P-170 RAPIDLY PROGRESSIVE SILICOSIS IN INDUSTRIAL COBALT MINE WORKERS: TWO CASES FROM DR CONGO

Abstract

Abstract Introduction Silicosis remains the most important occupational lung disease worldwide. However, the condition is not often diagnosed, even in the Katangan Copperbelt, an area of intense mining in DR Congo. Methods We analysed the medical and occupational history of two patients with probable pneumoconiosis identified in a public hospital in Kolwezi, when preparing a case-control study into occupational respiratory disease. Results Patients X (23y) and Y (40y) were non-smoking men who had been admitted, in May 2023, with chronic cough, dyspnoea and chest pain and were treated for pulmonary tuberculosis (without bacteriological evidence in patient Y). Chest x-rays read according to the ILO International Classification of Radiographs of Pneumoconioses showed diffuse small round opacities (r/q; 3/2) with larger opacities (B) in the left upper zone in addition to background ground glass opacities in patient X; and small opacities (q/q; 2/2) and a larger opacity (A) next to the left heart border in patient Y. Both men had worked for three and four years as ore-crushing operators in industrial surface mines, with unprotected exposure to mineral dust, presumably rich in silica. Patient X died in acute respiratory failure in June 2023. Discussion These two cases of severe pneumoconiosis after only short but presumably high exposures to silica-containing dust reveal a hitherto poorly documented existence of silicosis (including silico-proteinosis and rapidly progressive silicosis) in the mining basin of Kolwezi, the “world capital of cobalt”. Conclusion Efforts must be done to protect worker health and develop awareness of occupational diseases in the mining areas of the DR Congo.