Silicotuberculosis: Newer trends

Abstract

Silicosis, a progressive lung disease, caused by inhaling silica dust, poses a substantial health risk to workers in industries like mining, construction, and manufacturing. Development of new technological processes like jewellery manufacturing, processing of artificial stones etc has increased the number of cases with silicosis, especially in the female gender. Silicosis is incurable and leads to significant social and economic impact. Silicosis not only impairs the lung function but also raises the risk of several comorbidities, including chronic obstructive pulmonary disease (COPD), lung cancer, autoimmune disorders, and tuberculosis (TB). Silico-tuberculosis (Silico-TB), the overlap of TB in individuals with silicosis, is especially concerning as TB incidence is significantly higher among those with silica exposure, complicating both diagnosis and treatment. Advances in rapid molecular and culture-based diagnostics have improved TB detection in silicosis patients. TB treatment is done as per National Tuberculosis Elimination Programme (NTEP) Guidelines and TB preventive treatment (TPT) given to silicotic patients after ruling out TB. However, comprehensive management and prevention of Silico-TB remains challenging. Efforts to combat silicosis must include both effective diagnostics and preventive measures. Raising awareness about occupational hazards in affected industries and within communities is essential to reduce exposure risks. Furthermore, exploring innovative therapeutic options is essential for improving Silico-TB management.

Keywords: Changing trend; NPES; Silicosis; Silicotuberculosis; TPT.