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Accelerated silicosis has become uncommon in developed countries, whereas serious health threat still exists in small-scale mining in developing countries. This study was to investigate the prevalence and risk factors of accelerated silicosis among Chinese gold miners.A cross-sectional medical examination was conducted among 574 Chinese gold miners. All participants were male rock-drillers. The concentrations of total dust and quartz content were obtained from the government documentations. Descriptive data analyses were performed.The prevalence of accelerated silicosis was 29.1% (95% CI: 24.8-33.4%, 167 cases) after an average of 5.6 years of dust exposure, and a history of tuberculosis seemed to increase the risk. The concentration of respirable silica dust was estimated to be 89.5 mg/m3 (ranged: 70.2-108.8) in the underground goldmine, far exceeding the permissible exposure limits.This study illustrates a serious health threat to small-scale goldmine in China and indicates an urgent need for environmental control and disease prevention.