Silicosis prevalence and related issues in India: a scoping review.

Background: Silicosis remains a major occupational health challenge in India. This review systematically examines the prevalence, risk factors, regional differences, and diagnostic tools specific to India's high-risk industries. Additionally, it assesses policy gaps and offers insights from diverse clinical and qualitative studies, aiming to inform targeted public health interventions and support the development of effective occupational health policies.

Methods: For this review, data were extracted for each study, including author, location, design, study aims, sample size and characteristics, participant age, duration of silica exposure, diagnostic criteria, and primary outcomes. As an add-on analysis included, a random-effects meta-analysis was used to estimate the pooled prevalence of silicosis and assess variability among studies. The review also included qualitative analyses on awareness, diagnostic tools (e.g., CC16 protein), and differences in prevalence across various occupational groups and regions within India.

Results: The review initially identified 263 articles, narrowed down to 49 eligible studies on silicosis in India after exclusions and quality assessment. Among these, 11 prevalence studies (total sample size: 2072) showed an average silicosis rate of 31.39%. Specific studies reported high rates, including 52% among Rajasthan mine workers and 69.1% among Khambhat agate workers. Additionally, screening tools, like CC16 protein levels, showed promise for early diagnosis, while qualitative studies highlighted gaps in awareness and regulatory practices. Meta-analysis revealed a significant pooled prevalence (25.98%) and marked variability (I = 98.86%), underscoring the need for targeted interventions and worker protections.

Conclusions: This review of current knowledge on silicosis in India finds silicosis highly prevalent among workers in mining and stone industries, with gaps in regulatory enforcement and awareness. Biomarkers like CC16 offer the potential for early diagnosis, underscoring the need for preventive measures. Policy recommendations include stricter dust exposure limits, enhanced workers' education, routine screening, and improved access to protective equipment and health monitoring to reduce the risk of silicosis and health disparities in vulnerable occupational groups.