The 2021 tuberculosis (TB) preventive treatment guidelines in India included silicosis as a screening group, yet latent TB infection (LTBI) testing for silica-dust-exposed individuals is underemphasized. Focusing on an estimated 52 million silica-dust-exposed workers, particularly agate-stone workers in Khambhat, Gujarat, our study aims to estimate LTBI prevalence, identify predictors, and gather insights from TB and silicosis experts. Employing a sequential explanatory mixed-methods approach, a cross-sectional study involved 463 agate-stone workers aged ≥ 20 years in Khambhat, using IGRA kits for LTBI testing. In-depth interviews with experts complemented quantitative findings. Among agate-stone workers, 58% tested positive for LTBI, with predictors including longer exposure, type of work, and BCG vaccination. Our findings reveal a nearly double burden of LTBI compared to the general population, particularly in occupations with higher silica dust exposure. Experts advocate for including silica-dust-exposed individuals in high-risk groups for LTBI testing, exploring cost-effective alternatives like improved skin sensitivity tests, and shorter TB preventive treatment regimens to enhance compliance. Future research should explore upfront TB preventive treatment for silica-dust-exposed individuals with high LTBI prevalence and optimal exposure duration. This study underscores the urgent need for policy changes and innovative approaches to TB prevention among silica-dust-exposed populations, impacting global occupational health strategies.

Objective: To compare the clinical and imaging characteristics of patients with stage I coal worker\'s pneumoconiosis (CWP) . Methods: All 347 cases of coal workers\' pneumoconiosis diagnosed in the Third Hospital of Peking University from January 2014 to December 2018 were included in the study. According to different working posts, the subjects were divided into three categories: mining, tunneling and mixing workers. Dust exposure duration, initial dust exposure age, diagnosis age, latency, small shadow shape and lung regions distribution in X-ray chest film of different categories of CWP patients were analyzed. Results: Among the 347 patients, 216 were mining workers (62.2%) , 77 were tunneling workers (22.2%) and 54 were mixing workers (15.6%) . The dust exposure duration of mining, tunneling and mixing workers were (14.5±7.0) , (16.3±8.2) and (19.0±8.8) years, respectively. There are statistically significant differences in dust exposure duration between different categories of workers (P<0.05) . There were no significant difference in the age of diagnosis, initial dust exposure age and the latency between different categories of workers (P>0.05) . The X-ray films of mining, tunneling and mixing workers showed small round shadow, accounting for 50.9% (110/216) , 96.1% (74/77) and 96.3% (52/54) respectively. 48.1% (104/216) of the mining workers and 38.9% (21/54) of mixing workers, the distribution of small shadow in chest X-ray films reached middle and lower lung regions, while in the 48.1% (37/77) of the tunneling workers, the distribution of small shadow in chest X-ray films reached lower lung regions. There were differences in above indicators among workers with different categories (P<0.05) . Conclusion: The dust exposure duration, the shape and the distribution of lung area on chest X-ray films are different in stage I CWP patients of different occupational categories.
目的： 探讨不同工种煤工尘肺壹期患者的临床和影像学特征。 方法： 收集2014年1月至2018年12月在北京大学第三医院诊断为煤工尘肺壹期的347例患者资料。根据不同作业岗位将患者划分为采煤工、掘进工和混合工3类工种，分析不同工种患者的接尘工龄、开始接尘年龄、诊断年龄、潜伏期、X射线胸片小阴影形态及肺区分布。 结果： 347例患者中采煤工216例（62.2%）、掘进工77例（22.2%）、混合工54例（15.6%）。采煤工、掘进工、混合工的接尘工龄分别为（14.5±7.0）、（16.3±8.2）、（19.0±8.8）年，不同工种间差异有统计学意义（P<0.05）；不同工种患者的诊断年龄、开始接尘年龄和潜伏期差异均无统计学意义（P>0.05）。采煤工、掘进工、混合工X射线胸片表现为圆形小阴影者分别占50.9%（110/216）、96.1%（74/77）、96.3%（52/54）。48.1%（104/216）的采煤工和38.9%（21/54）的混合工X射线胸片小阴影分布范围达到双中和双下4个肺区，48.1%（37/77）的掘进工小阴影分布范围为双下肺区；不同工种患者X射线胸片小阴影形态分布和肺区分布差异均有统计学意义（P<0.05）。 结论： 不同工种煤工尘肺壹期患者的接尘工龄、X射线胸片小阴影形态和肺区分布范围存在差异。.