Silicosis is a particular form of lung fibrosis attributable to occupational exposure to crystalline silica. The occupational exposure to crystalline silica also increases the risk of chronic obstructive pulmonary disease (COPD), cancer and lung infections, especially pulmonary tuberculosis. Silicosis is currently diagnosed in previously exposed workers by standard chest X-ray, when lesions are visible and irreversible. Therefore, it would be necessary to find specific and non-invasive markers that could detect silicosis in earlier stages, before the occurrence of X-ray opacities. In this narrative review, we present several diagnostic, monitoring and predictive biomarkers with high potential in the management of silicosis, such as: pro- and anti-inflammatory cytokines (TNF (Tumour necrosis factor-α), IL-1 (Interleukin-1), IL-6, IL-10), CC16 (Clara cell 16, an indirect marker of epithelial cell destruction), KL-6 (Krebs von den Lungen 6, an indirect marker of alveolar epithelial damage), neopterin (indicator of cellular immunity) and MUC5B gene (Mucin 5B, a gel-forming mucin in mucus). Studies have shown that all the aforementioned markers have a high potential for early diagnosis or evaluation of progression in silicosis and represent promising alternatives to radiology. We consider that a multicentric study is needed to evaluate these biomarkers in correlation with occupational history, histopathological examination, imaging signs and pulmonary functions tests on large groups of subjects to better evaluate the accuracy of the presented biomarkers.

The infection with the new coronavirus SARS-CoV-2 was declared a global health emergency in early 2020 and, two months later, became recognized as a pandemic, affecting the world’s population regardless of age, ethnicity, geographical area. COVID-19 generally presents with altered general condition (fever, chills, marked fatigue, muscle aches, headache), respiratory manifestations from cough to dyspnea, acute respiratory distress, and multiorgan damage in critical forms. Manifestations can occur between 2 days and two weeks after exposure, the disease evolving from mildly symptomatic to moderate, severe, and even fatal forms. Our reported clinical case of COVID-19 is that of a 59-year-old nurse with diabetes and hypertension as risk factors. Accidental occupational exposure to SARS-CoV-2 infection occurred due to non-compliance with the existing dressing-undressing protective equipment protocols in facilities with treatment beds. We diagnosed a moderate-severe COVID-19, displaying bilateral lung damage and mild desaturation, complicated by bacterial superinfection with Klebsiella spp. The patient underwent antiviral, antibiotic, anticoagulant, cortisone treatment during hospitalization. In the first two months after discharge, we recommended seven hyperbaric therapy sessions to relieve respiratory symptoms and enhance regression of fibrotic lung lesions.

Work-related stress takes a toll on productivity and health. The negative effects of stress on the body’s physiology have been intensively studied (cardiovascular risk, high blood pressure, diabetes, sleep and musculoskeletal disorders etc.). Teleworking involves working from a remote location and making use of informatic communication systems. Be­fore the COVID-19 pandemic, telework was for few wor­kers in Romania part of their job. Thus, in the current epi­de­mio­lo­gi­cal context, in many occupational fields, tele­wor­king becomes the form of work. In this study we in­ves­ti­ga­ted the im­pact of the introduction of telework in se­ve­ral oc­cu­pa­tio­nal fields on a sample of the Romanian po­pu­la­tion, du­ring the COVID-19 pandemic. The objective of this study was to present the relationship between work domain and work effort, using a questionnaire applied to whomever was most likely to be working from home in this context. The main results showed that those in education services felt a greater workload during the pandemic. Regarding the level of effort, statistically significant differences were found between the fields of activity, with education being the most affected. By gender of respondents, a statistically sig­ni­fi­cantly higher perception of effort before and during the pandemic was found in women. In conclusion, telework was associated with an increase in work effort, especially in this rapid and underprepared transition, such as the case of the period du­ring the COVID-19 pandemic.