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.
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.
THE FACTORS THAT AFFECT RESTRICTIVE SPIROMETRIC ALTERATIONS IN SILICOSIS PATIENTS WORKING IN DENIM SANDBLASTING
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.
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.
İzmir Göğüs Hastanesi Dergisi, Sağlık Bilimleri Üniversitesi Dr. Suat Seren Göğüs Hastalıkları ve Cerrahisi Eğitim ve Araştırma Hastanesi’nin resmi bilimsel dergisidir. 1986’da yayın hayatına başlamış olan dergi 2004 yılına dek yılda iki sayı, bu yıldan günümüze dek yılda üç sayı olarak Nisan, Ağustos, Aralık aylarında düzenli olarak yayınlanmaktadır. Dergimiz, Türkiye Atıf Dizininde indekslenmektedir. Makalelerin değerlendirilmesi öncesi veya yayın aşamasında yazarlardan herhangi bir ücret talep edilmemektedir.
Yayın dili Türkçe ve İngilizcedir. ISSN : 1300-4115