PGPH-D-23-01031

Silicosis, tuberculosis and silica exposure among artisanal and small-scale miners: A systematic review and modelling paper

PLOS Global Public Health

Dear Dr. Howlett,

Thank you for submitting your manuscript to PLOS Global Public Health. After careful consideration, we feel that it has merit but does not fully meet PLOS Global Public Health’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Jul 19 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at globalpubhealth@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pgph/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

We look forward to receiving your revised manuscript.

Kind regards,

Palwasha Yousafzai Khan, MBBCh, MSc, PhD

Academic Editor

PLOS Global Public Health

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Additional Editor Comments (if provided):

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does this manuscript meet PLOS Global Public Health’s publication criteria? Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe methodologically and ethically rigorous research with conclusions that are appropriately drawn based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available (please refer to the Data Availability Statement at the start of the manuscript PDF file)?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS Global Public Health does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The study by Howlett et al highlights a major public health topic on silicosis, TB in ASM. The paper is well written and has great merit and is likely to gain much traction during the period leading to the UN-HLM in September.

The authors may highlight that there is need for multisectoral approaches involving Ministries of mines and Health-NTPs and Environmental Health specialties in order to implement the recommendations they suggested. Finally, given that ASM are hypermobile and usually operate in hard to reach and underserved areas, TB services (diagnostic and case holding) need to be tailored to the specific needs of this group.

Reviewer #2: General

1. Comments in abstract should also be addressed in the full text, where applicable.

Title and abstract

1. The authors can remove the colon in the title and keep a continuous line.

2. What was the research question behind this systematic review? As such, I could not pin point anything novel in the research question/ objective. Please describe the novelty which the authors targeted.

3. The relationship between silica dust exposure, silicosis and tuberculosis is very well known (https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10711-1). What did the authors add to the existing body of evidence?

4. Define ASM in the abstract itself.

5. The prevalence of silicosis in stone mines of Rajasthan (India) is reported between 38-79% (https://doi.org/10.1016/S2213-2600(15)00052-1). The reported pooled prevalence is an underestimate. In India, small-scale mining is more prevalent and mainly in the unorganized sector.

6. “Our modelling demonstrated decreases in RCS result in reductions in silicosis and tuberculosis, with greater effects at higher mean exposures.” – some numbers here would be more informative. This sentence is an interpretation and not the results.

Introduction

1. Silicosis also affects the TB treatment outcomes (https://www.nature.com/articles/s41598-023-30012-4). Authors might consider adding it.

2. Merge smaller paragraphs.

3. How do ASM and LSM differ? Please also define ASM first.

4. Most of the Indian studies focus on ASM as mining is many a times in the informal sector, illegal, and unregulated. Reference to such Indian studies and context would be helpful.

Materials and methods

1. Well-written

Results

1. “Variables in the model are held constant, unless otherwise stated, at values of: a baseline silicosis prevalence of 2%, an increased odds of 1.3 of silicosis per 1 mg/m3-year increase in RCS exposure, a baseline TB incidence of 200 cases per 100,000 per year, an increased odds of 1.05 of TB per 1 mg/m3-year increase in RCS exposure, an increased odds of TB of 4x in those with silicosis, a randomly distributed baseline prevalence of HIV of 2% and an increased odds of TB of 4x in those with HIV.” – what was the basis of these assumptions?

2. Any results on – at what levels of silica dust does the risk of TB increase?

Discussion

1. Well-written. Collaborative TB-silicosis activities can be discussed (https://www.nature.com/articles/s41598-023-30012-4).

2. Need for maintaining data and addressing underreporting of silicosis should be highlighted.

3. Data from periodic medical examinations would also be a ‘mine’ to analyze, provided they are truly reported data.

Conclusion

1. Collaborative TB-silicosis activities can be proposed to be included in national programs.

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6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

Do you want your identity to be public for this peer review? If you choose “no”, your identity will remain anonymous but your review may still be made public.

For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: Yes: Mihir Rupani

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[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PGPH-D-23-01031R1

Silicosis, tuberculosis and silica exposure among artisanal and small-scale miners: A systematic review and modelling paper

PLOS Global Public Health

Dear Dr. Howlett,

Thank you for submitting your manuscript to PLOS Global Public Health. After careful consideration, we feel that it has merit but does not fully meet PLOS Global Public Health’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Sep 15 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at globalpubhealth@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pgph/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

We look forward to receiving your revised manuscript.

Kind regards,

Najmul Haider, PhD

Academic Editor

PLOS Global Public Health

Journal Requirements:

1. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

2. Please insert an Ethics Statement at the beginning of your Methods section, under a subheading 'Ethics Statement'. It must include:

1) The name(s) of the Institutional Review Board(s) or Ethics Committee(s)

2) The approval number(s), or a statement that approval was granted by the named board(s) 

3) (for human participants/donors) - A statement that formal consent was obtained (must state whether verbal/written) OR the reason consent was not obtained (e.g. anonymity). NOTE: If child participants, the statement must declare that formal consent was obtained from the parent/guardian.

3. We noticed that you used "unpublished" in the manuscript. We do not allow these references, as the PLOS data access policy requires that all data be either published with the manuscript or made available in a publicly accessible database. Please amend the supplementary material to include the referenced data or remove the references.

Additional Editor Comments (if provided):

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Does this manuscript meet PLOS Global Public Health’s publication criteria? Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe methodologically and ethically rigorous research with conclusions that are appropriately drawn based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available (please refer to the Data Availability Statement at the start of the manuscript PDF file)?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception. The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS Global Public Health does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: No further comments. The authors have addressed my comments.

Reviewer #2: Thank you for making the changes and congratulations on writing a very important paper. Last few words:

1. You might want to correct the spelling on L483 from “challenging” to “challenges”.

2. A recent review has been published which highlights prevalence of silicosis and silico-tuberculosis in India (https://occup-med.biomedcentral.com/articles/10.1186/s12995-023-00379-1). The authors might want to go through it and the references which it cites for inclusion in the main text or analysis, if felt important. The high prevalence of silicosis and TB in the mining population as compared to other occupations can be considered to be highlighted.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

Do you want your identity to be public for this peer review? If you choose “no”, your identity will remain anonymous but your review may still be made public.

For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: Yes: Mihir Rupani

**********

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Silicosis, tuberculosis and silica exposure among artisanal and small-scale miners: A systematic review and modelling paper

PGPH-D-23-01031R2

Dear Dr Howlett,

We are pleased to inform you that your manuscript 'Silicosis, tuberculosis and silica exposure among artisanal and small-scale miners: A systematic review and modelling paper' has been provisionally accepted for publication in PLOS Global Public Health.

Before your manuscript can be formally accepted you will need to complete some formatting changes, which you will receive in a follow up email. A member of our team will be in touch with a set of requests.

Please note that your manuscript will not be scheduled for publication until you have made the required changes, so a swift response is appreciated.

IMPORTANT: The editorial review process is now complete. PLOS will only permit corrections to spelling, formatting or significant scientific errors from this point onwards. Requests for major changes, or any which affect the scientific understanding of your work, will cause delays to the publication date of your manuscript.

If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they'll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact globalpubhealth@plos.org.

Thank you again for supporting Open Access publishing; we are looking forward to publishing your work in PLOS Global Public Health.

Best regards,

Najmul Haider, PhD

Academic Editor

PLOS Global Public Health

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Reviewer Comments (if any, and for reference):