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 Table of Contents  
Year : 2021  |  Volume : 10  |  Issue : 1  |  Page : 47-52

Clinico-radiological profile of silicosis patients presenting at a tertiary care centre of Haryana, India

1 Department of Respiratory Medicine, Employee State Insurance Corporation Medical College, Faridabad, Haryana, India
2 Department of Community Medicine, North DMC Medical College, Hindu Rao Hospital, New Delhi, India

Date of Submission22-Nov-2019
Date of Decision11-Jul-2020
Date of Acceptance30-Aug-2020
Date of Web Publication31-Jan-2021

Correspondence Address:
Dr. Ruchi Arora Sachdeva
Department of Respiratory Medicine, Employee State Insurance Corporation Medical College, Faridabad, Haryana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijrc.ijrc_60_19

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Objectives: The aim of this study was to study the patients working in stone crushing units presenting with respiratory symptoms for occupational lung disease, silicosis. Patients and Methods: Over a span of 2 years, 176 consecutive new stone crusher workers diagnosed with silicosis were clinically evaluated, including radiological investigations, spirometry, and sputum for acid-fast bacilli. Results: All patients were male manual workers with average age and duration of stone dust exposure of 42.9 years and 20.11 years, respectively; 57 (32.3%) gave a history of smoking; 33% of patients had taken anti-tubercular treatment in the past. However, sputum of none of the patients was found positive for acid-fast bacilli. Only 4 (2.2%) patients mentioned the use of gloves and masks during work shifts. Breathlessness was the most common symptom (92%), followed by cough (61.9%), chest pain (48.3%), expectoration (6.8%), hemoptysis (5.7%), and wheezing (2.8%). Chest radiograms showed opacities-small (up to 10 mm, 57.95%) and large (>10 mm, 17.04%); pleural thickening (97.2%), diaphragmatic thickening (97.2%), and calcifications (71%) etc., Predominant lesions on high-resolution computerized tomography scan of the thorax were mediastinal lymphadenopathy (94.3%), round opacities (90.3%) followed by parenchymal bands (59.1%) and linear opacities (52.8%). On spirometry, 71 (40.3%) patients had findings within the normal limits. Conclusion: It is reiterated that silicosis has severe debilitating effects on the health of subjects, and the situation warrants continuous monitoring.

Keywords: Occupational lung disease, rehabilitation, stone crusher, smoking

How to cite this article:
Sachdeva RA, Dawar S, Nagar S, Parashar D, Sachdeva S. Clinico-radiological profile of silicosis patients presenting at a tertiary care centre of Haryana, India. Indian J Respir Care 2021;10:47-52

How to cite this URL:
Sachdeva RA, Dawar S, Nagar S, Parashar D, Sachdeva S. Clinico-radiological profile of silicosis patients presenting at a tertiary care centre of Haryana, India. Indian J Respir Care [serial online] 2021 [cited 2021 Feb 28];10:47-52. Available from: http://www.ijrc.in/text.asp?2021/10/1/47/308459

  Introduction Top

Silica is the most abundant material in the earth's crusts and can be found in quartz, granite, sandstone, slate, and sand. Silica exists in both crystalline and amorphous (noncrystalline) forms, the latter having a relatively lesser toxicity profile and less common form of exposure. The stone contains approximately 100% free silica and the stone crushing, grinding, sieving, screening, mixing, storing, and bagging process liberates a huge amount of respirable crystalline silica dust in the working environment. Occupations with high silica exposure are mining, tunneling, road construction, pottery making, sandblasting, rock drilling, stone cutting, and quarrying. Silicosis, a progressive, irreversible, and incurable fibrotic pulmonary disease caused by the inhalation of respirable crystalline silica dust is the most common occupational lung disease globally.[1],[2],[3]

Crystalline silica can result in respiratory and nonrespiratory health effects. Exposure to a large amount of free silica can pass unseen because silica is nonirritant, odorless and does not lead to any immediate evident effect and therefore confused with ordinary dust. The inhaled (<5 μm) silica particles are removed from the lung parenchyma at a very slow rate. Thus, chronic silicosis can develop or progress even after occupational exposure has ceased. Since silicosis is a preventable but incurable disease, only supportive care is available along with lung transplantation for terminal cases.[4],[5]

In India, according to estimates (1999), there were >3 million workers exposed to dust containing silica and another 8.5 million workers in construction and building activities who are similarly exposed to quartz.[6],[7] In our country, silicosis is prevalent in the states of Gujarat, Rajasthan, Haryana, Uttar Pradesh, Bihar, Chhattisgarh, Jharkhand, Odisha, West Bengal, and Puducherry. The prevalence of silicosis in India ranges from 3.5% in ordnance factories to 54.6% in slate-pencil industries.[8]

State of Haryana (India) has stone crushing units in many districts, while workers in Faridabad (a district in Haryana) visit our tertiary care center for their health needs. A large number of silicosis cases were being observed in our hospital and also there are limited studies in our region; hence, the study of this nature was conducted.

  Patients and Methods Top

A cross-sectional descriptive study was conducted at Employee State Insurance Corporation (ESIC) Medical College and Hospital, Faridabad, Haryana, India and consecutive new patients who reported to outpatient department of respiratory medicine during 2 years were evaluated to document clinical history, sociodemography, history of stone dust exposure, use of mask and gloves, smoking status, clinical evaluation, sputum examination for AFB by Zeihl-Neelsen staining method, cartridge-based nucleic acid amplification test (CBNAAT) for presumptive tuberculosis patients, spirometry, radiological investigation followed by clinical management.

All patients aged >18 years of age with a history of working in stone crusher units and who gave informed consent were included in the study after obtaining ethical clearance from the institute. The patients were informed about the confidential and voluntary nature of participation in the study without any fear or prejudice. However, none of the patients refused to participate in this study. All patients were offered symptomatic treatment, preventive (cough etiquette, tuberculosis, use of personal protective equipment, nutritional, prognostic) counseling, and anti-tobacco advice.

Spirometry was performed as per standard protocol following the American Thoracic Society/ERS guidelines.[9] Proper trials were given to ensure that subjects understood and become confident about the whole procedure. The reading was taken in a comfortable upright sitting position in front of the apparatus. Three readings were taken, and best of these was taken for the calculation. A spirometry record with FEV1/VC value below its predicted lower limit of normal (LLN) for patients age, height, and sex was interpreted as having an obstructive abnormality. A restrictive defect was suspected if the vital capacity was reduced below the LLN; in the presence of normal or increased FEV1/VC ratio (i.e., value above corresponding LLN).[10]

Smoking status was assessed using the smoking index (SI - product of the number of bidis/cigarettes smoked per day with the number of years smoked). Based on the SI, patients were categorized as never-smokers, light (SI: <100), moderate (SI: 101–300), or heavy (>300) smokers.

The findings of chest X-ray and high resolution computed tomography (HRCT) were noted as per the National Institute for Occupational Safety and Health of the Centers for Disease Control and Prevention (CDC/NIOSH 2.8(e), Revised January 2015) and International Labor Organization (ILO-2011) classification of radiograph of pneumoconiosis for epidemiological investigation.[11],[12] Accordingly, on chest X-ray, opacities were divided based on the size as small (up to 10 mm) or large (>10 mm). Further, small opacities could be round or irregular. Based on size, small opacities were further subdivided into (p [size: up to 1.5 mm]; q [size: 1.5–3 mm]; r [size: 3 mm to 10 mm]). Based on shape, these small opacities were labeled as round (p, q, r) or irregular (s, t, u). Large opacities were labeled as A-type (size between 10 to 50 mm); B-type (size >50 mm and up to right upper zone) and C-type (size of opacity more than right upper zone).

The radiological observations of all patients were reported based on mutual consensus among respiratory physicians, and in-case of discrepancy, an opinion was sought from a radiologist. The total study population consisted of 200 patients. However, radiological records of 24 patients were not available; hence, a total of 176 patients were finally considered. Data management was carried out to determine descriptive and bivariate statistics.

  Results Top

Sociodemographic details

A total of 176 patients were evaluated, and all patients were male manual laborers working in stone crusher units aged between 20 and 70 years (mean age: 42.90 years). Maximum (42.6%) patients were of age group 41–50 years. The majority of them were working as daily-wage workers. Duration of stone dust exposure ranged from 1 to 40 years (mean duration: 20.11 years); however, nearly half (50%) of patients had 11–20 years of exposure. Only 04 (2.2%) of the patients mentioned the use of gloves and masks provided by the employer during stone crushing activities; however, 50% also reported covering their face with any available cloth. Nearly 57 (32.3%) patients gave a history of smoking. SI was calculated for all patients: 32 (18.2%) were mild smokers (SI <100), 18 (10.2%) moderate (SI: 101-300), and 7 (4%) had heavy (>301) SI. About one-third of patients had taken anti-tubercular treatment in the past. None of our study samples was found to be positive for acid-fast bacilli or CBNAAT. The majority (95%) did not use any of the personal protective equipment (mask, gloves) while at work. Sociodemographic details are shown in [Table 1].
Table 1: Sociodemographic profile of silicosis patients

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Breathlessness was the most common symptom reported by 162 (92%) patients, followed by cough (61.9%), chest pain (48.3%), expectoration (6.8%), hemoptysis (5.7%). Wheezing was the least reported symptom (2.8%). The majority of the patients had more than one symptom. The duration of these symptoms ranged from 1 to 20 years; 88.7% had symptomatology of less than 5 years; mean duration of illness was 2.75 years.

Radiological observations

Chest radiograms (posteroanterior view) were graded as per the technical quality guidelines: 41 patients (23.3%) had X-ray technical quality 1, whereas technical quality 2 and 3 were found in 52 (29.5%) and 83 (47.2%) patients, respectively. On chest-X ray small opacities [size up to 10 mm; round or irregular]) were seen in 102 (57.9%) patients. The grading of small opacities were as follows: p-type (23.29%), q-type (14.20%), r-type (4.54%), s-type (5.11%), t-type (7.38%), u-type (9.09%); 64 chest x-rays did not have any smaller opacities. Large opacities were noted in 30 radiographs such as A-type in 18, while B and C-type opacity were seen in 6 radiographs. Large opacities were absent in 146 X-rays.

Zone wise distribution of opacities was noted for both right and left lung fields separately. The pattern of distribution was observed for upper (U), middle (M), lower (L) zones separately and in combinations (UM, ML, UL, UML). In the majority of radiographs, the opacities were present in all the three zones, UML of both right (57.9%) and left (59.6%) lung fields followed by UM (right 10.7%, left 9.6%); 16.4% and 18.1% of right and left lung fields did not have any opacities, respectively. Diffuse pleural thickening was present in almost all patients (97.2%), whereas localized pleural thickening was present in 75.6% of the patients. Many patients had both features. Other noted features were diaphragmatic thickening (171, 97.1%), costo-phrenic angle blunting (162, 92.0%), and calcifications (125, 71.0%).

Correlation was observed between the duration of stone dust exposure and opacities in chest X-rays, and it was noted that there was an overall increase in the number of opacities with the increasing duration of exposure. This increase was statistically significant for smaller opacities (P = 0.042) but not for larger ones (P = 0.260) [not shown in table].

High resolution computed tomography

On HRCT thorax, predominant lesions seen were mediastinal lymphadenopathy (94.3%), round opacities (90.3%) followed by parenchymal bands (59.1%), and linear opacities (52.8%). Other important findings were pleural thickening (25%), ground-glass opacities (24.4%), large opacities (20.5%), confluence of opacities (16.5%), emphysema (13.1%), bronchiectasis (11.9%), cavities (10.8%), tree-in-bud opacities (10.8%), bronchial wall thickening (6.3%), egg-shell calcification (3.4%), sub-pleural atelectasis (3.4%), round atelectasis (2.8%), pleural effusion (2.8%), dependent opacities (2.3%), and mosaic pattern (2.3%). Honeycomb appearance and bullae were seen in only two patients each. None of the patients demonstrated features of malignancy. Details are shown in [Table 2].
Table 2: High resolution computed tomography thorax findings of silicosis patients (n=176)

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Smaller opacities were seen in 102 (57.9%) radiographs, whereas 159 (90.3%) computed tomography (CT) scans had this finding. Large opacities and the confluence of opacities were visible in 65 (36.9%) CT scans but only in 30 (17.04%) radiographs, thereby showing limitation of radiograph as a 2-dimensional depiction.


71 (40.3%) patients had spirometric findings within the normal limits whereas 105 (59.65%) had findings outside normal limits that were suggestive of the restrictive, obstructive, or mixed pattern. These were as follows: 67 (38.1%) patients had the restrictive pattern, 24 (13.6%) mixed, and only 14 (8%) had the pure obstructive pattern. Details are shown in [Table 3].
Table 3: Spirometry findings of silicosis patients (n=176)

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  Discussion Top

Our hospital-based descriptive study covering 176 silicosis patients revealed all were male manual laborers with the average age of 42.9 years and mean duration of stone dust exposure of 20.11 years. The majority (95%) did not use any of the personal protective equipment (mask, gloves) while at work. Breathlessness was the most common symptom reported by 162 (92%) patients followed by cough (61.9%), chest pain (48.3%), etc., with an average duration of illness of 2.7 years. Chest radiograms showed small opacities (up to 10 mm) in 57.95% of patients and large (>10 mm) opacities in 17.04% of patients. In the majority of radiographs, the opacities were present in all the three zones, UML of both right (57.9%) and left (59.6%) lung fields. On HRCT thorax, predominant lesions were mediastinal lymphadenopathy (94.3%), round opacities (90.3%) followed by parenchymal bands (59.1%), and linear opacities (52.8%), etc.

Clinical spectrum of this disease can range from asymptomatic condition to patients presenting with acute silicosis, chronic obstructive pulmonary disease, bronchitis, emphysema, lung cancer, kidney damage, scleroderma, etc., requiring hospital admission.[13],[14],[15],[16],[17] Unless there is high suspicion, diagnosis may be missed by clinicians working in limited resource settings. We were able to evaluate such a large number of patients at our center since our hospital caters to occupational diseases. The present study findings reflect the largest database of silicosis patients from India, and based on our current experiences, it is proposed to develop a silicosis disease registry in future. A few of the limitations include the amount of actual dust exposure among workers may vary; there were no female patients; the possibility of human error in radiological observations plus the study covered only those patients who reported to our hospital out-patient department and therefore study findings lacks generalizability.

A review of the literature demonstrated a preponderance of males being affected more than females, probably due to the frequency of exposure and heavy physical demands of the stone crushing industry. However, authors have observed women, including spouses also working in the same occupational sector. Majority of patients (70.45%) belonged to economically and demographically young age of 20–50 years with wider social ramifications. Majority (90.34%) of patients had stone dust exposure of >10 years, and breathlessness (92%) was the most common symptom followed by cough (61.9%), chest pain (48.3%), etc., Similar findings were reported in other research studies as well.[18],[19],[20],[21],[22],[23]

In our study, it was observed that 71 (40.35%) patients had normal PFT, probably due to early-stage disease and younger age. However, 105 (59.65%) patients had PFT findings outside normal limits. The severity of spirometric findings was in contrast from community-based studies carried amongst stone quarry workers where-in abnormal PFT was found in 43.4% (Maharashtra) and 40.4% (West Bengal) persons.[24],[25] In our analysis, it was noticed that the pulmonary function test declines as the duration of stone dust exposure increases. Like most studies, we have included smokers in our study population, but Lopes et al.[26] have excluded smokers from their study as both smoking and silica are known to cause deterioration of lung volumes, decrease macrophage activity, and causes emphysema. We found that 57 (32.38%) of our subjects had a history of smoking.

Radiological imaging plays a critical role in the diagnosis of silicosis. Bhawna et al. have described similar findings among pneumoconiosis patients.[27] Sivanmani and Rajathinakar in their study carried out in Coimbatore (Tamil Nadu) reported radiological nodular opacities with upper-zone predominance in the majority of cases.[28] Hughes et al.,[29] in their study, showed an increasing trend of x-ray opacities with an increase in the duration of cumulative silica exposure and age of the workers. We did a similar correlation analysis between the years of silica dust exposure and opacities in chest x-rays. It was observed that there is an overall increase in the number of opacities with the increasing duration of exposure, but this increase was statistically significant for smaller opacities (P = 0.042) only and not for the larger ones (P = 0.260).

Silicosis, as an occupational disease, is mentioned in the ancient text but in the modern era was diagnosed for the first time in India among workers in Kolar goldfield in Mysore, Karnataka, during 1934. In India, there are constitutional provisions (legislation, act, schemes, rules) covering health, safety, working hours, conditions at work and employment, payment of wages, compensation, disability, death, and maternity-related issues.[30] Some of these are covered under Factories Act (1948), Employees State Insurance (ESI) Act (1948), Mines Act (1952), etc., The Ministry of Labour and Employment, Government of India, approved the national policy on safety, health, and environment at workplaces in 2009.

Occupational health has been one of the components of the National Health Policy in 1983, 2002, 2017, and the Government of India under the Ministry of Health and Family Welfare launched a program entitled “National Program for Control and Treatment of Occupational Diseases” in 1998–1999. The National Institute of Occupational Health, Ahmedabad, established in the year 1970 and has been earmarked as the nodal agency for the same. Lately, many state governments have started rolling out financial compensation for silicosis affected patients (personal communication).

  Conclusion Top

Our study provides a snapshot of clinical, radiological, and spirometric findings in patients from stone crushing units. This study provides an insight that warrants more societal attention even though poverty, social backwardness, malnutrition, risk exposure, alcohol intake, tuberculosis, limited awareness, poor health practices and treatment compliance, sporadic occupational health preventive measures, corruption, and poor resources is a stark reality in our society.[31],[32],[33],[34],[35],[36],[37],[38],[39],[40] It is reiterated that silicosis is a major occupational health hazard leading to respiratory debility of varying nature, as evident from this original study conducted in Haryana, India, and the situation warrants continuous monitoring, including the use of appropriate personal protective equipment.


Department of Physiology and Radiology, ESIC Medical College, Faridabad, Haryana, India.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

World Health Organization. Silicosis. The Global Occupational Health Network Newsletter. Vol. 12. GOHNET: World Health Organization; 2007. p. 1-20.  Back to cited text no. 1
Leung CC, Yu IT, Chen W. Silicosis. Lancet 2012;379:2008-18.  Back to cited text no. 2
Sachdeva R. Silicosis. In: Rapid Review of Respiratory Medicine. New Delhi: Ahuja Publishers; 2019.  Back to cited text no. 3
Greenberg MI, Waksman J, Curtis J. Silicosis: A review. Dis Mon 2007;53:394-416.  Back to cited text no. 4
Steenland K, Ward E. Silica: A lung carcinogen. CA Cancer J Clin 2014;64:63-9.  Back to cited text no. 5
GuptaA. Silicosis an uncommonly diagnosed common occupational disease. ICMR Bull 1999;29:1-7.  Back to cited text no. 6
Jindal SK. Silicosis in India: Past and present. Curr Opin Pulm Med 2013;19:163-8.  Back to cited text no. 7
Silicosis. Available from: https://www.nhp.gov.in/disease/non-communicable-disease/silicosis. [Last accessed on 2019 Oct 02].  Back to cited text no. 8
Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, et al. Interpretative strategies for lung function tests. Eur Respir J 2005;26:948-68.  Back to cited text no. 9
Aggarwal AN, Agarwal R, Dhooria S, Prasad KT, Sehgal IS, Muthu V, et al. Joint Indian chest society-national college of chest physicians (India) guidelines for spirometry. Lung India 2019;36:S1-35.  Back to cited text no. 10
Chest Radiograph Classification CDC/NIOSH 2.8(e); Revised January, 2015.  Back to cited text no. 11
ILO. Guidelines for the use of the ILO International Classification of Radiographs of Pneumoconioses. Geneva: ILO; Revised edition 2011.  Back to cited text no. 12
International Agency for Research on Cancer Monographs on the Evaluation of Carcinogenic Risks to Human, Silica, some Silicates, and Coal dust. Lyon: IARC Publications; 1997. p. 68. Available from: https://publications.iarc.fr/86. [Last accessed on 2019 Mar 28].  Back to cited text no. 13
Silica and the Lung. Workplace Health Safety, Queensland PN 10049; 2013. Available from: https://www.worksafe.qld.gov.au ' assets ' pdf_file ' silica-lung-factsheet. [Last accessed on 2019 Mar 05].  Back to cited text no. 14
Sachdeva R, Sachdeva S, Gupta KB. Pattern and outcome of patients discharged from chest ward of a university hospital. Med J DY Patil Univ 2013;6:240-4.  Back to cited text no. 15
  [Full text]  
Malhotra M, Sachdeva R, Sachdeva S. Assessment of sleep and quality of life among chronic obstructive airways disease patients. J Assoc Chest Phys 2018;6:45-52.  Back to cited text no. 16
Gupta KB, Mehta D, Sachdeva R, Sachdeva S. Knowledge of doctors, interns, and final year medical students on selected parameters of tuberculosis and RNTCP. JIACM 2016;17:198-200.  Back to cited text no. 17
Kohli S, Singhal A, Chaudhury B, Kohli R. Silicosis in stone crushing workers-a retrospective analysis. Ind J Basic App Med Res 2017;6:203-9.  Back to cited text no. 18
Nelson G, Girdler-Brown B, Ndlovu N, Murray J. Three decades of silicosis: Disease trends at autopsy in South African gold miners. Environ Health Perspect 2010;118:421-6.  Back to cited text no. 19
Chopra K, Prakash P, Bhansali S, Mathur A, Gupta PK. Incidence and prevalence of silico-tuberculosis in western Rajasthan: A retrospective study of three years. Natl J Comm Med 2012;3:161-63.  Back to cited text no. 20
Kuzhikkattil N. Prevalence of silicosis in sand mine workers in Kota: A cross sectional study. Intl J Cur Res 2019;11:3441-43.  Back to cited text no. 21
Rathod SB, Sorte SR. Effect of duration of exposure to silica dust on lung function impairment in stone crusher workers of Marathwada region. Int J Cur Res Rev 2013;05:121-25.  Back to cited text no. 22
Koo JW, Chung CK, Chung YP, Lee SH, Lee KS, Roh YM, et al. The effect of silica dust on ventilatory function of foundry workers. J Occup Health 2000;42:251-7.  Back to cited text no. 23
Prasad M, Wagh V. A study of pulmonary function test in stone quarry industry workers in Wardha district. J Acad Indus Res 2019;8:52-4.  Back to cited text no. 24
Mandal A, Majumdar R. Cardio-respiratory status of stone grinders and brick field workers from west Bengal, India. Prog Health Sci 2014;4:111-22.  Back to cited text no. 25
Lopes AJ, Mogami R, Capone D, Tessarollo B, de Melo PL, Jansen JM. High-resolution computed tomography in silicosis: Correlation with chest radiography and pulmonary function tests. J Bras Pneumol 2008;34:264-72.  Back to cited text no. 26
Bhawna S, Ojha UC, Kumar S, Gupta R, Gothi D, Pal RS. Spectrum of high resolution computed tomography findings in occupational lung disease: Experience in a tertiary care institute. J Clin Imaging Sci 2013;3:64.  Back to cited text no. 27
[PUBMED]  [Full text]  
Sivanmani K, Rajathinakar V. Silicosis in Coimbatore district of Tamil Nadu: A passive surveillance study. Ind J Occup Environ Med 2013;17:25-8.  Back to cited text no. 28
Hughes JM, Weill H, Checkoway H, Jones RN, Henry MM, Heyer NJ, et al. Radiographic evidence of silicosis risk in the diatomaceous earth industry. Am J Respir Crit Care Med 1998;158:807-14.  Back to cited text no. 29
Saha RK. Occupational Health in India. Ann Glob Health 2018;84:330-3.  Back to cited text no. 30
Sachdeva S, Behera BK, Rani B, Sachdeva Ruchi, Bharti, Nagar M, et al. Perception of selected risk factors for cancer and heart attack among visitors of a public hospital. Clin Cancer Investig J 2015;4:295-301.  Back to cited text no. 31
  [Full text]  
Sachdeva S, Kar HK, Sachdeva R, Mehta B, Tyagi AK. Information, education and communication: A revisit to facilitate change. JIACM 2015;16:106-9.  Back to cited text no. 32
Sachdeva R, Mehar S, Sachdeva S. Inhalational therapy for airway disease among adult patients: Compliance is a major challenge toward effective management. MAMC J Med Sci 2015;1:80-4.  Back to cited text no. 33
  [Full text]  
Sachdeva R, Sachdeva S. Delay in diagnosis amongst carcinoma lung patients presenting at a tertiary respiratory centre. Clin Cancer Investig J 2014;3:288-92.  Back to cited text no. 34
  [Full text]  
Khattter S, Arora R, Goyal P, Singh A, Sharma B. Prevalence of pulmonary tuberculosis in industrial population in a tertiary care center in North India. Saudi J Med Pharm Sci 2017;3:639-42.  Back to cited text no. 35
Sachdeva S, Nagar M, Tyagi AK, Sachdeva R, Mehta B. Alcohol consumption practices amongst adult males in a rural area of Haryana. Med J DY Patil Univ 2014;7:128-32.  Back to cited text no. 36
  [Full text]  
Sachdeva S, Sachdev TR, Sachdev R. Fruits and vegetables consumption: Challenges and opportunities. Ind J Comm Med 2013;38:192-7.  Back to cited text no. 37
Sarin R, Vohra V, Sachdeva R, Sachdeva S. Magnitude of malnutrition amongst hospitalized TB patients. Lung India 2011;28:231-2.  Back to cited text no. 38
[PUBMED]  [Full text]  
Yadav SP, Anand PK, Singh H. Awareness and practices about silicosis among the sandstone quarry workers in desert ecology of Jodhpur, Rajasthan, India. J Hum Ecol 2011;33:191-96.  Back to cited text no. 39
Nandi S, Burnase N, Barapatre A, Gulhane P, Dhatrak S. Assessment of silicosis awareness among stone mine workers of Rajasthan State. Indian J Occup Environ Med 2018;22:97-100.  Back to cited text no. 40
[PUBMED]  [Full text]  


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