Denim Sandblasting and Silicosis: Two Case Reports

Background: Silicosis is one of the oldest recorded occupational lung diseases, known since the time of Hippocrates and the ancient Egypt. It is an untreatable illness characterised by irreversible and progressive fibrotic reaction in the lung tissue caused by inhaling silica dust crystals with aereodynamic diameters of 0.5-5.0 micron diameter. It is a significant cause of mortality in the developing or the underdeveloped countries of the world. Denim cloth sandblasting has become a job type causing the development of silicosis and although banned in Turkey in 2009, there are still cases being reported. We present here the case of two patients diagnosed with acute and accelerating silicosis. Cases: Two male patients of 21 and 22 years of age, employed in the past in denim cloth sandblasting for approximately one year consulted our clinic with complaints of dyspnea and/ or weight loss. In both cases imaging by posteroanterior x-ray radiography andcomputerised tomography (CT) revealed dispersed reticulonodular and nodular opacities in the upper and middle zones and periheral regions of the lungs. After respiratory function tests, one of the patients was determined to have restrictive type of repiratory dysfunction and, given the symptoms, the radiological findings and the professional exposure to dust, was diagnosed with acute silicosis without the need for any invasive diagnostic intervention. The other patient developed obstructive type of repiratory disorder during follow up control. He was diagnosed with accelerated silicosis after wedge resection biopsy. Conclusion: Worldwide popularity of the semi-bleached denim cloth has resulted in the switch of the required sandblasting technology from countries which have banned the technique to countries like Bangladesh and India with tolerance of the activity and cheaper labour costs. Although sandblasting of cloth was banned in Turkey in 2009, occasional cases of silicosis are being met. As this type of occupation continues to threaten public health, there is need for effective intervention by the World Health Organisation (WHO) and the local health authorities in informing the public as well as controlling the work places.