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Electronic letters published:
![[Read eLetter]](/icons/misc/sectionDOWN.gif){kind=icon}
Need to emphasise limitation of diffusion capacity in silicosis
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Rhett S. Kahn, occupational health practitioner private practice
Send letter to journal:
rkahn{at}icon.co.za Rhett S. Kahn
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The article outlines the definite impairments caused by silicosis. This importantly shows the loss in diffusion capacity; a parameter that has been ignored for too long in an interstitial lung disease. Regretfully compensation in South Africa, and as far as I am aware most countries, is determined primarily on the impairment of FVC & FEV1. The deterioration in FVC & FEV1 may be delayed and does not necessarily closely follow the nodular progresion of the disease on x-ray. Having decided to do blood gases after 6 minutes of exercise, as a cost-effective alternative measure of interstitial disease, I was surprised to find there appears to be no clear cut linear relationship between the arterial oxygenation and arterial CO2 levels and the nodular progression and static lung functions in silicotic disease. There is a need to assess the oxygen diffusion within the different categories of silicosis and use this data to determine the respiratory impairment of workers suffering from silicosis. It does not necessarily follow that if the FVC & FEV1 values are above 70% of predicted that the worker does not suffer from interstitial disease as evidenced by decreased arterial oxygenation after exercise. Compensation and fitness to work criteria need to include blood gas measurements after exercise or work. |
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