Socio-Demographic and Clinical Characteristics of Turkish Workers with Pneumoconiosis.

INTRODUCTIONPneumoconiosis is a lung disease caused by inhaling dust (1). In Turkey it is a very common (the third common occupational health problem according to the Social Security Statistics) and preventable disease deteriorating the quality of life, with a higher mortality (according to the International Labour Organization (ILO) 21% of occupation-related deaths is due to chronic pulmonary diseases). Because the notification system for pneumoconiosis is generally inadequate, the occupational health statistical data regarding pneumoconiosis are thus insufficient in Turkey. Therefore, the socioeconomic and clinical features of the diagnosed cases are not well known. This is a very important issue when attempting to plan the health system response to pneumoconiosis. The largest data source in Turkey is available in three occupational disease hospitals' patient files. The aim of the study was to determine socio-demographic, clinical and radiological characteristics of the patients as well as the risky jobs in our region, to describe the people at risk of pneumoconiosis, and in the long run to make the policy makers to acknowledge the results of the study in order to control pneumoconiosis in Turkey.MATERIALS AND METHODSThe study setting - Istanbul Occupational Disease Hospital is one of the three occupational disease hospitals in Turkey. Its catchment area is the northwest part of Turkey and Izmir (both highly industrialized areas of Turkey). The participants recruited for this descriptive study were all pneumoconiosis patients diagnosed from January 1, 2008 to December 31, 2010 (N=208). Data was obtained from the patients' files in January 2011. Data collection was conducted by trained researchers (four physicians) who filled in a form. Demographic variables included age, sex, social security type, and smoking habit. Work related variables included occupation, exposed material and exposure time. The ILO classification of each case was done during hospitalization by an ILO reader and two other pulmonary physicians. The ILO classification, according to the revised 2011 edition, was used to classify the profusion and nodule existence (2). Clinical variables included pulmonary function tests (PFT) (FEV1 in percentage, FVC in percentage, FEV 1/FVC and DLCO (in Kco in percentage). Both tests were performed according to the American Thoracic Society guidelines. The most important symptom of the patient at admission was recorded.Statistical AnalysisData were presented as means ± SDs or median (25th-75th) for numerical variables, and percentages for categorical variables. Chi square test and Mann-Whitney U test were used with SPSS 16.0 (SPSS, Inc., Chicago, USA).RESULTSThe results are shown in Tables. All of the patients were male aged 38.82 ± 13 years. The smoking status of the patients is shown in Table 1 . The most important symptoms were breathlessness, cough and chest pain. Symptomless were 9.1% of patients (Table 2). Investigated workers were denim sandblasters (50.5%), dental technicians (12%), coal miners (6.7%), casting (4.8%), teflon kitchenware producers (3.8%), ceramic workers (3.8%), and others (4.8%) (Table 3). The mean exposure time before the occurrence of pneumoconiosis symptoms was significantly shorter in denim sandblasters and teflon kitchenware producers compared to the other workers (5.4 ± 4.2 and 4.5 ± 3.3 years, respectively) (Table 3). Silica was the most often detected hazardous material (86.5%) (Table 4). Profusion (76.5%) was more than 1/2 by the ILO classification (Table 5). The ratio of A or B nodules was 31.3% (Table 6). The pulmonary function test results of the patients are shown in Table 7. The period between the occurrence of symptoms and diagnosis did not change by the profusion. The pulmonary function tests were negatively correlated with the profusion (Table 8).DISCUSSIONSilicosis is a fibrogenic disease causing lung fibrosis. It causes disability and work loss. …