Clinical, spirometric, radiological characteristics and disease biomarkers in a silicosis patients cohort in north Sardinia-Italy

Silicosis is a lung disease due to respirable crystalline silica (RCS) exposure that progressively leads to an irreversible lung damage. It is associated with different conditions (mycobacterial diseases, autoimmune disorders, chronic obstructive pulmonary disease (COPD), lung cancer, respiratory failure (RF), etc). In the past years screening programs have allowed early diagnosis but assessing its evolution is still an unmeet need. <bold>Methods:</bold> This is an observational longitudinal study on gravel mine workers diagnosed with silicosis in the last thirty years followed until 2023. <bold>Results:</bold> we assessed 70 patients, all males, with a mean age at diagnosis of 52 years old and a mean RCS exposure of 27 years. Most workers (80%) did not use any protective equipment and were employed in a dry processing (98%). 60% of the subjects had a previous or active smoking history with a mean 18 packs years. The mean FEV1/FVC% was 75% and the mean FEV1% was 79%. 17% suffered from pulmonary tuberculosis on average 7 years after the diagnosis. COPD (40%) and RF (27%) were the most frequent comorbidities observed, the latter with the poorest prognosis. Seven individuals (10%) died with a mean survival rate of 17 years mostly for RF (85%). Our preliminary data showed a correlation between exposure time, dry processing and RF onset (p<0,005), while an elevated neutrophils/lymphocytes ratio at the time of diagnosis was associated with an high risk of RF (p<0,005). <bold>Conclusion:</bold> Silicosis is a work related lung condition with a severe prognosis and fatal comorbidities. Identify clinical, laboratorial or functional markers of the disease progression could improve the management of this patients.