A Roadmap to Combat Silica-tuberculosis

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The relationship between silicosis and tuberculosis is complex and often challenging to address. Both lung diseases gravely affect communities throughout India and while many of the symptoms are similar, the causes and treatment plans for each are distinct. Tuberculosis is an infectious bacterial disease and unlike silicosis, can be treated with proper medication, whereas silicosis can only be managed, never cured. Conversely, silicosis is entirely preventable. The illness develops due to unhealthy exposure to silica dust, and so limiting this exposure dramatically reduces the likelihood of an individual developing the disease.

However, throughout mining communities in Rajasthan and Gujarat, a lack of awareness about silicosis combined with insufficient safety measures puts thousands of mine workers at risk, many of which develop the disease and eventually are forced to stop working and die decades younger than otherwise projected. According to a number of national laws (the Workman Compensation Act of 1923, the Mine Act of 1952 and the Silicosis Rule of 1955) mine workers have a right to a healthy and safe working environment, and workers who develop occupational lung diseases, like silicosis, are owed compensation by their respective state government. Therefore, unlike TB, a silicosis diagnosis ascribes responsibility for the health issue onto the mine site and the government.

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Silicosis is often confused with TB and miners are frequently misdiagnosed. Moreover, TB and silicosis are often co-occurring diseases—together named silica-tuberculosis—as silicosis significantly increases a patients vulnerability to contracting TB. This creates two key problems: 1) it makes it possible for a patient who has silicosis or silica-tuberculosis to be misdiagnosed as someone who only has tuberculosis, which voids their ability to access compensation for the occupational health hazards from which they are suffering; and 2) it further exacerbates the spread of TB, a disease that infects 9 million new patients annually and has been declared a global health emergency by the World Health Organization for nearly 30 years. Considering this, a joint approach is essential to properly address both silicosis and TB.

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GRAVIS has worked to treat and prevent silicosis and TB for many years, and as part of their effort to advocate for better health in Rajasthan, especially within mine worker communities, GRAVIS organized a two day long workshop in partnership with the International Union Against Tuberculosis and Lung Disease in Jodhpur on July 6th and 7th to address the link between these diseases. The workshop joined together over 50 professionals from a variety of backgrounds, including medicine and public health, government and politics, non-profits and community organizing, and the mining industry, to share expertise and develop a road map to combat silica-tuberculosis.

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