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Occupational and Environmental Lung Diseases |

Validity of Pulmonary Functional Status Including 6 Minute Walk Test in Patients of Silicosis Classified According to ILO Guidelines FREE TO VIEW

UG Deepak, MBBS; Vinod Joshi, MD; K C Agarwal, MD; Gopal Purohit, MD; J Mohan, MBBS; U Narendra, MBBS
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Pulmonary Medicine, Dr S.N. Medical College, Jodhpur, Rajasthan, India


Chest. 2015;148(4_MeetingAbstracts):768A. doi:10.1378/chest.2246017
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Abstract

SESSION TITLE: Occupational and Environmental Lung Diseases Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: To assess the correlation of pulmonary functional status including 6MWT in silicosis patients according to ILO guidelines

METHODS: A descriptive study conducted at Dr SN medical college Jodhpur, India from july 2013 to august 2014. Total of 109 patients were selected on the basis of history of exposure to silica, chest x-ray was used to confirm the diagnosis of silicosis and to classify them according to ILO guidelines. Spirometry & 6MWT was performed by each patient. Pearson chi-square test & welch ANOVA was used for statistical analysis.

RESULTS: FEV1/FVC ratio, FEV1, FVC of patients with grade 1/0 & 1/1 was 97.15±7.1, 91.15±8.9%, 93.3±6.4% respectively & these parameters were within normal limits & these spirometric variables gradually decreased with increasing ILO grading & decreased to 62.5±22.6, 36.25±14.2% & 60±18.42% respectively in grade C of PMF patients, all these change in parameters were highly significant(p<0.001).The 6MWD ,Spo2 desaturation & BORG dyspnea scale during 6MWT in patients with grade 1/0 &1/1 was 439±36.7m, 1.03±0.82% & 0.54±0.66 respectively and changed gradually with advancing ILO grading of silicosis to 251.25±12.84m, 9.75±1.5% & 5.5±1 respectively in grade C of ILO with a difference in 6MWD of 188m, Spo2 desaturation of 8.72% & BORG dyspnea scale of 4.96, these changes were statistically significant (p<0.001).Spirometry & 6MWT parameters mainly FVC, 6MWD & Spo2 desaturation were significantly altered in patients with PMF compared to simple silicosis according to ILO.

CONCLUSIONS: The ILO classification of Pneumoconiosis to assess the severity of silicosis by chest X-ray is a very important tool since its grading of x-rays correlate with pulmonary functional status of silicosis patients. Patients with silicosis develop both obstructive and restrictive pattern in spirometry as severity of silicosis increases according to ILO classification. 6MWT is a simple, non-invasive test which also correlate well with severity of silicosis. Pulmonary functional status is severely affected in Patients with Progressive Massive Fibrosis than compared to simple silicosis.

CLINICAL IMPLICATIONS: Present study demonstrated that both 6MWT &Spirometry variables correlate well with severity of silicosis according to ILO classification, hence they can be used as a screening test in people working in silica exposed occupations.

DISCLOSURE: The following authors have nothing to disclose: Deepak UG, Vinod Joshi, K C Agarwal, Gopal Purohit, Mohan J, Narendra U

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