Silicosis
Conditions
Brief summary
An observational cohort study that will assess the efficacy of Whole Lung Lavage in workers with silicosis or silica-induced bronchitis.
Detailed description
BACKGROUND: Silicosis is a fatal lung disease caused by inhaling silica particles. Australia is currently facing an epidemic with hundreds of young workers having contracted silicosis from machining engineered stone. AIMS: To determine the effectiveness and safety of Whole Lung Lavage (WLL) in workers with silicosis due to significant engineered stone exposure. DESIGN: Participants (30) with silicosis or silica-induced bronchitis who are scheduled to undergo WLL as part of their normal care will be enrolled. They will undergo the following interventions pre and 3 months post WLL, some of which would have been carried out as part of routine standard care: 1. Complex pulmonary function tests (PFTs) - standard care 2. HRCT scan (if not within 6 months of WLL) - standard care 3. Blood tests 4. Cardiopulmonary exercise testing 5. Forced oscillatory technique 6. XV Lung Ventilation Analysis 7. Questionnaires (K-BILD and LCQ)
Interventions
Whole Lung Lavage (WLL) is performed as standard of care. Outcome following WLL is observed.
Sponsors
Study design
Eligibility
Inclusion criteria
* Males and females aged \>=18 years and scheduled for WLL at the study site as part of routine clinical care * History of exposure to respirable crystalline silica (RCS) while working in an at-risk industry (e.g. stonemasonry, construction, tunnelling, concreting, mining) * Elimination of workplace exposure to RCS for a minimum of 6 months * Ground glass nodularity \> extent of solid nodularity on HRCT, as judged by investigator or evidence of silica-induced bronchitis * Evidence of disease progression within the past 2 years, defined as any of * a relative decline in the FVC or FEV1 of at least 5% of the predicted value, * worsening of respiratory symptoms * increased extent of silicosis on high-resolution CT scan * Able to understand and sign a written informed consent form (or legally authorised representative)
Exclusion criteria
* Ongoing workplace exposure to RCS or removal of workplace exposure of less than 6 months * Progressive massive fibrosis, defined as areas of confluent fibrosis with diameter \> 10mm on HRCT. * FEV1 or FVC \< 50% predicted * DLCO \<50% predicted * Contraindication to WLL, as judged by the investigator * Actively or imminently listed for lung transplantation * Females with a positive pregnancy test at screening or currently breastfeeding * Any history of malignancy likely to result in significant disability or likely to require significant medical or surgical intervention within the next 24 months * Any condition other than silicosis that, in the opinion of the investigator, is likely to result in the death of the participant within the next 24 months * Significantly impaired cardiac function
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The primary outcome for evaluating WLL will be change in dual blind read CT ICOERD score from baseline to 3 months post WLL. | 3 months | Change in absolute dual-read CT ICOERD score at 3 months post-WLL. Data collected will be evaluated by a central reader blinded to treatment assignment. Baseline characteristics will be summarised for each group. Differences between group mean changes in CT ICOERD scores from baseline to 3 months will be tested using an independent sample t-test. |
Countries
Australia