KOT TAŞLAMA İŞİNDE ÇALIŞAN SİLİKOZİSLİ HASTALARDA RESTRİKTİF SPİROMETRİK DEĞİŞİKLİKLERİ ETKİLEYEN FAKTÖRLER

Year 2014, Volume: 28 Issue: 2, 91 - 98, 01.10.2014

Hayrettin Göçmen Selim Doğanay Yücel Akkaş Rahime Özgür Işığıbol

Abstract

Amaç: Kot taşlama işinde kullanılan silika, son yıllarda özellikle Türkiye'de trajik sonuçlara neden olan güncel bir silikozis kaynağıdır. Sağlıksız koşullarda uzun süre silikaya maruz kalan kot taşlama işçilerinde endemik olarak görülen önlenebilir fakat tedavi edilemez bu hastalık, uluslararası platformda büyük yankı uyandırmıştır. Çalışmada kot taşlamayla ilişkili silikoziste, restriktif patterne etki eden faktörlerin değerlendirilmesi amaçlanmıştır. Yöntem ve Gereç: Çalışmamızda kot taşlama işine bağlı silikozis gelişen ve parankimal hasara sekonder restriktif solunum yetmezliği nedeniyle çeşitli derecelerde maluliyet almış olguların demografik, spirometrik, laboratuar, klinik ve anamnestik verileri değerlendirilmiştir. Bulgular: Tümü erkek ve yaş ortalaması 20.4 yıl olan 21 silikozisli olgunun değerlendirilmiş olduğu çalışmada restriktif patern göstergelerinin silikaya maruziyete başlama yaşı ve çalışılan işyeri alan büyüklüğü ile pozitif, maruziyet süresi ve serum nötrofil/lenfosit oranı ile negatif yönde korele olduğu saptanmıştır. Sonuç: Çalışmamızın verilerine göre silika maruziyetine erken başlamanın, uzun maruziyet süresinin, küçük iş yerinde çalışmanın kot taşlama işine bağlı silikozis gelişen hastalarda restriktif patern açısından kötü prognostik değerler olduğu düşünülmektedir. Yüksek N/L oranları, hastalığın sistemik etkilerini monitorize etmede oldukça yararlıdır.

Keywords

Silikozis, Kot taşlama, Silika Maruziyeti

THE FACTORS THAT AFFECT RESTRICTIVE SPIROMETRIC ALTERATIONS IN SILICOSIS PATIENTS WORKING IN DENIM SANDBLASTING

Abstract

Aim: Silica used in denim sandblasting is current source of silicosis that cause tragic consequences especially in Turkey in recent years. This preventable but incurable disease that is so endemically widespread among the denim sandblasting workers which exposed for a long time in unhealthy conditions, had a great impact on international public health platform. In our study were aimed to determinate the factors that effect restrictive pattern in sandblasting releated silicosis. Material and Methods: In our study were evaluated the demographic,spirometric, laboratory, clinical and anamnestic findings of the patients who had silicosis due to denim sandblasting and were evaluated at various levels of disability for restrictive respiratory failure secondary parenchymal damage evolving. Results: The restrcitive pattern indicators correlated with the onset age of exposure to silica and areas of workplaces positively, with exposure duration and serum neutrophil / lymphocyte (N/L) ratio negatively, in study evaluated 21 patients with silicosis, all male and with the average age 20.4 years. Conclusion: According to datas of our study, early onset of silica exposure, long exposure time, work in smaller workplace is thought to be a poor prognostic value for restrictive pattern in patients with silicosis due to denim sandblasting. High N / L ratios is very useful for monitoring the systemic effects of the disease.

Keywords

Denim Sandblasting, Silica Exposure

References

• 1. Şahbaz S, İnönü H, Öcal S, Yılmaz A, Pazarlı C, Yeğinsu A et al. Denim sandblasting and silicosis two new subsequent cases in Turkey. Tüberk Toraks 2007;55: 87-91
• 2. Akgün M, Görgüner M, Meral M, et al. Silicosis caused by sandblasting of denims in Turkey: A report of two concomittant cases. J Occup Health 2005; 47: 346-9.
• 3. Jindal SK, Aggarwal AN, Gupta D. Dust-induced interstitial lung disease in the tropics. Curr Opin Pulm Med 2001; 7: 272-7.
• 4. Ooi CGC, Arakawa H. Silicosis. In: Gevenois PA, De Vuyst P, eds. Imaging of Occupational and Environmental Disorders of the Chest. Springer, Berlin, 2006; pp. 177–193.
• 5. Xiao GB, Morinaga K, Wang RY, Zhang X, Ma ZH. World at work: manufacturing ‘‘tatami’’ mats in China. Occup Environ Med 2004; 61: 372–3.
• 6. Hnizdo E, Vallyathan V. Chronic obstructive pulmonary disease due to occupational exposure to silica dust: A review of epidemiological and pathological evidence. Occup Environ Med 2003; 60: 237-43.
• 7. De la Hoz RE, Rosenman K, Borczuk A. Silicosis in dental supply factory workers. Respir Med 2004; 98: 791–794.
• 8. Akgun M, Mirici A, Ucar EY, Kantarci M, Araz O, Gorguner M: Silicosis in Turkish denim sandblasters. Occup Med (Lond) 2006, 56:554-8.
• 9. Sevinç C, Çimrin A, Manisalı M, et al. Sandblasting under uncontrolled and primitive conditions in Turkey. J Occup Health 2003;45:66-9.
• 10. Glady CA, et al. A Spirometry-Based Algorithm To Direct Lung Function Testing in the Pulmonary Function Laboratory Chest 2003; 123:1936-46.
• 11. Ministry of Labour and National service, Factories Act, 1937 and 1948–blasting (castings and other articles) special regulations. Factory Department, SI 1949. No. 2225. London, 1949; pp. 4331–4335.
• 12. Steenland K, Goldsmith DF. Silica exposure and autoimmune diseases. Am J Ind Med. 1995; 28: 603-608.
• 13. Mayes MD. Epidemiologic studies of environmental agents and systemic autoimmune diseases. Environ Health Perspect. 1999; 107S5:743-748.
• 14. Oberdorster G. Significance of particle parameters in the evaluation of exposure-doseresponse relationships of inhaled particles. Inhal Toxicol 1996;8 (Suppl):73–89. [PubMed: 11542496]
• 15. Steenland K, Brown D. Silicosis among gold miners: exposure-response analyses and risk assessment. Am J Public Health 1995; 85: 1372–7.
• 16. Verma DK, Purdham JT, Roels HA. Translating evidence about occupational conditions into strategies for prevention. Occup Environ Med 2002;59: 205–14.
• 17. Costello J, Castellan RM, Swecker GS, et al. Mortality of a cohort of US workers employed in the crushed stone industry, 1940–80. Am J Ind Med 1995;27:625–40.
• 18. Thomas TL, Stewart PA. Mortality from lung cancer and respiratory disease among pottery workers exposed to silica and talc. Am J Epidemiol 1987;125:35–43.
• 19. Rosenman KD, Reilly MJ, Rice C, et al. Silicosis among foundry workers: implication for the need to revise the OSHA standard. Am J Epidemiol 1996;144:890–900.
• 20. Tiwari RR, Narain R, Patel BD, Makwana IS, Saiyed HN. Spirometric measurements among quartz stone ex-workers of Gujarat, India. J Occup Health. 2003 Mar;45(2):88-93
• 21. Akgun M, Araz O, Akkurt I, Eroglu A, Alper F, Saglam L, Mirici A, Gorguner M and Nemery B. An epidemic of silicosis among former denim sandblasters. Eur Respir J 2008; 32: 1295– 1303.
• 22. Raymond FH, Thakur SA, Holian A. Silica binding and toxicity in alveolar macrophages. Free Radic Biol Med. 2008; 44: 1246–58.
• 23. Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001;102:5-14.
• 24. Niblett SH, King KE, Dunstan RH, Clifton-Bligh P, Hoskin LA. Haematologic and urinary excretion anomalies in patients with chronic fatigue syndrome. Exp Biol Med. 2007;232:1041-9.
• 25. Göçmen H, Çoban H, Yıldız A, Ursavaş A, Coş- kun F, et al. Is there any correlation between serum CRP level and haematological parameters with severity of disease in acute exacerbation of COPD? Solunum Hastalıkları 2007; 18: 141-7.
• 26. Duffy BK, Gurm HS, Rajagopal V, et al. Usefulness of an elevated to lymphocyte ratio in predicting long term mortality after percutaneous coronary intervention. Am J Cardiol 2006; 97:993-6.