PART A READING - SILICOSIS

READING TEXT 2 – Some expert opinions

PART A READING - SILICOSIS
READING TEXT 3 – Compensation payments
PART A READING - SILICOSIS

READING TEXT 4 – Some findings

Br J Ind Med 1991;48:267-269

doi:10.1136/oem.48.4.267
The relationship between fibrosis of hilar lymph glands
and the development of parenchymal silicosis.
1. J Murray,
2. I Webster,
3. G Reid,
4. D Kielkowski
Author Affiliations: National Centre for Occupational
Health, Braamfontein, Republic of South Africa.

Abstract
The necropsy findings on the cardiorespiratory organs of
849 South African gold miners were analysed to test the
hypothesis that fibrosis of the hilar lymph glands
predisposes to the development of parenchymal silicotic
nodules. Four hundred and eighty three cases had
fibrosed glands, 34% of which also had parenchymal
silicosis. By comparison, of 238 cases with silicosis, 88%
had fibrosed glands. The proportion of cases with both
silicosis and fibrosed glands, as well as those with gland
fibrosis only, increased with increasing duration of
exposure. As far as can be ascertained from a necropsy
series such as this, it is possible that fibrosis of the
lymph glands may predispose to the development of
lung parenchymal silicosis
 Part A Reading: Silicosis:

GAP FILL EXERCISE - Silicosis

In the first text, a global picture of the incidence of Silicosis is given. China, Vietnam,
Brazil and [India] have all reported high levels of the disease. It would seem that
worldwide there’s a widespread ignorance about its [magnitude] . Unfortunately,
many nations do not exercise adequate [preventative] measures, for example
controlling the generation, [release] and spread of [dust] in the workplace, having
[respiratory] protection - and not enough legislative [enforcement] .

Research done by John Bisby and Haydn Walters has similar yet different results.
Bisby believes the silica issue is basically [over] and that Australian industry is [free]
of [silicosis] . In fact, Bisby refers to Silicosis as being a fairly [mild] disease. Walters
agrees that lung diseases due to exposure to [dust] are largely [historic] . He does,
however, add a proviso: if [regulations] are not strenuously observed, Silicosis will
still continue to [appear] .

Does fibrosis of the hilar lymph glands predispose an individual to the development
of parenchymal silicotic nodules? Research amongst 849 South African gold miners
revealed that 483 had fibrosed glands and of these, about one

• third
• 128

had parenchymal silicosis. 238 suffered from silicosis. 88% of this cohort had
fibrosed glands. Only the remaining 12% or ##17## would appear to have been
disease-free. Increasing duration of [exposure] to mining increased the [proportion]
of cases with both [silicosis] and [fibrosed] glands.

These findings led the researchers to the conclusion that it is indeed possible that
fibrosis of the lymph glands may predispose to the development of [lung]
parenchymal silicosis.

Table 3.1 sets out compensation payments during 2004 - [2005] grouped according
to disease for the New South Wales Dust Diseases Scheme. The four diseases which
represented the most affected workers were [mesothelioma], [asbetosis] [silicosis]
and [ARPD]