The Diagnostic Value of Routine Spirometry in Occupational Health Practice for Early Detection of Silicosis: A Retrospective Belgian Study Among Silica-Exposed Workers.
Nele Van Loon, Kevin Lamote, David Ruttens, Mathieu Verbrugghe, Sofie Acke, Cindy Mai, Annemiek Snoeckx, Wim Siemons, Steven Ronsmans, Pierre Van Damme, Thérèse Lapperre
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Abstract
Objective: Silicosis is a pneumoconiosis caused by respirable crystalline silica (RCS). As current surveillance methods have low sensitivity for early detection, we evaluated the value of prediagnostic occupational spirometry monitoring.
Methods: To investigate the possibility of detecting disease, we assessed 58 RCS-exposed cases by linking lung function abnormalities to CT readings. Univariate, stepwise logistic regression and ROC analysis were performed.
Results: Of 31 workers with RCS-related CT abnormalities, 25 were classified as silicosis. Fixed cutoff predicted values (FCO) for FEV 1 and FVC of <80% and FEV 1 /FVC of <0.7, FEV 1 % predicted decline >15%, and FEV 1 decline >60 mL/year were significantly associated with pathological outcome. Combining FCO ( P = 0.001) and percentage predicted method (PPM) ( P = 0.023) best predicted silicosis (AUC ROC = 0.84).
Conclusions: To identify RCS-exposed workers requiring diagnostic referral, priority should be given to those with FCO, PPM, and annual FEV 1 decline abnormalities.
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