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Correspondence |

Prognosis of Patients With Silicosis Due to Denim SandblastingPrognosis for Silicosis in Denim Sandblasters FREE TO VIEW

Metin Akgun, MD, FCCP; Elif Yilmazel Ucar, MD; Omer Araz, MD; John E. Parker, MD, FCCP
Author and Funding Information

From the Department of Pulmonary Diseases, School of Medicine (Drs Akgun, Yilmazel Ucar, and Araz), Ataturk University; and the Pulmonary and Critical Care Medicine Section (Dr Parker), West Virginia University.

Correspondence to: Metin Akgun, MD, FCCP, Aziziye Arastirma Hastanesi, Gogus Hastaliklari Anabilim Dali, 25070, Palandoken, Erzurum, Turkey; e-mail: akgunm@gmail.com


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2012 American College of Chest Physicians


Chest. 2012;141(3):831. doi:10.1378/chest.11-2558
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To the Editor:

We read with great interest the article by Bakan et al1 in a recent issue of CHEST (November 2011). The authors describe the patient characteristics in yet another important but tragic description of the ongoing silicosis epidemic among denim sandblasters in the textile sector in Turkey. As they report, this silicosis outbreak emerged with the new millennium, the magnitude of the problem has continued to increase,2-5 and it remains uncertain how much of the iceberg has been revealed.

Although they give detailed information about the patients and report a statistically significant association of reduced lung function tests with mortality, the information provided about fatal cases is insufficient to ascertain the cause of death and the progression to massive fibrosis. Younger workers dominate this work sector,3 and we noted rapid progression of the disease, and mortality was associated with younger age and also with higher exposures to crystalline silica. However, in their study, the mean age of the patients in the fatal cases is older compared with the entire study population (35 years vs 31½ years). We also wonder if there was a relationship between invasive procedures and mortality for the patients in their study.

Before silicosis was recognized in the textile sector, we established a diagnosis using invasive procedures, including bronchoscopic transbronchial biopsy and surgical lung biopsy, as detailed in our previous studies.2,3 However, both patients who had surgical biopsies died following the biopsy. Their study dataset might shed information about such risks. In addition to disease progression and mortality, the high compensation rates of the patients in the study by Bakan et al1 also attracted our attention. It would be useful to know whether the patients received compensation because they were insured or if they were successful in receiving compensation as the results of the temporary national law that provided compensation rights for uninsured workers through May 2011. It is plausible too that poor working conditions are more likely for workers employed without insurance because such workplaces are unlikely to be well regulated and inspected. Thus, being insured might confer better working conditions and better health outcomes.

Bakan ND, Özkan G, Çamsari G, et al. Silicosis in denim sandblasters. Chest. 2011;1405:1300-1304. [PubMed] [CrossRef]
 
Akgun M, Gorguner M, Meral M, et al. Silicosis caused by sandblasting of jeans in Turkey: A report of two concomitant cases. J Occup Health. 2005;474:346-349. [PubMed]
 
Akgun M, Mirici A, Ucar EY, Kantarci M, Araz O, Gorguner M. Silicosis in Turkish denim sandblasters. Occup Med (Lond). 2006;568:554-558. [PubMed]
 
Sahbaz S, Inönü H, Ocal S, et al. Denim sandblasting and silicosis two new subsequent cases in Turkey. Tuberk Toraks. 2007;551:87-91. [PubMed]
 
Akgun M, Araz O, Akkurt I, et al. An epidemic of silicosis among former denim sandblasters. Eur Respir J. 2008;325:1295-1303. [PubMed]
 

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References

Bakan ND, Özkan G, Çamsari G, et al. Silicosis in denim sandblasters. Chest. 2011;1405:1300-1304. [PubMed] [CrossRef]
 
Akgun M, Gorguner M, Meral M, et al. Silicosis caused by sandblasting of jeans in Turkey: A report of two concomitant cases. J Occup Health. 2005;474:346-349. [PubMed]
 
Akgun M, Mirici A, Ucar EY, Kantarci M, Araz O, Gorguner M. Silicosis in Turkish denim sandblasters. Occup Med (Lond). 2006;568:554-558. [PubMed]
 
Sahbaz S, Inönü H, Ocal S, et al. Denim sandblasting and silicosis two new subsequent cases in Turkey. Tuberk Toraks. 2007;551:87-91. [PubMed]
 
Akgun M, Araz O, Akkurt I, et al. An epidemic of silicosis among former denim sandblasters. Eur Respir J. 2008;325:1295-1303. [PubMed]
 
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