Prevalence of chronic respiratory disease symptoms and associated occupational risk factors among certified silicosis patients of Rajasthan.
Silicosis is an irreversible, fibrotic occupational lung disease caused by the chronic inhalation of respirable crystalline silica dust, and persists as a significant source of morbidity among sandstone quarry workers in Rajasthan, India. Despite the prevalence of silicosis, there has been no comprehensive assessment of the symptom load and occupational risk factors of Chronic Respiratory Symptoms among certified silicosis patients in the Balesar sandstone area.
A community-based cross-sectional study was conducted in 355 certified silicosis patients (mean age 50.4 ± 10.6 years; all were exclusively male) who had resided for a minimum of 2 years in Balesar Block, Jodhpur, Rajasthan. Respiratory symptoms were evaluated using the ATS-DLD questionnaire. Predictors with a univariate chi-square p < 0.25 were included in a multivariable binary logistic regression model (IBM SPSS v25) to determine the independent predictors of composite Chronic Respiratory Symptoms status.
The findings showed that 286/355 patients, 80.6%, had composite Chronic Respiratory Symptoms. The most prevalent symptoms were morning cough (80.0%), morning phlegm production (79.7%), and dyspnoea attributable to cardiopulmonary impairment (78.0%); wheeze was noted by 51.3% and nocturnal breathlessness by 30.4%. The average age of symptom start was 40.4 ± 8.6 years, compared to 50.4 ± 10.6 years at certification, indicating a delay of about 10 years. In logistic regression, a conventional 8-h daily continuous work shift emerged as the most potent independent predictor of chronic respiratory disease symptoms (AOR 6.53, 95% CI 1.74-24.51, p = 0.005), while residing 6-10 km from the quarry also shown a significant correlation (AOR 2.74, 95% CI 1.07-6.99, p = 0.035). The associations between age at diagnosis (31-50 years) and illiteracy were statistically significant in the model (p = 0.021 and p = 0.035, respectively).
This is the first study conducted on certified silicosis patients, illustrating that 80.6% of Balesar Block's certified silicosis patients had active Chronic Respiratory Symptoms. The independent predictors were continuous standard-shift exposure and intermediate residential distance from quarries, strengthening the rationale for stricter daily exposure limits, mandatory dust suppression, and initial active case diagnosis in this occupational group.
A community-based cross-sectional study was conducted in 355 certified silicosis patients (mean age 50.4 ± 10.6 years; all were exclusively male) who had resided for a minimum of 2 years in Balesar Block, Jodhpur, Rajasthan. Respiratory symptoms were evaluated using the ATS-DLD questionnaire. Predictors with a univariate chi-square p < 0.25 were included in a multivariable binary logistic regression model (IBM SPSS v25) to determine the independent predictors of composite Chronic Respiratory Symptoms status.
The findings showed that 286/355 patients, 80.6%, had composite Chronic Respiratory Symptoms. The most prevalent symptoms were morning cough (80.0%), morning phlegm production (79.7%), and dyspnoea attributable to cardiopulmonary impairment (78.0%); wheeze was noted by 51.3% and nocturnal breathlessness by 30.4%. The average age of symptom start was 40.4 ± 8.6 years, compared to 50.4 ± 10.6 years at certification, indicating a delay of about 10 years. In logistic regression, a conventional 8-h daily continuous work shift emerged as the most potent independent predictor of chronic respiratory disease symptoms (AOR 6.53, 95% CI 1.74-24.51, p = 0.005), while residing 6-10 km from the quarry also shown a significant correlation (AOR 2.74, 95% CI 1.07-6.99, p = 0.035). The associations between age at diagnosis (31-50 years) and illiteracy were statistically significant in the model (p = 0.021 and p = 0.035, respectively).
This is the first study conducted on certified silicosis patients, illustrating that 80.6% of Balesar Block's certified silicosis patients had active Chronic Respiratory Symptoms. The independent predictors were continuous standard-shift exposure and intermediate residential distance from quarries, strengthening the rationale for stricter daily exposure limits, mandatory dust suppression, and initial active case diagnosis in this occupational group.