Qualitative method to re-evaluate cases of acute and accelerated silicosis from West Bengal

Abstract

Background: A marginal farmer’s income is inadequate to sustain a decent living. Hence, they work in brick fields or similar jobs during the lean season, which generates respirable dust containing silica. Lungs are sensitised. Lung already sensitised to crystalline silica, and the lack of use of personal protection equipment during this work worsen the symptoms. Objectives: Evaluate the actual cumulative period of exposure in brick fields and ramming mass industry. Combine the Direct Acyclic Graph and Bradford Hill Graph to identify the causal pathway. To find out the epidemiological pathway, follow a characteristic pathway. Results: Twenty-five workers are affected by Silicosis; two medical officers of the local hospital and one interviewee have been interviewed in depth.  Thematic content analysis using open, axial, and selective has been used for coding. Interviews have been coded as explained, and reached saturation. Objectives has been achieved by eight interviews. Data Triangulated with ILO/WHO radiographic grade (mostly 1/2/3), health camp data, and DAG modelling of confounders such as chronic malnutrition. Worked in the brickfield for some years, not recorded, the only record is of the brickfield lung already affected by respirable crystalline silica only worsens even for a short time. . ILO ratings indicated moderate to severe profusion; all Bradford Hill requirements were satisfied, affirming cumulative RCS as the causative factor inside migratory chains from farms to kilns through intermediaries. Conclusion: Gradual improvement in the social and economic context and advocacy for active community nutrition, promotion of personal protective equipment and screening may prevent silicosis.