Silicosis

Definition

Silicosis is a progressive disease that belongs to a group of lung disorders called pneumoconioses. Silicosis is marked by the formation of lumps (nodules) and fibrous scar tissue in the lungs and is caused by exposure to inhaled particles of silica, mostly from quartz in rocks, sand, and similar substances.

Description

Silicosis is the oldest known occupational lung disease. It was first described in 1705 in stonecutters. An estimated 2 million workers in the United States are employed in occupations at risk for the development of silicosis. These include miners, foundry workers, stonecutters, potters and ceramics workers, sandblasters, tunnel workers, and rock drillers. Risk of developing silicosis increases with increasing years of exposure.

Silicosis is mostly found in adults over 40 years of age. It has four forms:

KEY TERMS
Alveoli—
The small air sacs located at the ends of the breathing tubes of the lung, where oxygen normally passes from inhaled air through the membranes into the capillaries and the bloodstream.
Bronchoscopy—
A procedure in which a fiber optic instrument called a bronchoscope is inserted in the airways allowing the physician to inspect the linings of the airways.
Fibrosis—
A condition characterized by the presence of scar tissue or collagen proliferation in tissues to the extent that it replaces normal tissues.
Pneumoconiosis (plural, pneumoconioses)—
Any chronic lung disease caused by inhaling particles of silica or similar substances that lead to loss of lung function.
Silica—
A substance (silicon dioxide) occurring in quartz sand, sandstone, flint, and agate and other rocks. It is used in certain processes, such as making glass or pottery and scouring and grinding powders.

Causes and symptoms

The precise mechanism that triggers the development of silicosis is still unclear. What is known is that particles of silica dust get trapped in alveoli in the lungs where air exchange takes place. White blood cells called macrophages enter the alveoli, ingest the silica, and die. The resulting inflammation attracts other macrophages to the region. The nodule forms when the immune system forms fibrous tissue to seal off the reactive area. The disease process may stop at this point or speed up and destroy large areas of the lung. The fibrosis may continue even after the worker is no longer exposed to silica.

Diagnosis

Diagnosis of silicosis is based on the following:

Treatment

Symptom management

There is no cure for silicosis. Therapy is intended to relieve symptoms, treat complications, and prevent respiratory infections. It includes careful monitoring for signs of TB. Respiratory symptoms may be treated with bronchodilators, increased fluid intake, steam inhalation, and physical therapy. Patients with severe breathing difficulties may be given oxygen therapy or placed on a mechanical ventilator. Acute silicosis may progress to complete respiratory failure. Heart-lung transplants are the only hope for some patients.

Patients with silicosis should call their doctor for any of the following symptoms:

Lifestyle changes

Patients with silicosis should be advised to quit smoking, prevent infections by avoiding crowds and persons with colds or similar infections, and receive vaccinations against influenza and pneumonia. They should be encouraged to increase their exercise capacity by keeping up regular activity and to pace themselves with their daily routine.

Prognosis

Silicosis is currently incurable. The prognosis for patients with chronic silicosis is generally good. Acute silicosis, however, may progress rapidly to respiratory failure and death.

QUESTIONS TO ASK YOUR DOCTOR

Prevention

Silicosis is a preventable disease. In the United States, the National Institute for Occupational Safety and Health (NIOSH) standard for exposure to inhalable silica is 0.05 mg/m3, whereas the Occupational Safety and Health Administration (OSHA) has set a permissible exposure limit slightly higher at 10 mg/m3. These workplace rules have substantially decreased the number of cases of silicosis in American workers.

Other preventive occupational safety measures are:

Coworkers of anyone diagnosed with silicosis should be examined for symptoms of the disease. The state health department and OSHA or the Mine Safety and Health Administration (MSHA) must be notified whenever a diagnosis of silicosis is confirmed.

See also Fibrosis ; Smoking .

Resources

BOOKS

Rosner, David, and Gerald Markowitz. Deadly Dust: Silicosis and the On-going Struggle to Protect Workers' Health. Ann Arbor: University of Michigan Press, 2006.

Tarlo, Susan, Paul Cullinan, and Benoit Nemery, eds. Occupational and Environmental Lung Diseases: Diseases from Work, Home, Outdoor and Other Exposures. Hoboken, NJ: Wiley, 2010.

WEBSITES http://www.nlm.nih.gov/medlineplus/ency/article/000134.htm (accessed September 18, 2012).

National Center for Biotechnology Information. “Resources for Silicosis.” http://www.ncbi.nlm.nih.gov/sites/ga?disorder=Silicosis (accessed September 18, 2012).

National Institute for Occupational Safety and Health (NIOSH). “Silica.” Centers for Disease Control and Prevention. http://www.cdc.gov/niosh/topics/silica (accessed September 18, 2012).

Varkey, Basil. “Silicosis.” Medscape Reference. http://emedicine.medscape.com/article/302027-overview (accessed September 18, 2012).

ORGANIZATIONS

Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd., Atlanta, GA, 30333, (404) 639-3534, (800) 232-4636; TTY: (888) 232-6348, inquiry@cdc.gov, http://www.cdc.gov .

Mine Safety and Health Administration, 4015 Wilson Blvd., Arlington, VA, 22203, (877) 778-6055, MSHAhelp desk@dol.gov, http://www.msha.gov .

National Center for Biotechnology Information, 8600 Rockville Pike, Bethesda, MD, 20894, (301) 496-2475, http://www.ncbi.nlm.nih.gov .

Occupational Safety & Health Administration, 200 Constitution Ave. NW, Washington, DC, 20210, http://www.osha.gov .

Maureen Haggerty
Revised by Tish Davidson, AM

  This information is not a tool for self-diagnosis or a substitute for professional care.