LABORATORY AND RADIOGRAPHIC DIFFICULTIES IN MONITORING INDIVIDUALS OCCUPATIONALLY EXPOSED TO CRYSTALLINE SILICA

Resumo

INTRODUCTION: Approximately 2 million Brazilian workers are exposed to respirable crystalline silica, a mineral widely present in nature. Occupational exposure is common, especially among miners, and occurs through the inhalation of dust containing silica. Inhaled particles can reach the pulmonary alveoli, favoring the development of diseases such as silicosis, cancer and COPD. OBJECTIVE: To analyze clinical records and radiographic reports of miners exposed to crystalline silica, with the aim of evaluating health outcomes, considering medical records and reports at two different times and by different professionals. METHODOLOGY: This study was carried out with prior approval from the CAAE of the Federal University of Rio Grande do Sul, No. 53706121.6.1001.5347. Initially, 77 miners' medical records were analyzed, and from these, 36 miners who presented radiographic reports in accordance with the standards of the International Labor Organization (ILO) were selected to continue the study. Chest radiographs were analyzed by two ILO-certified pulmonologists. These records were initially  evaluated in 2016/2017 and subsequently in 2024 by other professionals. RESULTS AND CONCLUSIONS: Analyzing the workers' medical records and questionnaires, a gap in communication between patient and physician was observed. Five miners, when answering the questionnaire, claimed not to have silicosis, although the disease had already been diagnosed in their medical records. Of these, 2 had silicosis and mild chronic obstructive pulmonary disease (COPD), 2 had silicosis and mild obstructive ventilatory disease (VOD), and 1 had mild silicosis. When checking the data from the analyses of radiographs performed in 2021 by different ILO-certified professionals, differences were found between the results. It was observed that patients who, according to the analysis of one professional, did not have silicosis and in another analysis, performed by a second professional, had silicosis with grade 2 profusion. The hypothesis that may explain these differences is the quality of the equipment used by the professionals who performed the radiographic evaluations. Therefore, the quality of chest radiographs and the equipment used by ILO-accredited physicians can clearly contribute to these differences, demonstrating the need for accredited professionals, but also for high-quality equipment to evaluate radiographs.