Underdiagnosis of silicosis revealed by reinterpretation of chest radiographs in Thai ceramic workers

Supakorn Chansaengpetch; Narongpon Dumavibhat; Rathachai Kaewlai; Apinut Jaroonpipatkul; Tirathat Virojskulchai; Sitthiphon Bunman; Kawintra Khantharot; Arunee Pholngam; Thanabadee Thanakunchai

doi:10.4081/mrm.2023.910

Underdiagnosis of silicosis revealed by reinterpretation of chest radiographs in Thai ceramic workers

Authors

Supakorn Chansaengpetch Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok https://orcid.org/0000-0003-4076-7751
Narongpon Dumavibhat Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok https://orcid.org/0000-0001-8587-7351
Rathachai Kaewlai Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok https://orcid.org/0000-0002-0650-9380
Apinut Jaroonpipatkul Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Tirathat Virojskulchai Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok https://orcid.org/0009-0002-8968-9600
Sitthiphon Bunman Department of Community and Family Medicine, Faculty of Medicine, Thammasat University, Khlong Luang District https://orcid.org/0000-0001-8751-1409
Kawintra Khantharot Department of Occupational Health, Lampang Hospital, Lampang
Arunee Pholngam Department of Occupational Health, Lampang Hospital, Lampang
Thanabadee Thanakunchai Department of Medicine, Bhumibol Adulyadej Hospital, Bangkok https://orcid.org/0000-0002-4475-0802

DOI: https://doi.org/10.4081/mrm.2023.910

Keywords:

Silicosis, ceramics, thoracic radiography, mobile health unit, occupational health physician

Abstract

Background: In Thailand, epidemiological data on silicosis in the ceramic sector is lacking and the underdiagnosis of silicosis remains an extensive concern. Therefore, this study aimed to determine the prevalence of silicosis and the extent of underdiagnosis among Thai ceramic workers by reinterpreting chest radiographs previously taken by a health check-up unit.
Methods: This retrospective cross-sectional study was conducted on ceramic workers undergoing health surveillance using chest radiographs in one ceramic factory in September 2018. All chest radiographs were done retrospectively, then were reinterpreted by professional readers specially trained in using the ILO International Classification of Radiograph of Pneumoconioses (ILO/ICRP). Chest radiographs with a profusion of 1/1 or greater were suggestive of silicosis.
Results: Out of the 244 participants undergoing chest radiography, the prevalence of silicosis was 2.9%. Overall, the mean age of the participants was 41 years, and 72.1% were female. Among individuals with silicosis, the median age was 43 years; 71.4% were male; the average employment duration was 26.9 years; while the male sex was the significant variable associated with silicosis with an odds ratio of 7.01 (95% confidence interval 1.31 to 37.4). Regarding the underdiagnosis, the health check-up unit failed to recognize all individuals with silicosis, and could not detect any radiographic chest abnormalities in 57.1% of those with silicosis.
Conclusions: Despite the low prevalence of silicosis among Thai ceramic workers, this finding indicates ongoing exposure to silica in the ceramic industry. In addition, a significant proportion of the silicosis cases were underrecognized. Future efforts to prevent underdiagnosis and improve an occupational health surveillance service in Thailand are needed.

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