Prevalence of silicosis, tuberculosis among silicotic individuals, and silico-tuberculosis in India: A systematic review

Silicosis, a progressive and irreversible pneumoconiosis resulting from crystalline silica particle inhalation, represents a significant occupational health burden in India. This condition disproportionately affects workers in high-risk industries, such as mining, construction, and manufacturing. Silicosis not only increases susceptibility to tuberculosis (TB) infection but also adversely impacts TB outcomes. Despite the long-established association between silicosis and TB, a clear understanding of the burden within the Indian context has remained unexplored. A thorough search of electronic databases was conducted to identify relevant studies reporting on the prevalence of silicosis, TB, and silico-tuberculosis (concurrent silicosis and TB). Data extraction and meta-analyses were conducted to estimate pooled prevalence proportions, employing random or fixed-effects models based on heterogeneity assessments. The analysis included four studies, encompassing 953 participants in the silicosis group and 959 participants in the TB group. Meta-analytical results yielded a pooled silicosis prevalence of 39.87 per 100 observations (95% CI: 21.43-58.31). TB in silicotic individuals was 40.99 per 100 observations (95% CI: 5.18-76.80), while the proportion of silico-tuberculosis cases was 8.74 per 100 observations (95% CI: 5.01-12.47). Notably, substantial inter-study heterogeneity was observed. This review reveals the prevalence of silicosis, 39.87 per 100 observations, and TB among silicotic individuals was 40.99 per 100, with 8.74 per 100 affected by silico-tuberculosis. These findings underscore the urgent need for enhanced occupational health measures and further comprehensive research across diverse Indian populations.