In a letter to the Director General, Indian Council of Medical Research (ICMR), New Delhi, Dr Jagdish Parikh, trustee, health rights NGO People’s Training and Research Centre (PTRC), Vadodara, and Jagdish Patel, director, PTRC, have said that the claim being made for the use of biomarker for detection of silicosis raises concern about scientific tenacity of the diagnosis of the deadly occupational disease.
The letter also objects to the reported claim by a top health official that it is possible to detect silicosis at the sub-radiological stage. It asks, “What is this subradiological stage of silicosis? We have not heard any such scientific term being used. Again, the report is using a term which is not found in any scientific literature so far. Is this term acceptable by ICMR? Is ICMR thinking of any explanation?”
Text:
This is with reference to our letter dated November 28, 2021. In our communication we had raised our concern about the scientific tenacity of the biomarker for early detection of silicosis. We had questioned sensitivity and specificity of this test. We reiterated that CC66 protein decreases in many lung diseases.Therefore positive screening test can be due to other lung disease. The screening test is not diagnostic. It suggests high probability. Therefore, X-ray is required for confirmation. It may happen that the screening test is positive but X-ray is negative. The authors have not given data for this possibility. We have not heard from you in this regard until now.
In the meanwhile the “Times of India” carried a report in its issue of April 20, 2022. We wish to draw your attention to this report which quotes Dr Kamlesh Sarkar, Ex-Director, National Institute of Occupational Health (NIOH) generously. The report claims that “scientists at NIOH, based at Ahmedabad, are now in the final stages of obtaining new detection kits for subradiological silicosis for mass use.” We have failed to understand what is new? Is it something different than the kit developed in 2021?
The report identifies Dr Sarkar as ICMR-NIOH Director. As per our information Dr Sarkar had been removed long back as Director NIOH, and if the newspaper is still claiming him to be director, it is misinformation being spread, and a matter of grave concern. ICMR is expected to make public clarification in this regard as NIOH is a national institute.
The report further claims, “if silicosis is detected at the sub-radiological stage…” What is this subradiological stage of silicosis? We have not heard any such scientific term being used. Again, the report is using a term which is not found in any scientific literature so far. Is this term acceptable by ICMR? Is ICMR thinking of any explanation?
The report also claims, “if silicosis is detected at the sub-radiological stage, major silico-tuberculosis and lung cancer occurrences can be prevented.” We have not a single diagnosed case of lung cancer following silica exposure in India yet. So the claim that the test would help prevent lung cancer is farfetched.
.jpeg)
The report says, “NIOH scientists say that an intervention at this stage can help save lakhs of Indians who are vulnerable to contracting TB or lung cancer.” It does not clarify on the method of intervention.
At present, the workers who have silicosis on X-ray and continue working in the very industry or occupation where they were exposed to silica, do not get any help for preventing further deterioration of the disease. Unless the government approves the method suggested by Dr Sarkar intervention is not possible.
We think that there should not be any haste in advocating this method of early detection of silicosis. another study with proper epidemiologic design is required to confirm specificity and sensitivity of the CC16 biomarker before its use on mass scale is recommended.
We invite your immediate intervention in stopping using name of ICMR and science. Let ICMR sponsor more research on proving sensitivity and specificity of CC16 to diagnose silicosis.
Comments