successful in reaching out to many ASMs operating in remote and hard-to-reach mining areas. The KNTB project has brought to light the positive health-seeking behavior of ASMs operating in remote areas. The project has brought to the fore the effectiveness of multi-stakeholder engagement and collaboration in reaching out to ASMs in remote areas with health screening services. There is a high burden of TB, HIV and silicosis in ASMs. Screening for TB, HIV and silicosis using workplace-based screening and occupational health clinics is an effective strategy and should be rolled out to all areas with high artisanal and small-scale mining activity.

Association between silicosis and autoimmune disease.

PURPOSE OF REVIEW: There is a well established association between silica inhalational exposure and autoimmune disease, particularly in the context of intense exposure. We will provide in this article an update overview of new sources of silica dust exposure, with evidences of mechanisms from human and animal studies for association between silica and autoimmune diseases, their early detection of silicosis and new options for treatment. RECENT FINDINGS: New industries such as jewelry polishing, denim jean production, fabrication of artificial stone benchtops, glass manufacturing and glassware has led to re-emergence of silicosis around the world. Silicosis with long term exposure to dust containing crystalline silica has been examined as a possible risk factor with respect to several autoimmune diseases as scleroderma, rheumatoid arthritis, lupus erythematosus, and some types of small vessel vasculitis with renal involvement. The dust may act to promote or accelerate disease development, requiring some other factors to break immune tolerance or initiate autoimmunity. Autophagy, apoptosis, or pyroptosis-related signaling pathways have also been suggested to contribute to the formation of those pathways with coordination of environmental co-exposure that can magnify autoimmune vulnerability. SUMMARY: Better understanding the mechanisms that involve silica -induced autoimmune diseases may contribute to early diagnosis.

Accelerated silicosis in sandblasters: Pathology, mineralogy, and clinical correlates.

BACKGROUND: With increasing reports of accelerated and acute silicosis, PMF, and autoimmune disease among coal miners and silica-exposed countertop workers, we present previously incompletely-described pulmonary pathology of accelerated silicosis and correlations with mineralogy, radiography, and disease progression in 46 Texas oilfield pipe sandblasters who were biopsied between 1988 and 1995. METHODS: Worker examinations included pulmonary function tests, chest X-ray (CXR), high-resolution computed tomography (HRCT), and Gallium-67 scans. Quantitative mineralogic analysis of pulmonary parenchymal burden of silica, silicates, and metal particles used scanning electron microscopy with energy dispersive x-ray spectroscopy (SEM EDS). RESULTS: Workers had clinical deterioration after <10 years exposure in dusty workplaces. Although initial CXR was normal in 54%, Gallium-67 scans were positive in 68% of those with normal CXR, indicating pulmonary inflammation. The histology of accelerated silicosis is diffuse interstitial infiltration of macrophages filled with weakly birefringent particles with or without silicotic nodules or alveolar proteinosis. Lung silica concentrations were among the highest in our database, showing a dose-response relationship with CXR, HRCT, and pathologic changes (macrophages, fibrosis, and silicotic nodules). Radiographic scores and diffusing capacity worsened during observation. Silica exposure was intensified, patients presented younger, with shorter exposure, more severe clinical abnormalities, higher lung particle burdens, and more rapid progression in a subset of patients exposed to recycled blasting sand. CONCLUSIONS: Accelerated silicosis may present with a normal CXR despite significant histopathology. Multivariable analyses showed silica, and not other particles, is the driver of observed radiologic, physiologic, and histologic outcomes. Eliminating this preventable disease requires higher physician, public health, and societal awareness.

Knowledge, Attitudes, and Practices of Artisanal and Small-Scale Miners regarding Tuberculosis, Human Immunodeficiency Virus, and Silicosis in Zimbabwe.

In Zimbabwe, artisanal and small-scale miners (ASMs) have a high prevalence of tuberculosis (TB), human immunodeficiency virus (HIV), and silicosis. Previous studies on ASMs utilised programme data, and it was not possible to understand reasons for the high prevalence of these comorbidities. We conducted a cross-sectional study to investigate the knowledge, attitudes, and practices of ASMs regarding TB, HIV, and silicosis. We enrolled a convenience sample of 652 ASMs. Their mean (standard deviation) age was 34.2 (10.8) years. There were 602 (92%) men and over 75% had attained secondary education. A total of 504 (80%) of the ASMs knew that TB is a curable disease, and 564 (87%) knew that they were at higher risk of TB than the general population. However, they were less likely to know that HIV increases the risk of TB disease, 340 (52%), with only 226 (35%) who perceived the risk of TB infection to be high among ASMs. Only 564 (59%) were aware that silica dust causes permanent and incurable lung diseases. Six hundred and twenty (97%) showed a positive attitude towards healthcare when they were sick, and 97% were willing to use special respirators to prevent dust inhalation. On practices, only 159 (30%) reported consistent use of either cloth or respirators to prevent dust inhalation. Three hundred and five (49%) ASMs reported consistent use of condoms outside their homes and 323 (50%) reported use of water to suppress dust. Only 480 (75%) of ASMs sought healthcare services when sick. ASMs cited challenges of accessing healthcare services due to lack of money to pay for healthcare (50%), long distances to clinics (17%), and the shortage of medicines at clinics (11%). Effective control of TB, silicosis, and HIV among ASMs requires addressing the identified knowledge gaps and barriers that are faced by ASMs in accessing personal protective equipment and healthcare services. This will require multisector collaboration and the involvement of ASMs in co-designing a package of healthcare services that are tailored for them.

[Analysis of Hospital Care Registers due to Silicosis in Spain, 1997-2020]. / Análisis de los procesos asistenciales hospitalarios por silicosis en España, 1997-2020.

OBJECTIVE: The re-emergence of silicosis in Spain since 2007 has been identified by the increase in the number of occupational disease reports. The aim of our study was to analyse the silicosis care processes attended by the National Health System between 1997 and 2020 to better understand the epidemiological dimension of the problem. METHODS: Processes were obtained from the Registro de Actividad Sanitaria Especializada (RAE-CMBD), with ICD-9-CM codes 500 and 502 (1997-2016) and ICD-10-CM J60, J62.0 and J62.8 (2017-2020). Descriptive statistical methods and modelling by logistic regression and Joinpoint regression methodology were applied. RESULTS: A total of 111,325 records were obtained (ages twenty-one hundred years), 4.3% for silicosis as the main diagnosis (PD) and 95.7% as a secondary diagnosis (SD). Men accounted for 98% and women for 2%. The mean age for SD processes was 75.1, and 68.7 for PD processes. The median age increased by eight years for SD and decreased by three years for PD. Although the overall burden of care decreased, under-fifty PD procedures between 2006 and 2009 showed an upward trend (APC=27.01%). SD processes showed a non-significant upward trend (APC=1.92%) between 2005 and 2020. CONCLUSIONS: The upward trend in silicosis care processes in people under fifty years of age since 2005 confirms the healthcare impact of the re-emergence of silicosis in Spain. The associated burden of care constitutes a present and future public health problem given the decreasing age of those affected.

OBJECTIVE: La remergencia de la silicosis en España desde 2007 ha sido objetivada por el incremento de partes de enfermedad profesional. El objetivo de nuestro estudio fue analizar los procesos asistenciales por silicosis atendidos por el Sistema Nacional de Salud entre 1997 y 2020 para una mejor comprensión de la dimensión epidemiológica del problema. METHODS: Se empleó el RAE-CMBD, aplicando los códigos CIE-9-CM 500 y 502 (1997-2016) y CIE-10-CM J60, J62.0 y J62.8 (2017-2020). Se aplicaron métodos de estadística descriptiva y modelización por regresiones logísticas y metodología de regresión Joinpoint. RESULTS: Se obtuvieron 111.325 registros (veinte-cien años), el 4,3% por silicosis como diagnóstico principal (DP) y el 95,7% como diagnóstico secundario (DS). El 98% eran hombres y el 2% mujeres. La edad media de los procesos por DS fue de 75,1, y de 68,7 para los procesos por DP. La mediana de edad aumentó ocho años para los DS y disminuyó tres para los DP. Aunque la carga asistencial global disminuyó, los procesos en menores de cincuenta años por DP entre 2006 y 2009 registraron una tendencia ascendente (APC=27,01%). Los procesos por DS mostraron una tendencia ascendente no significativa (APC=1,92%) entre 2005 y 2020. CONCLUSIONS: La tendencia al crecimiento de los procesos asistenciales por silicosis en menores de cincuenta años desde 2005 confirma el impacto asistencial de la remergencia de la silicosis en España. La carga asistencial asociada constituye un problema de Salud Pública presente y futuro dada la reducción de edad de los afectados.

Concept of health surveillance programme for workers exposed to respirable crystalline silica at present and in the past.

In the paper authors present general assumptions of health surveillance programme concept for workers employed in respirable crystalline silica (RCS) exposure at present and in the past. There is no effective treatment for silicosis thus disease prevention is of paramount significance. For decades efforts of World Health Organization (WHO) and International Work Organization (ILO) have been focused on eliminating silicosis globally. Unfortunately silicosis is still one of the most lethal occupational diseases and the preventative programmes have not yet been successful. The authors identify main steps to complete an overview of RCS exposure and suggest lines of actions to be taken before launching the health surveillance programme. Introduction of the health surveillance programme would increase awareness of harmful health effects of the RCS exposure, emphasize the significance of preventive medical check-ups and early diagnostics of occupational diseases as well as the importance of using appropriate protective equipment. The programme development on a national level might be carried out with the cooperation of multiple backgrounds and institutions. This would allow for detailed planning, implementation, monitoring and effective evaluation of its results. Having a better and updated knowledge of silicosis epidemiology, early diagnostics, the possible sources of RCS occupational exposure and evaluation of undertaken preventive actions are crucial factors in disease prevention. The programme introduction would be of educational significance for all the stakeholders and the groups engaged in the project implementation, which would contribute to high effectiveness of the preventive activities and their improvement in the future. Med Pr Work Health Saf. 2023;74(4):341-6.

Application of Multiple Occupational Health Risk Assessment Models for Crystalline Silica Dust among Stone Carvers.

OBJECTIVE: Silica is the most abundant substance on the Earth's crust and is a proven carcinogen. The aim of this study was to measure the occupational exposure of stone carvers to crystalline silica and to evaluate the health risks.  Methods: This descriptive and analytical cross-sectional study was performed on 79 stone carvers. Inhalation air sampling was performed by the NIOSH7500 method and the amount of silica was determined by X-ray diffraction (XRD). Semi-quantitative and quantitative risk assessments were performed using the methods of the Singapore Department and the US Environmental Protection Agency (EPA), respectively. Mortality due to silicosis and lung cancer were estimated using the Manettej and Rice models. Data were analyzed using SPSS23 software. RESULTS: The mean exposure to total inhalable dust and crystalline silica among the stone carvers was 1.44 and 0.5 mg/m3, respectively. Exposure to total dust and silica was significantly higher than the occupational standard (P <0.0001). Stone carvers' exposure to silica was at very high-risk level, and the carcinogenicity of silica considering two cancer slopes was 7.40 × 10-6 and 3.12 × 10-7 and the risk of non-carcinogenicity was unacceptable. CONCLUSION: The mortality rate due to silicosis was between 3 and 12 people per thousand, and due to lung cancer was 150.24 people per thousand. Based on the results of risk assessment, serious control measures should be implemented in order to reduce workers' exposure to silica.

[Analysis on morbidity characteristics of occupational diseases in Taian City from 2006 to 2021].

Objective: To analyze the morbidity characteristics of new occupational diseases in Taian City from 2006 to 2021 and provide scientific evidence for local prevention and treatment of occupational diseases. Methods: In March 2022, the data of newly diagnosed occupational diseases in Taian City from 2006 to 2021 were obtained from Information Monitoring System for Occupational Diseases and Health Hazards. A descriptive analysis was performed for the distribution of onset age, working years, types of occupational diseases, region, industries, enterprise scale, enterprise economic type and the epidemic trend of occupational diseases. Results: 1362 cases of occupational diseases in 29 species of 9 categories were reported in Taian City from 2006 to 2021, including 1311 males and 51 females. The M (P(25), P(75)) of onset age and working age were 53 (47, 64) and 24.08 (16.56, 29.25) respectively. The top three categories of occupational diseases were occupational pneumoconiosis and other respiratory diseases (1128 cases, 82.82%), occupational otolaryngology and oral diseases (107 cases, 7.86%), and occupational chemical poisoning (70 cases, 5.14%) in sequence. Coal worker's pneumoconiosis, noise deafness, silicosis, poisoning of manganese and its compounds and cataract were the top five species of occupational diseases, which accounted for 69.60% (948/1362), 7.64% (104/1362), 5.58% (76/1362), 3.38% (46/1362) and 2.94% (40/1362) of the total cases of occupational diseases.There were significant differences among the composition of occupational diseases categories reported annually (P<0.001), but the number of occupational pneumoconiosis and other respiratory diseases was the highest on each year. The number of occupational diseases showed a decreasing trend with the year, and the optimal fitting curve was an growth curve. The number of newly diagnosed occupational diseases was predicted to be 172 cases from 2022 to 2026. Occupational pneumoconiosis and other respiratory diseases was the main disease in 6 counties. The occupational diseases cases were mainly distributed in Feicheng County and Xintai County, with 520 cases and 504 cases respectively, accounting for 75.18% of occupational diseases cases. The coal mining and washing industry had the largest number of occupational diseases cases, accounting for 73.05% of all occupational diseases cases. 91.85% of occupational diseases cases came from large and medium-sized enterprises. The economic type of enterprises with the most occupational diseases was state-owned enterprises, accounting for 74.52% of occupational diseases cases. Conclusion: The predominant occupational diseases in Taian City are occupational pneumoconiosis and other respiratory diseases, occupational otolaryngology and oral diseases, occupational chemical poisoning. And the prevention and control of occupational diseases should be strengthened in key industries such as coal mining and washing industry, key enterprises such as state-owned large and medium-sized enterprises.

Analyzing the incidence of silicosis across various industries in Taiwan: a study of occupational disease surveillance by linking national-based workers' and medicoadministrative databases.

OBJECTIVES: This study aimed to establish an occupational disease surveillance system by identifying high-risk industries for silicosis in Taiwan using a national database linkage approach. METHODS: The study was based on a comprehensive analysis of benefit claims from the National Labor Insurance Research Database and medical records from the National Health Insurance Research Database between 2004 and 2020, providing coverage for more than 88.5% of the workforce and 99.9% of citizens. Silicosis was defined as having received compensation for labor insurance benefits or having received a diagnosis of silicosis (International Classification of Diseases, 10th Revision: J62 or International Classification of Diseases, Ninth Revision: 502). The study used the International Standard Industrial Classification of All Economic Activities for industry-specific classification. Cox proportional hazard models were used to compare the silicosis incidence and risk among each industry and identify high-risk industries for silicosis. RESULTS: This study analyzed 1466 cases of silicosis between 2004 and 2020 and found that 28 industries had incidence rates of over 40 cases per 100,000 workers, indicating more than double the risk of developing silicosis. Of these industries, 14 were considered high risk (relative risk of over four times). Among these, this study identified industries rarely mentioned in the past, such as wholesale of brick, sand, cement, and products, artistic creation, landscape construction, and materials recovery. Stratification by years of work experience reveals those industries such as quarrying of stone, sand, clay, and other mining, construction of buildings, landscape construction, site preparation, foundation and structure construction, building completion and finishing, manufacture of ships, boats, and floating structures, and plumbing, heat, and air conditioning installation display higher hazard ratios for individuals with <10 years of work experience. CONCLUSIONS: The current surveillance system has identified certain industries that are at a higher risk of developing silicosis, which could be used for future occupational epidemiological surveys and targeted preventive measures in these sectors.

Exploring the Impact of Silicosis Incidence on Tuberculosis Mortality and Morbidity: A Multi-Country Study.

INTRODUCTION: There are several risk factors attributed to tuberculosis (TB) mortality and morbidity. There are few studies and systematic reviews showing the association of silicosis and tuberculosis at a country level. Very limited studies have been conducted using multi-country data in studying the association of incidence of silicosis with TB mortality and morbidity. Hence, the aim of this research was to explore the association of incidence of silicosis and other important risk factors with TB mortality and morbidity using multi-country data. METHODS: Data from 217 WHO region countries were utilized, sourcing TB-related statistics from the Institute of Health Metrics and Evaluation and additional risk factors from the Demographic and Health Survey, Global Burden of Disease, and World Bank for 2019. Regression analysis was conducted to examine the association between silicosis incidence and TB outcomes. RESULTS: The study found an average silicosis incidence of 121.92 per 100,000 population. Additionally, 62.69% of the sample population are exposed to air pollution from solid fuel cooking. Sanitation access stands at an average of 59.67%. Regression outcomes indicate that while alcohol consumption's influence on TB is not statistically significant, a unit increase in silicosis incidence significantly elevates TB deaths (235.9, p = 0.005), YLL (9399.3, p = 0.011), and YLD (910.8, p = 0.002). CONCLUSION: The burden of silicosis is found to be one of the important determinants of deaths, YLL, and YLD due to tuberculosis. Country-specific strategies to prevent and control silicosis is a need of the hour.