AWMF S2k Guideline: Diagnosis and Assessment of Lung Disease Caused by Occupational Silica Dust Exposure (Silicosis) - Disease No. 4101 as per Occupational Diseases Ordinance (BKV) Annex 1.

Abstract

This manuscript is a translation of the corresponding German Guideline "S2k-Leitlinie Diagnostik und Begutachtung der Berufskrankheit Nr. 4101 Quarzstaublungenerkrankung (Silikose) der Berufskrankheitenverordnung (BKV)." The guideline provides a structured framework for the expert assessment of quartz dust-related lung disease (Occupational Disease No. 4101, German Ordinance on Occupational Diseases, BKV). It targets medical assessment experts who are responsible for determining the presence of silicosis and related conditions, assessing their causal relationship to occupational quartz dust exposure, and evaluating functional consequences including loss or reduction of earning capacity (MdE). In addition, it offers guidance for clerks of statutory accident insurance institutions as well as social courts and aimed to improve the plausibility, internal consistency, and transparency of expert reports and resulting decisions for affected individuals. The guideline specifies required investigations and their evaluation, emphasizing that symptomatology, cardiopulmonary functional, and conventional chest radiography display rather low levels of correlation. It details radiological and pathological manifestations of silicosis on qualified low-dose volumetric HRCT, including typical findings in lung parenchyma, hilum, mediastinum, and lymph nodes, with notes on standards, limitations, and diagnostic pitfalls.