Silicosis and coal workers’ pneumoconiosis in Slovakia in the years 1981–2010

Summary

Introduction and objective:
Pneumoconiosis belongs permanently to serious occupational diseases. They occurred in considerable numbers also in Slovakia, especially in connection with the mining and processing of ores, and construction of railway tunnels in severe working conditions. The diseases often affected young people, and developed even as early as after 3 to 7 years of work at risk. These diseases markedly complicated and shortened the life. The aim of the work was a longitudinal study of the group of patients with acknowledged occupational disease.

Material and methods:
The entry criteria for selection of the disease: item No. 33 of the List of Occupational Diseases of CSSR, SR time period of 1981 to 2010.

Analyzed data:
acknowledgement of 33-1 simple silicosis, 33-2 complicated silicosis, 33-3 silicotuberculosis and 33-4 coal workers’ pneumoconiosis, the incidence according to age, sex, industrial branch and area of health institutions. The descriptive methods of statistical analysis were used.

Results:
In the 30 year period 1127 cases of pneumoconiosis were acknowledged in item 33 in the Slovak Republic, 787 of the cases being simple silicosis, 82 cases of complicated silicosis, 166 cases of silicotuberculosis and 92 diseases of coal workers’ pneumoconiosis. The annual rate revealed decreasing tendency with the exception of 1991, when the X-ray criteria indicating the limit for acknowledgement of occupational disease in simple and coal workers’ pneumoconiosis were reduced. That was the years when occupational diseases were acknowledged additionally in the Slovak Republic in the same way as in the Czech Republic (at the time of politic climate changes after November of 1989) as well as cases of increased risk of occupational diseases of respiratory system in the miner occupations. In the ten years of 1981 to 1990 520 cases of pneumoconiosis were acknowledged with 123 cases of silicotuberculosis (24% of this cohort), whereas in the ten years of 2001 to 2010 there were 214 cases of pneumoconiosis and only 9 cases of silicotuberculosis (4% of this cohort). The numbers of simple and complicated silicosis decreased markedly. The numbers of coal miner pneumoconiosis in the three compared decades were in the range of 30 (years 1981 to 1990) through 37 (years 1991 to 2000) to 31 cases (years 2001 to 2010). Most pneumoconioses were acknowledged in the branch of coal and ore mining. The positive tendency in the years of 2001 to 2010 is suggested by the fact that among 214 cases of pneumoconiosis, 97 pneumoconioses were acknowledged at the age of 60 and higher. In these previous miners at the retirement age, however, there were most – 11 – cases of silicotuberculosis, which draws attention to importance of epidemiological vigilance. Only 7 cases of pneumoconiosis were acknowledged at the age of up to 40 years and no cases of complicated silicosis was detected. There were 4 women in the cohort, 3 of them with simple silicosis and one with silicotuberculosis 3 years after the acknowledgement of simple silicosis after 60 years of life. The highest number of pneumoconioses was acknowledged in the Košice region, where there were also most cases of silicotuberculosis. The second position in the number of pneumoconioses, mainly silicosis and coal miner pneumoconiosis was occupied by the Trenčín region.

The decreasing numbers of pneumoconioses is associated with reduction of coal and ore mining, decreased production in metallurgy, which became manifest in the Slovak Republic after 1990 by decreasing numbers of workers exposed to work at risk. Moreover, more consistent hygienic-technical procedures were introduced including protection and promotion of health of the employees. The decrease of silicotuberculosis follows the decrease of tuberculosis incidence in the Slovak population.

Pneumoconioses belong to preventable diseases. It is the task od the society, public health and occupational medicine to contribute of improvement of primary prevention to uncover and reduce the works at risk in so far unregistered working activities with the risk of fibrogenous dust. In the dispensarization of the patients by occupational medicine workplaces is necessary to at least slow down the progress by remedies of secondary prevention including setting right the life style in this group of patients.

Key words:
occupational disease – pneumoconiosis – silicotuberculosis – industrial branch – gender – case report in women – workers at risk