Scholarly record
SILICA DUST EXPOSURE, STILL PRESENT ISSUE FOR DOCTORS
Abstract
The secondary interstitial lung diseases have been an intensely debated topic lately. Recent research describes increasingly more associations between various occupational hazards and the incidence of pulmonary fibrosis. Even the well-known category of pneumoconioses, in which silicosis has a long-established inclusion, continues to raise challenges and create delays in diagnosis while affecting the patient's psychological and social wellbeing. The diagnosis delay also avoids the decision to end the exposure that modifies the rate of progression of the disease. Prolonged exposure to free crystalline silica dust causes silicosis through its deposition in the lung tissue. On the one hand, the diagnosis difficulties rely on the ignorance of the occupational exposure, and the other hand, on the lack of a specific clinical picture and biomarkers. Next, we describe the diagnose trajectory of a non-smoking male patient, 56-year-old, from a rural area, who worked for 12 years in a cast iron and steel foundry. Before being admitted in Occupational Medicine Department, the patient checked in repeatedly with the territorial pulmonology services since 2008. The presumptive diagnoses were pulmonary tuberculosis and lung cancer, without conclusive diagnostic proof for any of these entities. His clinical status deteriorated, and his anxiety continued to rise in the face of a death prognostic due to an, in reality, inexistent lung cancer. After 11 years of uncertainty, the actual diagnosis became apparent during the hospitalization in the Occupational Medicine Clinic. Finally, we discuss the possibilities of reducing the delay in diagnosis, including some novel biomarkers that might be relevant.
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