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Pulmonology Jun 2023Silicosis mostly happens in workers with high silica exposure and may accompany the development of various diseases like tuberculosis, cancer, or autoimmune diseases.... (Review)
Review
INTRODUCTION
Silicosis mostly happens in workers with high silica exposure and may accompany the development of various diseases like tuberculosis, cancer, or autoimmune diseases. The term silico-tuberculosis describes a condition in which an individual is affected by both silicosis and tuberculosis at the same time. This systematic review and meta-analysis study was conducted to evaluate the risk of tuberculosis in silicosis patients and individuals exposed to silica dust.
METHODS
We performed a systematic search for relevant studies up to 6 September 2022 using PubMed/ Medline, and Embase with the following keywords in titles or abstracts: "silicosis" OR "silicoses" OR "pneumoconiosis" OR "pneumoconioses" AND "tuberculosis". Cohort and case-control studies containing relevant and original information about tuberculosis infection in silicosis patients were included for further analysis. Pooled estimates and 95% confidence intervals (CI) for the relative risk of tuberculosis in individuals with silicosis compared to those without; these were evaluated using the random effects model due to the estimated heterogeneity of the true effect sizes.
RESULTS
Out of 5352 potentially relevant articles, 7 studies were eligible for systematic review, of which 4 cohort studies were included for meta-analysis. The total population of all studies was 5884, and 90.63% were male. The mean age of participants was 47.7 years. Our meta-analysis revealed a pooled risk ratio of 1.35 (95%CI 1.18-1.53, I : 94.30%) which means an increased risk of silicosis patients and silica-exposed individuals to tuberculosis infection.
CONCLUSION
Silicosis and silica dust exposure increase the risk of tuberculosis. Therefore, we suggest that individuals with long-time silica exposure, like mine workers, be routinely considered for both silicosis and tuberculosis screening programs.
PubMed: 37349198
DOI: 10.1016/j.pulmoe.2023.05.001 -
European Respiratory Review : An... Jan 2024Molecular pathways found to be important in pulmonary fibrosis are also involved in cancer pathogenesis, suggesting common pathways in the development of pulmonary... (Meta-Analysis)
Meta-Analysis Review
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.
Topics: Humans; Silicon Dioxide; Lung Neoplasms; Pulmonary Fibrosis; Asbestosis; Silicosis; Occupational Exposure
PubMed: 38355151
DOI: 10.1183/16000617.0224-2023 -
BMC Public Health May 2021While the association between occupational inhalation of silica dust and pulmonary tuberculosis has been known for over a century, there has never been a published... (Meta-Analysis)
Meta-Analysis
BACKGROUND
While the association between occupational inhalation of silica dust and pulmonary tuberculosis has been known for over a century, there has never been a published systematic review, particularly of experience in the current era of less severe silicosis and treatable tuberculosis. We undertook a systematic review of the evidence for the association between (1) silicosis and pulmonary tuberculosis, and (2) silica exposure and pulmonary tuberculosis controlling for silicosis, and their respective exposure-response gradients.
METHODS
We searched PUBMED and EMBASE, and selected studies according to a priori inclusion criteria. We extracted, summarised and pooled the results of published case-control and cohort studies of silica exposure and/or silicosis and incident active tuberculosis. Study quality was assessed on the Newcastle-Ottawa Scale. Where meta-analysis was possible, effect estimates were pooled using inverse-variance weighted random-effects models. Otherwise narrative and graphic synthesis was undertaken. Confidence regarding overall effect estimates was assessed using the GRADE schema.
RESULTS
Nine studies met the inclusion criteria. Meta-analysis of eight studies of silicosis and tuberculosis yielded a pooled relative risk of 4.01 (95% confidence interval (CI) 2.88, 5.58). Exposure-response gradients were strong with a low silicosis severity threshold for increased risk. Our GRADE assessment was high confidence in a strong association. Meta-analysis of five studies of silica exposure controlling for or excluding silicosis yielded a pooled relative risk of 1.92 (95% CI 1.36, 2.73). Exposure-response gradients were observable in individual studies but not finely stratified enough to infer an exposure threshold. Our GRADE assessment was low confidence in the estimated effect owing to inconsistency and use of proxies for silica exposure.
CONCLUSIONS
The evidence is robust for a strongly elevated risk of tuberculosis with radiological silicosis, with a low disease severity threshold. The effect estimate is more uncertain for silica exposure without radiological silicosis. Research is needed, particularly cohort studies measuring silica exposure in different settings, to characterise the effect more accurately as well as the silica exposure threshold that could be used to prevent excess tuberculosis risk.
Topics: Dust; Humans; Occupational Exposure; Risk Factors; Silicon Dioxide; Silicosis
PubMed: 34016067
DOI: 10.1186/s12889-021-10711-1 -
PLOS Global Public Health 2023An estimated 44 million artisanal and small-scale miners (ASM), largely based in developing economies, face significant occupational risks for respiratory diseases which...
An estimated 44 million artisanal and small-scale miners (ASM), largely based in developing economies, face significant occupational risks for respiratory diseases which have not been reviewed. We therefore aimed to review studies that describe silicosis and tuberculosis prevalence and respirable crystalline silica (RCS) exposures among ASM and use background evidence to better understand the relationship between exposures and disease outcomes. We searched PubMed, Web of Science, Scopus and Embase for studies published before the 24th March 2023. Our primary outcome of interest was silicosis or tuberculosis among ASM. Secondary outcomes included measurements of respirable dust or silica, spirometry and prevalence of respiratory symptoms. A systematic review and narrative synthesis was performed and risk of bias assessed using the Joanna Briggs Prevalence Critical Appraisal Tool. Logistic and Poisson regression models with predefined parameters were used to estimate silicosis prevalence and tuberculosis incidence at different distributions of cumulative silica exposure. We identified 18 eligible studies that included 29,562 miners from 13 distinct populations in 10 countries. Silicosis prevalence ranged from 11 to 37%, despite four of five studies reporting an average median duration of mining of <6 years. Tuberculosis prevalence was high; microbiologically confirmed disease ranged from 1.8 to 6.1% and clinical disease 3.0 to 17%. Average RCS intensity was very high (range 0.19-89.5 mg/m3) and respiratory symptoms were common. Our modelling demonstrated decreases in cumulative RCS are associated with reductions in silicosis and tuberculosis, with greater reductions at higher mean exposures. Despite potential selection and measurement bias, prevalence of silicosis and tuberculosis were high in the studies identified in this review. Our modelling demonstrated the greatest respiratory health benefits of reducing RCS are in those with highest exposures. ASM face a high occupational respiratory disease burden which can be reduced by low-cost and effective reductions in RCS.
PubMed: 37733799
DOI: 10.1371/journal.pgph.0002085 -
Indian Journal of Occupational and... 2023This systematic review and meta-analysis study evaluates a relationship between occupational exposure to respirable crystalline silica and serum copper (Cu) levels as an... (Review)
Review
BACKGROUND
This systematic review and meta-analysis study evaluates a relationship between occupational exposure to respirable crystalline silica and serum copper (Cu) levels as an indicator for early detection of silicosis.
MATERIALS AND METHODS
A systematic search was conducted, and the quality of results was evaluated in accordance with the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The following databases were searched, including Web of Sciences, Scopus, and PubMed from inception until November 2021. The following keywords were selected for searching in the mentioned databases including, "copper" OR "serum copper" AND "silicosis". The mean (standard deviation [SD]) of Cu was extracted for both silicosis and non-silicosis subjects. The differences in mean effect size were pooled using the random-effect model. Heterogeneity and publication bias were evaluated using the I value and Begg's test and Egger's test, respectively.
RESULTS
A total of 159 studies were initially found, among which eight studies were included in the meta-analysis. Random-effect meta-analysis of these eight studies showed that silicosis patients had higher copper levels than the non-silicosis group with a pooled standardized mean difference (SMD) of 3.02 (95% confidence interval: 0.25, 5.78); I = 99.3%, value < 0.001. The subgroup analysis showed that the corresponding figures in those with mean age >40 years and <40 years were 5.79 (2.06, 9.52) and -0.43 (-4.57, 3.70), respectively. Moreover, no publication bias was found in the analyses.
CONCLUSIONS
The results of the present study demonstrated that silica exposure may be associated with increasing serum Cu levels.
PubMed: 37303997
DOI: 10.4103/ijoem.ijoem_99_22 -
American Journal of Industrial Medicine Aug 2012Individual epidemiological studies generally lack the power to examine the association between silica exposure or silicosis and laryngeal cancer. We summarized pertinent... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Individual epidemiological studies generally lack the power to examine the association between silica exposure or silicosis and laryngeal cancer. We summarized pertinent evidence from published literature by using meta-analysis.
METHODS
A systematic literature search was performed to identify cohort and case-control studies, and the method of meta-analysis was used to combine standardized mortality ratios (SMRs) or standardized incidence ratios (SIRs) from cohort studies and odds ratios (ORs) from case-control studies.
RESULTS
A significantly increased risk of laryngeal cancer (pooled OR = 1.39, 95% confidence interval (95% CI): 1.17-1.67) among workers exposed to silica dust was observed by combining six case-control studies with adjustment for smoking and alcohol consumption. A similarly increased but statistically non-significant risk estimate was observed from cohort studies, with a pooled SMR of 1.38 (95% CI: 0.79-1.96) for silicosis cases; and a pooled SMR of 1.13 (95% CI: 0.82-1.45) and a pooled SIR of 1.50 (95% CI: 0.59-2.42) for workers with silica dust exposure.
CONCLUSION
This systematic review demonstrated a weak association between silica or silicosis and laryngeal cancer. Owing to the inherent limitations of the original studies, interpretation of the results of this meta-analysis should be cautious.
Topics: Air Pollutants, Occupational; Dust; Humans; Laryngeal Neoplasms; Occupational Diseases; Occupational Exposure; Odds Ratio; Silicon Dioxide; Silicosis
PubMed: 22457229
DOI: 10.1002/ajim.22037 -
BMJ Open Mar 2023To determine the incidence of pneumoconiosis worldwide and its influencing factors. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To determine the incidence of pneumoconiosis worldwide and its influencing factors.
DESIGN
Systematic review and meta-analysis.
SETTING
Cohort studies on occupational pneumoconiosis.
PARTICIPANTS
PubMed, Embase, the Cochrane Library and Web of Science were searched until November 2021. Studies were selected for meta-analysis if they involved at least one variable investigated as an influencing factor for the incidence of pneumoconiosis and reported either the parameters and 95% CIs of the risk fit to the data, or sufficient information to allow for the calculation of those values.
PRIMARY OUTCOME MEASURES
The pooled incidence of pneumoconiosis and risk ratio (RR) and 95% CIs of influencing factors.
RESULTS
Our meta-analysis included 19 studies with a total of 335 424 participants, of whom 29 972 developed pneumoconiosis. The pooled incidence of pneumoconiosis was 0.093 (95% CI 0.085 to 0.135). We identified the following influencing factors: (1) male (RR 3.74; 95% CI 1.31 to 10.64; p=0.01), (2) smoking (RR 1.80; 95% CI 1.34 to 2.43; p=0.0001), (3) tunnelling category (RR 4.75; 95% CI 1.96 to 11.53; p<0.0001), (4) helping category (RR 0.07; 95% CI 0.13 to 0.16; p<0.0001), (5) age (the highest incidence occurs between the ages of 50 and 60), (6) duration of dust exposure (RR 4.59, 95% CI 2.41 to 8.74, p<0.01) and (7) cumulative total dust exposure (CTD) (RR 34.14, 95% CI 17.50 to 66.63, p<0.01). A dose-response analysis revealed a significant positive linear dose-response association between the risk of pneumoconiosis and duration of exposure and CTD (P-non-linearity=0.10, P-non-linearity=0.16; respectively). The Pearson correlation analysis revealed that silicosis incidence was highly correlated with cumulative silica exposure (r=0.794, p<0.001).
CONCLUSION
The incidence of pneumoconiosis in occupational workers was 0.093 and seven factors were found to be associated with the incidence, providing some insight into the prevention of pneumoconiosis.
PROSPERO REGISTRATION NUMBER
CRD42022323233.
Topics: Male; Humans; Middle Aged; Incidence; Pneumoconiosis; Dust; Odds Ratio; PubMed
PubMed: 36858466
DOI: 10.1136/bmjopen-2022-065114 -
Archives of Public Health = Archives... May 2023Treatment of latent tuberculosis infection (LTBI) is effective in preventing progression to TB disease. This study aimed to synthesize available evidence on the...
Efficacy and safety of different regimens in the treatment of patients with latent tuberculosis infection: a systematic review and network meta-analysis of randomized controlled trials.
BACKGROUND
Treatment of latent tuberculosis infection (LTBI) is effective in preventing progression to TB disease. This study aimed to synthesize available evidence on the efficacy, adherence, and safety of LTBI treatment in order to assist policymakers to design appropriate national treatment policies and treatment protocols.
METHOD
The PRISMA-NMA was used to review and report this research. Randomized controlled trials which compared the efficacy and safety of LTBI treatments were included. A systematic literature search was done to identify relevant articles from online databases PubMed/ MEDLINE, Embase, and Cochrane Center for Clinical Trial database (CENTRAL). The network meta-analysis was done using R- studio Version 1.4.1103.
RESULT
In this review, 42 studies were included, which enrolled 46,022 people who had recent contact with patients with active tuberculosis, evidence radiological of previous tuberculosis, tuberculin test equal or greater than 5 mm, radiographs that indicated inactive fibrotic or calcified parenchymal and/or lymph node lesions, had conversion to positive results on a tuberculin skin test, participants living with HIV, chronic Silicosis, immigrants, prisoners, old people, and pregnant women who were at risk for latent TB were included. The incidence of TB among people living with HIV who have taken 3RH as TPT was lower, followed by 48%,followed by 6H (41%). However, 3HP has also the potential to reduce the incidence of TB by 36% among HIV negative patients who had TB contact history. Patients' adherence to TPT was higher among patients who have taken 4R (RR 1.38 95% CI 1.0,1.89) followed by 3RH (34%). The proportion of subjects who permanently discontinued a study drug because of an adverse event were three times higher in the 3RH treatment group. Furthermore, the risk of grade 3 and 4 liver toxicity was significantly higher in 9H followed by 1HP, and 6H.
CONCLUSION
From this review, it can be concluded 3RH and 6H has a significant impact on the reduction of TB incidence among PLWH and 3HP among HIV negative people who had TB contact history. However, combinations of rifampicin either with isoniazid were significantly associated with adverse events which resulted in permanent discontinuation among adult patients. Furthermore, grade 3 and 4 liver toxicity was more common in patents who have taken 9H, 1HP, and 6H. This may support the current recommended TPT regimen of 3HP, 3RH, and 6H.
PubMed: 37143101
DOI: 10.1186/s13690-023-01098-z -
Indian Journal of Occupational and... 2023Tuberculosis (TB) and Silicosis are public health problems with high morbidity and mortality. They also exist as comorbidities and are highly prevalent among mine...
CONTEXT
Tuberculosis (TB) and Silicosis are public health problems with high morbidity and mortality. They also exist as comorbidities and are highly prevalent among mine workers.
AIMS
This study aims to estimate the risk of TB in miners with silicosis than in miners not having silicosis.
METHODS AND MATERIAL
This systematic review was conducted by literature search using PubMed, and EMBASE for studies published from 1 Jan 2017 till 20 July 2022. From the data obtained using relevant keywords for the search, a total of 345 articles were selected for screening after applying our inclusion-exclusion criteria and removing duplicates. PRISMA guidelines were followed. items JBI critical appraisal checklist for cross-sectional studies was used for assessment of the risk of bias. The odds ratio was used to estimate the strength of the association.
RESULTS
After extensive screening, four studies have met our selection criteria. The meta-analysis of those studies revealed that the prevalence of TB in miners with silicosis is 27.11% while the prevalence of TB in miners with non-silicosis is 16.75%. The estimated pooled odds ratio (fixed effect model) is 1.34 (95% CI 1.01 - 1.76).
CONCLUSIONS
The present study reveals that there is an increased risk of TB in miners with Silicosis. Newer initiatives must be taken to prevent TB in miners.
PubMed: 38390483
DOI: 10.4103/ijoem.ijoem_287_22 -
International Journal of Environmental... Feb 2019Silicosis is a progressive fibrotic lung disease that is caused by the inhalation of respirable crystalline silica. Due to its high silica content, artificial stone (AS)...
Silicosis is a progressive fibrotic lung disease that is caused by the inhalation of respirable crystalline silica. Due to its high silica content, artificial stone (AS) can become a possible source of hazardous dust exposure for workers that are employed in the manufacturing, finishing, and installing of AS countertops. Therefore, the aim of this review was to verify the association between AS derived silica exposure and silicosis development, and also then define the pathological characteristics of the disease in relation to specific work practices and preventive and protective measures that were adopted in the workplace. A systematic review of articles available on Pubmed, Scopus, and Isi Web of Knowledge databases was performed. Although the characteristics of AS-associated silicosis were comparable to those that were reported for the disease in traditional silica exposure settings, some critical issues emerged concerning the general lack of suitable strategies for assessing/managing silica risks in these innovative occupational fields. Further research that is designed to assess the hazardous properties of AS dusts, levels of exposure in workplaces, and the effectiveness of protective equipment appears to be needed to increase awareness concerning AS risks and induce employers, employees, and all factory figures that are engaged in prevention to take action to define/adopt proper measures to protect the health of exposed workers.
Topics: Construction Materials; Dust; Humans; Occupational Exposure; Pulmonary Fibrosis; Silicon Dioxide; Silicosis; Workplace
PubMed: 30781462
DOI: 10.3390/ijerph16040568