ROLE OF EVALUATING EXERCISE CAPACITY AND DLCO IN APPARENTLY HEALTHY STONE WORKERS IN AGRA- A CASE CONTROL STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 8
Abstract
BACKGROUND Occupational Lung diseases are on the rise and contribute to the burden of lung disease. Worldwide, silicosis is the most common occupational lung disease. Exposure includes stone cutting, quarrying, rock blasting, pottery, foundry and sandblasting. Silicosis is caused by inhalation of crystalline silica quartz (silica dioxide) leading to inflammation, scarring and eventually lung fibrosis and destruction. Aims and Objectives- Evaluation of exercise capacity (6MWT) and diffusion study in apparently healthy stone workers in Agra and to assess the role of exercise tolerance and diffusion capacity in early detection of occupational lung disease and prognosis. MATERIALS AND METHODS This is a descriptive comparative study. We evaluated 54 patients who were apparently healthy and had occupational exposure as stone workers, among which 24 were excluded due to previous tuberculosis and other lung diseases. It was a case control study between exposed workers and unexposed healthy persons. Evaluation included detailed history and clinical examination, CXR, Spirometry including DLCO, Exercise performance assessment (6MWT) and Sp02 at rest. RESULTS 30 Cases and 28 Controls were included in the study. They were sub divided further on the basis of age, sex, duration of exposure, respiratory rate, oxygen saturation, pulmonary function testing including DLCO and 6MWT. Mean DLCO in cases was 25.4812 and in controls was 28.6371 (p-0.0452). The 6MWT in cases was 476.32 and controls was 540.4643 (p-0.0436). Spirometry showed restrictive pattern in 8 patients, mixed pattern in 2 patients and was normal in 20 patients. The mean SpO2 was 94.633% in cases and 94.642% in controls. CONCLUSION The study shows that in apparently healthy cases of silica workers, the earliest indicator of disease is the reduction of DLCO. Also, the exercise capacity is significantly reduced in these patients. (Though spirometry was normal in more than half of these cases). These 2 parameters help in early disease identification and allow for prevention of exposure, stop disease progression and alter the final course of illness and decrease significant morbidity and possible mortality
Authors and Affiliations
Santosh Kumar, Sanjeev Anand, Gajendra Vikram Singh, Benhur Joel Shadrach, Rishabh Goel, Parul Mittal, Avinash Kumar, Chandrakant Kachru Khandare
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