0423 Development of a disease surveillance system for Silicosis and respiratory disorders in stone carving workers in Thailand
本研究针对泰国石雕工人开发了矽肺监测系统，发现767名参与者中8.9%有影像学异常，其中55例与结核病相似，提示两者鉴别困难，并正在制定筛查指南。
<sec><st>Objectives</st> To (a) develop a surveillance system for silicosis (b)estimate prevalence of silicosis and respiratory disorders among stone carversand (c) develop a guideline for screening for silicosis. </sec> <sec><st>Method</st> This was a cross-sectional, descriptive study of 1257 stone carvers. Data were collected between July and October, 2012. The 767 participants in the study were classified by job categories. Exposure indices were constructed. Health outcomes (including job description, respiratory symptoms and chest radiographs) were assessed and confirmed bydiagnosis by a B reader. </sec> <sec><st>Results</st> Of the total population, 767 underwent chest radiographs (age24 to 75 years; 97.1% male). The duration of exposure was between 2 and 30 years. The prevalence of radiographic change was 8.9%(68 subjects). There were 66 subjects with parenchymal lesions and profusion (> grade 1/0 as per ILO classification). Two subjects have pleural abnormalities. Importantly, 55 cases among 68 with radiographic abnormalitieswere compatible with tuberculosis; 32 of whom showed no clinical evidence of tuberculosis. </sec> <sec><st>Conclusions</st> The diagnostic differentiation between silicosis and tuberculosis ischallenging; consequently, discrepancies can arise when reporting the prevalence of the two diseases. Our research group isdeveloping CPG for screening silicosis forreferral to a clinician in chest medicine. The remaining at-risk population will be examined by chest X-ray in July 2013 and the hazard surveillance and exposure to silica performed next. </sec>