<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2183-8453</journal-id>
<journal-title><![CDATA[Revista Portuguesa de Saúde Ocupacional online]]></journal-title>
<abbrev-journal-title><![CDATA[RPSO]]></abbrev-journal-title>
<issn>2183-8453</issn>
<publisher>
<publisher-name><![CDATA[Ajeogene Serviços Médicos Lda]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2183-84532022000100157</article-id>
<article-id pub-id-type="doi">10.31252/rpso.25.06.2022</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[SILICOSE]]></article-title>
<article-title xml:lang="en"><![CDATA[SILICOSIS]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Almeida]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lopes]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Especialista em Medicina Geral e Familiar Licenciada em Medicina ]]></institution>
<addr-line><![CDATA[Gondomar ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidade Católica Portuguesa Instituto da Ciências da Saúde - Escola de Enfermagem Enfermeiro Especialista em Enfermagem Comunitária, com Competência Acrescida em Enfermagem do Trabalho]]></institution>
<addr-line><![CDATA[Gondomar ]]></addr-line>
</aff>
<aff id="Af3">
<institution><![CDATA[,Licenciada em Enfermagem  ]]></institution>
<addr-line><![CDATA[Braga ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>06</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>06</month>
<year>2022</year>
</pub-date>
<volume>13</volume>
<fpage>157</fpage>
<lpage>171</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2183-84532022000100157&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2183-84532022000100157&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2183-84532022000100157&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO  Introdução/enquadramento/objetivos As pneumoconioses são as doenças profissionais mais frequentes. A Silicose é causada pela inalação de Sílica cristalina respirável. Trata-se de uma patologia pulmonar fibronodular intersticial difusa. Inicialmente ela é assintomática, contudo, geralmente progressiva e sem cura. O diagnóstico fundamenta-se parcialmente na história profissional de exposição. É mais prevalente em países com uma taxa de desemprego considerável e/ou pouca ou nenhuma vigilância da Saúde e Segurança no trabalho.  Metodologia Trata-se de uma Revisão Bibliográfica, iniciada através de uma pesquisa realizada em janeiro de 2022, nas bases de dados &#8220;CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina e RCAAP&#8221;.  Conteúdo A Sílica ou o dióxido de silício (SiO2) é constituída por oxigénio e silício. Na natureza existe nas formas amorfa e cristalina. A International Agency for Research on Cancer (IARC) considerou a Sílica cristalina inalada como cancerígena para humanos (grupo 1), provavelmente devido ao dado celular, inflamação, stress oxidativo e inibição da clearence. A Sílica amorfa não é considerada cancerígena para humanos (grupo 3). A Silicose existe em todos os países, mas é mais prevalente nos menos desenvolvidos, mesmo percebendo-se que a incidência real deverá ser superior à oficial, devido à situação estar sub-reportada. Nos países mais desenvolvidos a incidência/prevalência tem diminuído, devido à melhoria das condições de trabalho. A exposição é relevante via inalatória; vias cutânea e digestiva não têm geralmente consequências importantes em contexto laboral. O risco para a saúde varia com a concentração, dimensão das partículas- diâmetro, superfície e forma (mais perigosas se mais pequenas), tempo de exposição, tipo de Sílica (a cristalina, tridimita e a cristobalita são as mais lesivas, ainda que mais raras), densidade, solubilidade em água e lípidos, reatividade química, carater higroscópico e eletrostático, temperatura, velocidade do ar e atividade física do funcionário. Por sua vez, neste último, destacam-se o género, área corporal, idade, estado geral de Saúde, patologias prévias e tabagismo; ou seja, a suscetibilidade individual. As partículas podem ser inaláveis, torácicas ou respiráveis (estas últimas conseguem se depositar nos pulmões). A forma, tamanho e densidade das poeiras irão condicionar o comportamento e penetração no aparelho respiratório. A fração respirável é constituída por partículas com menos de 10 micrómetros, ou seja, com capacidade para atingir a zona onde se efetua a troca gasosa; maiores que isso, geralmente ficam depositadas na região nasal e torácica. As nanopartículas com Sílica menores que 100 nanómetros podem chegar à circulação sanguínea. Após a inalação, as partículas de Sílica depositam-se sobretudo nos bronquíolos e alvéolos; se a clearence mucociliar não for suficiente, surge inflamação (alveolite), que poderá posteriormente levar a fibrose e cancro. A ativação dos macrófagos origina radicais livres/espécies reativas de oxigénio, que nem sempre são atenuados pelas defesas anti-oxidantes. A exposição continuada potencia a libertação de citoquinas que, por sua vez, ativam mais macrófagos, neutrófilos e linfócitos; a produção aumentada de colagénio levará então à dita fibrose, diminuindo a rentabilidade e eficácia pulmonares; ou seja, diminuindo as trocas gasosas; sendo que esta pode também atingir a pleura.  Discussão e Conclusões Apesar dos avanços proporcionados por um sistema de Saúde e Segurança cada vez mais eficaz, ainda assim a Silicose constitui um problema em alguns contextos, pelo que é necessário que os profissionais a exercer nestas equipas tenham conhecimentos razoáveis relativos aos setores/tarefas onde esta pode ocorrer, exames auxiliares de diagnóstico e restantes parâmetros da vigilância, medidas de proteção coletivas e individuais, bem como eventuais implicações para a classificação de aptidão. Seria relevante conhecer melhor o panorama nacional, através da divulgação de investigações efetuadas neste contexto.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction/framework/objectives Pneumoconiosis are the most frequent occupational diseases. Silicosis is caused by inhaling breathable crystalline Silica. It is a diffuse interstitial fibronodular lung disease. Initially it is asymptomatic, however, it is usually progressive and without cure. The diagnosis is partially based on a history of professional exposure. It is more prevalent in countries with considerable unemployment and/or little or no Health and Safety Surveillance at Work.  Methodology This is a Bibliographic Review, initiated through a search carried out in January 2022, in the databases &#8220;CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP&#8221;.  Contents Silica or silicon dioxide (SiO2) is made up of oxygen and silicon. In nature it exists in amorphous and crystalline forms. The International Agency for Research on Cancer (IARC) considered inhaled crystalline Silica as a human carcinogen (group 1), probably due to cellular damage, inflammation, oxidative stress and inhibition of clearance. Amorphous silica is not considered carcinogenic to humans (group 3). Silicosis exists in all countries, but is more prevalent in the ones less developed, even realizing that the real incidence should be higher than the official one, due to the situation being underreported. In more developed countries, the incidence/prevalence has decreased, due to the improvement of working conditions. Exposure is relevant via inhalation; cutaneous and digestive tracts generally do not have important consequences in the work context. The health risk varies with concentration, particle size- diameter, surface and shape (more dangerous if smaller), exposure time, type of silica (crystalline, tridymite and cristobalite are the most harmful, although more rare), density, water and lipid solubility, chemical reactivity, hygroscopic and electrostatic character, temperature, air speed and employee physical activity. Also important are gender, body area, age, general health status, previous pathologies and smoking- that is, individual susceptibility. The particles can be inhaled, thoracic or respirable (the latter are able to settle in the lungs). The shape, size and density of dust will affect the behavior and penetration into the respiratory system. The respirable fraction consists of particles smaller than 10 micrometers, that is, they can reach the area where gas exchange takes place; larger than that, they are usually deposited in the nasal and thoracic region. Silica nanoparticles smaller than 100 nanometers can reach the bloodstream. After inhalation, Silica particles are mainly deposited in the bronchioles and alveoli; if mucociliary clearance is not sufficient, inflammation (alveolitis) develops, which can lead to fibrosis and cancer. Macrophage activation generates free radicals/reactive oxygen species, which are not always attenuated by anti-oxidant defenses. Continued exposure enhances the release of cytokines which, in turn, activate more macrophages, neutrophils and lymphocytes; the increased production of collagen will then lead to said fibrosis, decreasing lung profitability and efficiency; that is, decreasing gas exchange; being that it can also reach the pleura.  Discussion and Conclusions Despite the advances provided by an increasingly effective Health and Safety system, Silicosis is still a problem in some contexts, so it is necessary that the professionals working in these teams have reasonable knowledge regarding the sectors/tasks where it can occur, auxiliary diagnostic tests and other surveillance parameters, collective and individual protection measures, as well as possible implications for the classification of aptitude to work. It would be relevant to better understand the national scenario, through the dissemination of investigations carried out in this context.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[sílica]]></kwd>
<kwd lng="pt"><![CDATA[silicose]]></kwd>
<kwd lng="pt"><![CDATA[segurança no trabalho]]></kwd>
<kwd lng="pt"><![CDATA[saúde ocupacional e medicina do trabalho]]></kwd>
<kwd lng="en"><![CDATA[silica]]></kwd>
<kwd lng="en"><![CDATA[silicosis]]></kwd>
<kwd lng="en"><![CDATA[safety at work]]></kwd>
<kwd lng="en"><![CDATA[occupational health and occupational medicine.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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