Silicosis Update
Categories: Respiratory Health, Silica
June 15th, 2015 3:23 pm ET -
Jacek Mazurek, MD, MS, PhD and David Weissman, MD
Silicosis is a potentially fatal but preventable occupational lung disease caused by inhaling respirable particles containing crystalline silicon dioxide (silica).
Quartz, a type of crystalline silica, is the second most abundant mineral in the earth’s crust and workers across a wide range of occupations and industries are exposed to silica-containing dusts.
The risks, causes, and prevention of this avoidable disease have been known for decades. There is no cure for silicosis and only symptomatic treatment is available, including lung transplantation for the most severe cases.
New national data have become available since a prior report on silicosis surveillance was published earlier this year. The new data show that silicosis continues to cause or contribute to the deaths of about 100 Americans each year. There were 88, 103, and 111 such deaths in 2011, 2012, and 2013 respectively.
The most common form of silicosis, chronic silicosis, takes at least 10 years from first exposure to develop and death does not typically occur until many years after that.
Onset of silicosis can be faster and the severity of disease worse in the setting of high level exposures, which can cause accelerated or acute silicosis. From 2011-2013, 12 people younger than 45 years of age had silicosis listed as causing or contributing to death. Although we do not know the details of their cases, this is concerning because silicosis deaths in these young adults may reflect higher exposures than those causing chronic silicosis mortality in older individuals.
Examples of occupations with known high silica exposure include: mining, quarrying, sandblasting, rock drilling, road construction, pottery making, stone masonry, and tunneling operations. New settings for occupational exposure to respirable crystalline silica continue to emerge. For example, hazardous silica exposures have been newly documented in the United States during hydraulic fracturing of gas and oil wells (see related blog) and during fabrication and installation of engineered stone countertops (see related blog).
While silicosis mortality in the U.S. has declined over time, the continuing occurrence of silicosis deaths in young adults and reports of new occupations and tasks that place workers at risk for silicosis underscore the need for strengthening efforts to limit workplace exposure to respirable crystalline silica. Effective silicosis prevention strategies for employers are available from the Occupational Safety and Health Administration (OSHA) and NIOSH.
Healthcare providers should consider reporting silicosis cases to their health departments. In 2010, silicosis was a reportable condition in 25 states (click here
for more information). State health departments can help strengthen
silicosis prevention efforts by identifying silicosis cases through
review of state morbidity and mortality data and investigating the
circumstances surrounding silicosis cases.Jacek Mazurek, MD, MS, PhD and David Weissman, MD
Dr. Mazurek is the Lead Research Epidemiologist in the NIOSH Division of Respiratory Disease Studies.
Dr. Weissman is Director of the NIOSH Division of Respiratory Disease Studies.
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June 15, 2015 at 4:18 pm ET - Patrick B
thank you for this article Mr Mazurek. That’s very helpful for my degree.
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June 16, 2015 at 11:13 am ET - Mark Ellis, NISA
The reported deaths are tragic and clearly the result of overexposures on the job. As noted in the article, these deaths are completely preventable. What are needed to prevent such outcomes are dust control, dust monitoring, medical surveillance, and strict compliance with the current PEL. An occupational health program that incorporates these elements was developed by the National Industrial Sand Association (NISA) and I recommend it for your consideration. It can be accessed at [http://www.sand.org/Silica-Occupational-Health-Program]. You also should be aware of a recent NIOSH publication, Dust Control Handbook for Industrial Minerals Mining and Processing, Report of Investigations 9689/2012, NIOSH Pub. No.2012-112. It can be accessed through the following hyperlink: http://www.cdc.gov/niosh/mining/pubs/pubreference/outputid3675.htm. Many of the dust controls identified for the industrial minerals industry potentially could be applied to other industrial sectors . . . perhaps with some modification.