Balkan Medical Journal
Original Articles

Premature Deaths Due to Silicosis in Turkey, 2006–2017: A Twelve-Year Longitudinal Study


Department of Occupational Medicine, İstanbul Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey


Department of Public Health, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey


Department of Pulmonology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey


Department of Pulmonology, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey

Balkan Medical Journal 2021; 38: 374-381
DOI: 10.5152/balkanmedj.2021.21208
Read: 206 Downloads: 30 Published: 15 November 2021

Background: Deaths due to epidemics of silicosis still continue to be reported both in developing and developed countries, and silica exposure from different sectors remains an important occupational health

Aims: To identify characteristics of silicosis cases by focusing on a developing country and evaluate the frequency of and factors related to premature deaths and also reveal preventable causes of premature
deaths in silicosis.

Study Design: Retrospective cohort.

Methods: We reviewed the records of 9769 patients who were diagnosed with occupational diseases in İstanbul Occupational Diseases Hospital between 2006 and 2017. According to International Classification of Diseases (ICD)-10 codes, 1473 silicosis cases were detected. The sociodemographic characteristics, job characteristics, comorbidities, serological, functional, and radiological data, and follow-up time were
obtained from the medical records. Mortality data were gathered from The National Death Notification System of Ministry of Health.

Results: The study examined 9769 cases diagnosed with an occupational disease, and 15.0% (n = 1473) of them were diagnosed with silicosis. The median age of silicosis patients was 40.0 years, and 26.9% of them were child labor when they started to work in dusty industries. Child labor was mostly seen among dental technicians (57.7%), denim sandblasters (46.4%), and miners (37.0%). In the follow-up period, 26.3% of Teflon sandblasters, 11.1% of coal miners, 8.6% of denim sandblasters had died before their average life expectancy, and the years of loss of life was 26.0 ± 11.6 years all over the group. Premature death was associated with occupation [hazard ratio (Teflon sandblasting): 3.93, CI: 1.43-10.78; hazard ratio (marble production): 4.4, CI: 1.02-19.21]; large opacities in posterior anterior chest X-ray [hazard ratio: 2.14, CI: 1.18-3.86]; tuberculosis [hazard ratio: 2.60, CI: 1.42- 4.76]; and reduction in forced vital capacity (forced vital capacity% ≤80) during diagnosis [hazard ratio: 4.43, CI: 2.22-8.83].

Conclusion: More than a quarter of silicosis cases are those who start working in dusty industries at an early age. Factors associated with premature death in patients with silicosis are patient occupation, large opacities on chest X-ray, tuberculosis, and pulmonary function loss at diagnosis.

Cite this article as: Altundaş Hatman E, Acar Karagül D, Oyman EK, Tüzün B, Şimşek KO, Kılıçaslan Z. Premature deaths due to silicosis in Turkey, 2006-2017: A twelve-year longitudinal study. Balkan Med J. 2021; 38(6):374-381.

ISSN 2146-3123 EISSN 2146-3131