What Is Silicosis and Why Is It Making A Comeback?


What Is Silicosis and Why Is It Making A Comeback?
You can barely see this construction worker for dust. His lack of protective face mask puts him at risk of silicosis and other lung diseases. Lamiot/Wikimedia, CC BY-SA

Silicosis is a group of occupational lung diseases caused by breathing in silica dust. It has been described since ancient times, when miners and stone cutters were exposed to dust containing this crystalline mineral.

Silicosis was more common in Australia in the 1940s to 60s, particularly in construction and demolition workers. Growing awareness of the disease and the importance of reducing exposure to dust – for instance, wearing masks at work, wetting the dust and other safe work practices – has reduced the number of cases.

However, there has been a worrying resurgence of cases recently, as a recent New South Wales parliamentary committee has heard. Now one of the fastest growing occupational groups we’re seeing with silicosis are people who make and install engineered stone products, the type of benchtops and tiles you might find in your kitchen or bathroom.

This resurgence in cases is likely related to a poor understanding of the risks involved in working with engineered stone, and a lack of adherence to safety regulations and surveillance requirements.

What is silica and how are people exposed?

Silica is in quartz, sand, stone, soil, granite, brick, cement, grout, mortar, bitumen and engineered stone products.

Any occupation disturbing the earth’s crust increases the risk of silicosis. That includes sand blasting, cutting, excavating, building on sandstone, demolition work, tunnelling, quarry work and mining. Air-polishing concrete, foundry work, bricklaying, stone masonry, and making glass and ceramics also increase the risk.

About 6.6% of Australian workers are exposed to crystalline silica dust that can be breathed in, and 3.7% are heavily exposed.

While not all of these will go on to develop silicosis a significant proportion will, with symptoms appearing between months and many years after exposure, depending on the type of silicosis.

The likelihood of developing severe silicosis increases depending on how much dust people are exposed to and for how long. Genetics may also play a role in susceptibility, with some groups, like African Americans, having a higher risk.

Symptoms of silicosis include a cough, breathlessness and tiredness. But in the early stages of the disease, there may be no symptoms.

As silicosis can progress long after exposure at work, people should report any troublesome symptoms to their GP, even after they have left the industry. If silicosis is suspected, they should be referred to a respiratory physician.

Different types of silicosis

There are three different types of silicosis :

* acute silicosis can develop within weeks of very heavy exposure to silica. The lungs are filled with a fluid containing a lot of protein, which causes severe breathlessness

* accelerated silicosis is also associated with high exposures (the type currently being seen in people working with engineered stone products), where

* chronic silicosis, the most common form of silicosis, where fibrosis occurs more slowly over 10-30 years after first being exposed.

Then there’s simple and complicated silicosis. Simple silicosis results in many small white spots (nodules) that you can see on a chest x-ray or CT scan. With complicated silicosis there are large areas of scarring called progressive massive fibrosis.

In general, the more scarring and the more widespread it is, the more trouble people have breathing as their lungs lose their capacity to expand and contract with each breath. Silicosis also increases people’s susceptibility to tuberculosis.

How is silicosis treated and what are the outcomes?

Diseases due to silica exposure are serious and potentially lethal, and there is no specific treatment other than supportive care. This can include stopping smoking, using inhalers, vaccination against infections, and antibiotics. In the late stages, oxygen treatment or a lung transplant may be needed.

Once diagnosed, the disease generally progresses over time. Patients with accelerated silicosis may progress to progressive massive fibrosis over a period of four to five years. Overall, people diagnosed with silicosis lose an average 11.6 years of life. So, prevention is vital.

How can we prevent silicosis?

Diseases due to silica exposure – for instance silicosis, lung cancer, connective tissue disorders like scleroderma, kidney disease and chronic obstructive lung disease – are entirely preventable.

Wetting of silica dust, using appropriate exhaust ventilation and extraction hoods, and wearing the right dust masks and air filters all reduce the chances of someone breathing in silica dust at work.

There are also workplace standards on exposure to silica dust. And workplace screening for lung disease is mandatory for those at significant risk, which can include a physical examination as well as x-rays and lung function tests.

How can we keep track of silicosis?

Silicosis carries a high social and economic cost. And workers can receive compensation for silica-related disease in some states. In NSW, for instance, 186 workers received compensation payments through the Dust Diseases Board in 2002-2003.

Yet, we don’t know the true number of new cases in Australia. While there are voluntary reporting systems in Victoria, Tasmania and NSW, these are likely to have underestimated the true incidence of disease.

So specialist doctors concerned about the resurgence of silicosis have called for mandatory reporting of occupational lung disease to a centralised registry, as occurs in Europe and America.

The ConversationAustralia is seeing the re-emergence of diseases like silicosis and coal worker’s lung (also known as black lung) that were previously believed to have disappeared. So, workers, employers, doctors, public health officials, and legislators need to work together to prevent more cases of these deadly, but preventable, lung diseases.

About The Author

Susan Miles, Respiratory, sleep and general physician and conjoint lecturer in medicine, University of Newcastle

This article was originally published on The Conversation. Read the original article.

Related Books:

Silicosis: A World History

healthBinding: Hardcover
  • John Hopkins University Press

Brand: John Hopkins University Press
  • Paul-André Rosental

Studio: Johns Hopkins University Press
Label: Johns Hopkins University Press
Publisher: Johns Hopkins University Press
Manufacturer: Johns Hopkins University Press

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Editorial Review:

Despite the common perception that "black lung" has been relegated to the dustbin of history, silicosis remains a crucial public health problem that threatens millions of people around the world. This painful and incurable chronic disease, still present in old industrial regions, is now expanding rapidly in emerging economies around the globe. Most industrial sectors―including the metallurgical, glassworking, foundry, stonecutting, building, and tunneling industries―expose their workers to lethal crystalline silica dust. Dental prosthodontists are also at risk, as are sandblasters, pencil factory workers in developing nations, and anyone who handles concentrated sand squirt to clean oil tanks, build ships, or fade blue jeans.

In Silicosis, eleven experts argue that silicosis is more than one of the most pressing global health concerns today―it is an epidemic in the making. Essays explain how the understanding of the disease has been shaken by new medical findings and technologies, developments in industrializing countries, and the spread of the disease to a wide range of professions beyond coal mining. Examining the global reactions to silicosis, the authors trace the history of the disease and show how this occupational health hazard first came to be recognized as well as the steps that were necessary to deal with it at that time.

Adopting a global perspective, Silicosis offers comparative insights into a variety of different medical and political strategies to combat silicosis. It also analyzes the importance of transnational processes―carried on by international organizations and NGOs and sparked by waves of migrant labor―which have been central to the history of silicosis since the early twentieth century. Ultimately, by bringing together historians and physicians from around the world, Silicosis pioneers a new collective method of writing the global history of disease. Aimed at legal and public health scholars, physicians, political economists, social scientists, historians, and all readers concerned by labor and civil society movements in the contemporary world, this book contains lessons that will be applicable not only to people working on combating silicosis but also to people examining other occupational diseases now and in the future.

Contributors: Alberto Baldasseroni, Francesco Carnevale, Éric Geerkens, Martin Lengwiler, Gerald Markowitz, Jock McCulloch, Joseph Melling, Julia Moses, Paul-André Rosental, David Rosner, Bernard Thomann

Deadly Dust: Silicosis and the On-Going Struggle to Protect Workers' Health (Conversations In Medicine And Society)

healthAuthor: David Rosner
Binding: Paperback
Studio: University of Michigan Press
Label: University of Michigan Press
Publisher: University of Michigan Press
Manufacturer: University of Michigan Press

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Editorial Review:
During the Depression, silicosis, an industrial lung disease, emerged as a national social crisis. Experts estimated that hundreds of thousands of workers were at risk of disease, disability, and death by inhaling silica in mines, foundries, and quarries. By the 1950s, however, silicosis was nearly forgotten by the media and health professionals. Asking what makes a health threat a public issue, David Rosner and Gerald Markowitz examine how a culture defines disease and how disease itself is understood at different moments in history. They also explore the interlocking relationships of public health, labor, business, and government to discuss who should assume responsibility for occupational disease.
Back Cover

“If there is a paradigmatic tale of occupational health . . . Deadly Dust is it.”
―James L. Weeks, Science

“Rosner and Markowitz have produced a carefully crafted history of the rise and fall of this occupational disease, focusing especially on the political forces behind changing disease definitions. . . Deadly Dust comes as a fresh breeze into one of the more stuffy and too often ignored alleys of medical history.”
―Robert N. Proctor, The Journal of the American Medical Association

“A thought-provoking, densely referenced, uncompromising history. . . Like all good history, it challenges our basic assumptions about how the world is ordered and offers both factual information and a conceptual framework for rethinking what we ‘know’.”
―Rosemary K. Sokas, The New England Journal of Medicine
Back Cover continued
Deadly Dust raises an important methodological problem that has long gone underarticulated in medical historical circles: how can social historians of medicine offer political or economic explanations for the scientific efforts of their professional subjects without losing a grip on the biological aspects of disease?”
―Christopher Sellers, The Journal of the History of Medicine

"A sophisticated understanding of how class and conflict shape social, economic, political, and intellectual change underlies this first attempt at a history of occupational health spanning the twentieth century."
―Claudia Clark, The Journal of American History%; FONT-FAMILY: Arial"
"This volume is well worth reading as a significant contribution to American social history."
―Charles O. Jackson, The American Historical Review

David Rosner is Distinguished Professor of History and Sociomedical Sciences, and Director of the Center for the History and Ethics of Public Health, Columbia University.

Gerald Markowitz is Professor of History at John Jay College of Criminal Justice of the City University of New York.

Deadly Dust

healthAuthor: David Rosner
Binding: Paperback
Format: International Edition
  • Used Book in Good Condition

Brand: Princeton University Press
Studio: Princeton University Press
Label: Princeton University Press
Publisher: Princeton University Press
Manufacturer: Princeton University Press

Buy Now
Editorial Review:

During the Depression, silicosis, an industrial lung disease, emerged as a national social crisis. Experts estimated that hundreds of thousands of workers were at risk of disease, disability, and death by inhaling silica in mines, foundries, and quarries. By the 1950s, however, silicosis was nearly forgotten by the media and health professionals. Asking what makes a health threat a public issue, David Rosner and Gerald Markowitz examine how a culture defines disease and how disease itself is understood at different moments in history. They also consider who should assume responsibility for occupational disease.


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