Elimination of tuberculosis requires prior control of silicosis including sub-radiological silicosis.

India is committed to the elimination of tuberculosis by 2025. But its achievement appears to be difficult as India has a huge burden of silicosis as well as sub-radiological silicosis, which was never given its required attention. Silicotic subjects are highly vulnerable to pulmonary tuberculosis due to the progressive decline of lung immunity. A study among vulnerable glass factory workers in Firozabad, Uttar Pradesh, revealed that silicotic workers were 7.5 times more at risk of pulmonary tuberculosis compared to non-silicotic subjects. Since India has a huge burden of silicosis and sub-radiological silicosis, the elimination of tuberculosis needs prior attention on silicosis. This article may be viewed as an eye-opener for understanding the necessity of dual control of both silicosis as well as tuberculosis by integrating both together.