Which investigations are recommended to confirm a diagnosis of silicosis in primary care settings?

The provided UK guidelines do not specifically detail investigations recommended to confirm a diagnosis of silicosis in primary care settings. However, for individuals presenting with respiratory symptoms that may suggest an occupational lung disease, primary care assessment typically involves several initial investigations and considerations:

• Detailed History and Clinical Examination: A thorough history, including environmental and occupational exposure, and a clinical examination are essential ².
• Spirometry: This is a key investigation to assess lung function and is recommended for people with respiratory symptoms ¹,²,³,⁴.
• Chest X-ray: A chest radiograph is performed to exclude other pathologies and can show signs of chronic airways disease or emphysema ¹,²,³,⁴.
• Blood Tests: Blood tests, including a full blood count, are used to identify conditions like anaemia or polycythaemia, and to help exclude alternative diagnoses, including lung diseases associated with environmental and occupational exposure ¹,²,³,⁴.
• Oxygen Saturation Levels: Checking oxygen saturation levels using a pulse oximeter is also recommended ³,⁴.

While a CT scan of the thorax (including high-resolution images) is crucial for investigating signs that may suggest other lung diagnoses such as fibrosis or bronchiectasis, and for diagnosing conditions like idiopathic pulmonary fibrosis, it is often a secondary care investigation ¹,²,³,⁴. Definitive diagnosis of complex lung conditions, particularly those involving fibrosis, typically requires specialist assessment and the consensus of a multidisciplinary team ². People with suspected bronchiectasis, for example, are referred to a respiratory consultant for investigations to confirm the diagnosis and determine the underlying cause ³. Similarly, for suspected idiopathic pulmonary fibrosis, diagnosis is made with the consensus of a multidisciplinary team based on clinical features, lung function, and radiological findings ².