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Query: UMLS:C0037116 (silicosis)
 1,822 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

1. At world level, silicosis does not predispose to bronchial cancer. But from region to region, the relationship silicosis-cancer varies and depends on factors other than silica. 2. It has not been proved that silica is cancerigen in laboratory animal. 3. Subjects exposed to silica can also be exposed in other circumstances to known carcerigen agents (ionizing radiations, iron oxides, arsenic, exhaust gases of explosion engins). In Switzerland, it is possible that miners in galeries could breath low concentrations of radon and benzopyrene. But it is very difficult to know to what extent these potential risks are involved. 4. Bronchial carcinoma in silicotic patients does not own any characteristics. It is quite similar to that found in the remainder of the population. On the other hand, its diagnosis and treatment are more difficult because of the presence of silicosis. 5. The fortuitous association of silicosis and bronchial cancer is due to overlapping of the profiles of both diseases. The increasing life span of the silicotic patient and the high frequency of bronchial cancer explain why this association is not more exceptional.
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PMID:[Silicosis and bronchial cancer (author's transl)]. 738 60

Without imaging procedures a variety of chest diseases cannot be diagnosed sufficiently. Examples are acute and chronic pneumonia, toxic effects on the bronchial and alveolar system, immunologic and malignant changes and cardiovascular disease involving the lung. Especially important are the types of disease that attack large sections of a population, because a path of infection may be hidden or because of short- or long-term exposure to relevant concentrations of toxic or allergic agents--not necessarily recognized as such--at work, in the general environment or associated with certain types of behaviour or illness. All this may have effects on biostatistical and socioeconomic data. Considering available epidemiologic data on morbidity and mortality, then pulmonary tuberculosis, unspecific pneumonias, drug-induced and AIDS-associated lung disease, pneumoconioses (silicosis and asbestosis) and primary and secondary chest malignancies have to be included in this category. Conventional chest radiography with high-kV technique and modern film-screen combinations continues to be the imaging modality for initial evaluation of chest disease worldwide. Low radiation exposure, low cost and overall availability are major advantages. Conventional tomography, however, has nowadays been largely replaced by CT, though a few special indications remain. High-resolution CT (HRCT) and the spiral technique bring additional benefits. Periodic radiographic mass screening of populations with certain disease prevalence still seems feasible, taking risk assessment, cost effectiveness and radiation exposure into account.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The importance of thoracic radiology for public health since 1896]. 761 Feb 49

The presence of radiographic silicosis was assessed as a risk factor for lung cancer in a cohort and case-control study of miners in the Ontario Silicosis Surveillance Database. Subjects were 328 miners with silicosis matched on age to 970 miners with normal radiographs. In a cancer incidence follow-up, there was a significant excess of lung cancer among miners with silicosis (Standardized Incidence Ratio 2.55; 95% Confidence Interval 1.43-8.28). Miners with normal radiographs had lung cancer incidence about the same as the Ontario average (Standardized Incidence Ratio 0.90; 95% Confidence Interval 0.51-1.47). In a matched case-control analysis of lung cancer, cumulative radon exposure was associated with lung cancer risk (increase in odds ratio 0.4% per WLM; 95% Confidence Interval -0.3% to 1.1%). When the presence of silicosis was added to the model, silicosis was a highly significant risk factor for lung cancer (Odds Ratio 6.99 95% Confidence Interval 1.91-25) and the risk factor for radon was diminished (increase in Odds Ratio -0.5% per WLM; 95% confidence Interval -1.4% to 0.4%). This finding suggests that additional study is warranted before concluding that radon risk factors derived from mining populations do not need to be modified for application to the general population.
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PMID:Silicosis, radon, and lung cancer risk in Ontario miners. 856 96

Risk groups with regard to bronchopulmonary precancerous and tumor diseases of occupational origin can be deduced from current occupational disease statistics. Most prominent are those working with asbestos. Each year about 250 asbestos-associated bronchial carcinomas and 400 mesotheliomas are recognized and compensated; the tendency is increasing. Because of the long latency time, the frequency peak will probably be reached in about 15 years in spite of the prohibition of asbestos usage. The second place is probably taken by malignomas among the underground uranium mine workers in Thuringia and Saxony (SDAG Wismut). Next come bronchial carcinomas with silicosis (carcinoma in scar tissue) after exposure to chromium(VI) and arsenic compounds as well as various other chemicals and metals. Dose-activity relationships are significant for all occupational carcinogenic agents, as there are also often syncancerogenic influences (especially smoking). From the data on previous loading, high risk groups, for example, among the insulation workers exposed to asbestos or uranium miners in the so-called "wild years", can be defined. A suitable screening method for the detection of bronchopulmonary tumors in the early stages has not yet been established. Medical checkups for the respective risk groups concentrate on the early X-ray detection of circular foci. As shown by recent studies, cytological sputum diagnosis, (fluorescence) bronchoscopy, and BAL cytology must be employed much more frequently in the high risk groups so that the prognostically more favorable stages of preneoplasm and carcinoma in situ can be detected and possibly treated curatively. These procedures are currently reaching a considerably higher sensitivity with the help of modern molecular biology techniques (e.g. detection of tumor-associated genetic changes and gene products). This contributes to an improvement in surveillance examinations with increasing detection of the curable early forms of tumors. However, only the further development of primary prevention, i.e. the greatest possible minimization or, if possible, total elimination of contact with carcinogenic agents and the consequent control of occupational protection will lead to a drastic reduction in the occupational risk of cancer.
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PMID:[Bronchopulmonary precancerous conditions and tumors--risk groups from the occupational medicine viewpoint]. 784 56

For the management of severe haemoptysis we have developed a double-lumen, bronchus-blocking catheter that can be introduced through the working channel of a standard fibrebronchoscope. We wondered whether this catheter would be suitable to control pulmonary haemorrhage in clinical practice. Over a period of 36 months, 30 of these catheters were used in 27 patients with moderate and massive pulmonary bleeding from various lesions. Underlying diseases were: malignancies (11), vascular deformities (5), tuberculosis (4), silicosis (2), carcinoids (2), silicosis (2), endometriosis (1), bronchiectasis (1). In 26 cases, the transbronchoscopic balloon tamponade was successful. In one patient, tumour growth close to the carina prevented securing of the balloon and double-lumen tube intubation was required. There were only minor complications attributable to the balloon. With the catheter in place for up to seven days, patients underwent surgery, received radiation, chemotherapy, drug treatment or bronchial arterial embolization. In conclusion, we found this double-lumen, bronchus-blocking device safe and the technique practicable to control pulmonary haemorrhage.
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PMID:Three years experience with a new balloon catheter for the management of haemoptysis. 787 78

Thrombotic thrombocytopenic purpura (TTP) causes severe haemolytic anaemia, thrombopenia, fever and neurological and renal involvement. Currently five large aetiologic groups have been identified: viral or bacterial infection, drugs, conjunctive tissue diseases, pregnancy and solid tumours. We observed two cases resulting from an adenocarcinoma. In the first case, a 71-year-old man with chronic silicosis, the presenting signs were asthenia, fever, epistaxis with diffus purpura and spontaneous haematomas of the lower limbs. Diagnosis of TTP was based on routine laboratory tests and the patient responded well to fresh frozen plasma. On the 5th day of treatment, haemoglobin level dropped sharply and melana occurred. Upper digestive tract endoscopy revealed a tumoural formation of the antrum-fundic junction and histology examination of the biopsy confirmed the diagnosis of adenocarcinoma. Ten months after gastrectomy the patient was in excellent health with no relapse of the TTP. In the second case, the presenting signs included spontaneous haematomas, rectorrhagia and low grade fever. Microscopic haematuria and renal failure were observed in addition to the biological syndrome of TTP. The patient responded poorly to fresh frozen plasma and packed cell transfusions. Plasma exchange was equally unsuccessful. The disease continued a fulminant course and the diagnosis of adenocarcinoma located in a pulmonary lymph nodes was made at autopsy. These rare cases of TTP caused by cancer emphasize the importance of a thorough aetiological research. Plasma exchange has been shown to be effective but mortality at 1 year approximately 85% in cancer related cases. Early diagnosis and specific anti-cancer therapy might improve prognosis. We report our personal experience with 16 other similar cases.
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PMID:[Thrombotic thrombocytopenic purpura disclosing cancer: apropos of 2 cases]. 763 25

Cancer incidence during 1953 to 1991 in 811 Finnish silicotic patients diagnosed between 1936 and 1977 was evaluated. In comparison with the general population, excesses were observed for all cancers (standardized incidence ratio, 1.7 [95% confidence interval, 1.4 to 1.9]), all lung cancers (2.9 [2.4 to 3.5]), squamous cell lung cancers (3.3 [2.3 to 4.5]), and skin cancers: melanoma (3.0 [0.8 to 7.6]) and nonmelanoma (2.9 [1.2 to 6.1]). Confounding by tobacco smoking did not explain the lung cancer increment. The consistency of the association between silicosis and lung cancer across a large number of studies suggests that silicosis represents a direct or indirect lung cancer hazard. The skin cancer excess, a relatively novel finding, may be explained either by carcinogens in foundries, or silica-induced lowering of immunocompetence, which would lead to a more pronounced effect of solar ultraviolet radiation.
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PMID:Increased incidence of lung and skin cancer in Finnish silicotic patients. 807 22

Pathological examinations of 233 consecutive autopsy cases with nonasbestos pneumonconiosis revealed evidence of diffuse interstitial fibrosis (DIF) in 64 (27.5%), among whom 45 (19.3%) showed bilateral involvement and 9 (3.9%) extensive disease closely resembling usual interstitial pneumonia. The patients with DIF were significantly older and had longer occupational histories as compared with those without DIF. There was no correlation between the occurrence of DIF and the type of the underlying disease (silicosis or mixed dust pneumoconiosis) except that an extensive DIF was more frequently associated with mixed dust pneumoconiosis. The extensive DIF developed an in situ malignancy much more frequently (33.3%) than the focal disease (2.6%).
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PMID:Diffuse interstitial fibrosis in nonasbestos pneumoconiosis--a pathological study. 834 54

Silicotics have increased mortality from tuberculosis (TB) and from nonmalignant respiratory diseases (NMRD), including silicosis and silicotuberculosis. Since the publication of the International Agency for Research on Cancer monograph in 1987 indicating that silica was a probable human carcinogen, there has been an extensive debate about the cancer risks among silicotics. The authors identified 590 claims for silicosis among a registry of lung diseases compiled from California Workers' Compensation cases from 1945 to 1975. Using state vital records, we determined the mortality risks from 1946 to 1991. Our findings confirmed that these claimants had a significantly elevated risk for all causes of death with a standardized mortality ratio (SMR) of 1.30 (95% confidence interval [CI] = 1.18, 1.43); TB had a SMR of 56.35 (95% CI = 41.10, 75.40) and NMRD a SMR of 3.80 (95% CI = 3.11, 4.60). Cancers of the trachea, bronchus, and lung had a SMR of 1.90 (95% CI = 1.35, 2.60). For malignancies of the large intestine, there was a previously unreported SMR of 2.08 (95% CI = 1.14, 3.50). Mortality from all diseases of the heart was significantly less than expected with a SMR of 0.68 (95% CI = 0.55, 0.83); cancers of the prostate and lymphatic system were also significantly low with SMRs of 0.26 (95% CI = 0.03, 0.94) and 0.17 (95% CI = 0.04, 0.97), respectively. Workers with silicosis should be warned about these chronic disease risks, and prevention efforts to control occupational silica dust exposure should become a higher priority.
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PMID:Respiratory cancer and other chronic disease mortality among silicotics in California. 853 88

The relation between exposure to crystalline silica and lung cancer has been a controversial topic, and findings have appeared inconsistent. In this paper, we focus on lung cancer risks in epidemiologic studies of silicotics. We abstracted data from 29 studies for quantitative evaluation. We identified several studies that suffered from biases due to competing risks of different causes of death--in particular, death due to silicosis itself. After adjustment for competing risks, all 29 studies demonstrated lung cancer relative risk (RR) estimates greater than one. The pooled RR estimate for the 23 studies that could be combined was 2.2, with a 95% confidence-interval (CI) of 2.1-2.4. The pooled estimates by study design were 2.0 (95% CI = 1.8-2.3) for cohort studies and 2.5 (95% CI = 1.8-3.3) for case-control studies. The proportional mortality studies combined gave a summary RR of 2.0 (95% CI = 1.7-2.4), whereas the studies of cancer incidence gave a summary RR of 2.7 (95% CI = 2.3-3.2). Although statistical tests demonstrated heterogeneity between studies, and the confidence intervals given above may therefore be a little too narrow, the overall findings could not be attributed to chance, confounding by smoking, or other sources of bias. We conclude that the association between silicosis and lung cancer is causal, either due to silicosis itself, or due to a direct effect of the underlying exposure to silica.
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PMID:Meta-analysis of studies of lung cancer among silicotics. 858 94


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