Clinical and Radiological Profile of Pulmonary Tuberculosis Among Patients Having Occupational Exposure to Silica Dust: An Observational Study

Abstract

Background: Silicotuberculosis, a condition where tuberculosis develops as a complication of silicosis, is a critical public health concern, particularly prevalent in low- and middle-income countries where prolonged exposure to crystalline silica particles is widespread. This dual impact amplifies the complexity of managing these conditions, posing significant challenges for healthcare systems. By leveraging a combination of radiographic techniques and clinical expertise, healthcare providers can optimize the diagnostic process, enabling timely intervention and improving outcomes for individuals affected by silicosis-associated tuberculosis.
Material & Methods: A hospital-based prospective observational study was done over 18 months with 65 TB patients having occupational exposure to silica dust, who have met the inclusion and exclusion criteria, were included in the study. A detailed demographic, occupational and clinical history were recorded for these patients and all were subjected to chest x-ray imaging to assess their radiological profile.
Results: Among the TB patients with occupational silica dust exposure, the mean age of distribution was 43.56 ± 12.5 years with a greater number of patients between the 31 to 40-year age group (32.3%), males more in proportion (97%) with more population from a rural background (95.4%), about 62% study population belongs to upper lower socioeconomic status. The most common type of occupational exposure was seen in stone drilling (32.3%) and a majority of the patients (47.6%) had duration of exposure >10 years. The most common symptoms experienced by these patients were cough (96.9%) along with fever (90.8%), and shortness of breath (90.8%). Among the clinical signs, pallor (43.1%) and pedal edema (32.3%) were predominantly exhibited by these patients. Among the study population, most patients predominantly exhibit bilateral lung disease (92.3%), with a significant proportion having cavitary disease (60%). Moderate and far advanced disease was more common (46.1% moderate and 43.1% far advanced) in these patients.
Conclusion: A comprehensive, multifaceted approach is needed to better manage TB in the context of occupational silica exposure, which includes active surveillance for early TB detection in individuals with silicosis, and the development of enhanced diagnostic methods.