Silicosis diagnostic criteria

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Diagnostic criteria

  • In general, the diagnosis of silicosis is a clinical diagnosis, When the three clinical requirements for the diagnosis of silicosis are met, additional evaluation is not necessary to make the diagnosis.
  • 1.Occupational history of crystalline silica exposure
  • 2.Characteristic radiologic findings as follows: simple chest X-ray with profusions ≥1/1 (see ILO classification)
  • 3.Other possible diseases ruled out.
  • An occupational history must be obtained to estimate accumulated exposure to silica dust. Occasionally job changes can make it difficult to obtain an accurate occupational history, but at least the following should be included[1]
  • Prior and current working activity, recording time of exposure to crystalline silica.
  • Detailed description of job.
  • Technical protective measures (use of waterjet cutter, ventilation, dust extraction) and individual precautions (masks).
  • Measurement of respirable dust, in order to determine accumulated exposure risk (when this information is available).
  • ILO Classification is a system of classifying radiographs (chest X-rays) for persons with pneumoconiosis. The intent was to provide a means for describing and recording systematically the radiographic abnormalities in the chest provoked by the inhalation of dusts
  • The International Labor Office (ILO) has established a classification coding radiological changes in a reproducible format.[2][3]
  • ILO Classification contains five sections:
  • Technical quality of radiographs:
  • 1: good,
  • 2: acceptable,
  • 3: poor, and
  • 4: unacceptable.
  • Parenchymal alterations: size, profusion, shape and site
  • Small opacities: Small opacities are described according to profusion, affected zones of the lung, shape and size.
  • Large opacities: A large opacity is defined as an opacity having the longest dimension exceeding 10 mm. There are 3 categories: A, B, and C.
  • Pleural abnormalities.
  • Symbols, for recording additional coded findings.
  • Comments, not included above.

References

  1. Fernández Álvarez R, Martínez González C, Quero Martínez A, Blanco Pérez JJ, Carazo Fernández L, Prieto Fernández A (2015). "Guidelines for the diagnosis and monitoring of silicosis". Arch Bronconeumol. 51 (2): 86–93. doi:10.1016/j.arbres.2014.07.010. PMID 25479706.
  2. Halldin CN, Petsonk EL, Laney AS (2014). "Validation of the international labour office digitized standard images for recognition and classification of radiographs of pneumoconiosis". Acad Radiol. 21 (3): 305–11. doi:10.1016/j.acra.2013.11.019. PMID 24507420.
  3. "GUIDELINES FOR THE USE OF THE ILO INTERNATIONAL CLASSIFICATION OF RADIOGRAPHS OF PNEUMOCONIOSES" (PDF).

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