A significant proportion of workers exposed to silica dust are at risk of developing tuberculosis (TB). The higher the International Labor Organization (ILO) category of silicosis, the greater the TB risk. Subtle radiographic presentations of TB may be the initial manifestation of TB, particularly in the absence of sputum identification of TB bacilli. A proposed TB x-ray-reading form in addition to the ILO categorization of silicosis is offered. The implementation of a standardized TB x-ray-reading approach should alert the clinician to indolent TB lesions.
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