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Silicosis

Occupational lung disease

Being told that you or someone you love has silicosis can be an overwhelming experience. Silicosis is a complex condition and there are many decisions to be made, as well as emotional and practical concerns. It is important to remember that you are not alone.

What is silicosis?

Silicosis is an occupational lung disease caused by breathing in small particles of silica dust. Inhaling this dust causes inflammation which over time, leads to scarring of the lung tissue. This causes stiffening of the lungs, which can make it difficult to breathe.

Exposure to silica dust can also cause:

  • Chronic Obstructive Pulmonary Disease (COPD) (which includes emphysema and chronic bronchitis)
  • Lung cancer
  • Chronic kidney disease
  • Scleroderma and other autoimmune conditions
  • An increased risk of infections such as tuberculosis and fungal diseases

Who develops silicosis?

Silica dust is generated when silica-containing materials are cut, crushed, drilled, ground, polished, sanded, sawed – or disturbed with force. If you are exposed to silica dust, you are at risk of developing silicosis.

The risk of developing silicosis primarily depends on how much silica dust you have been exposed to, and for how long you were exposed to it. For example, you may have been exposed to a high level of silica dust over a short duration (weeks or months) or been exposed to a low level of silica dust over a long duration (years).

Symptoms

In most cases, people with silicosis will not experience any symptoms in the early stages. Over time, if the disease progresses, symptoms may slowly develop, even if exposure to silica dust has ceased. Progression of the disease can vary considerably among individuals. Common symptoms of silicosis include:

No symptoms

Shortness of breath

Cough

Tiredness

Chest pain

Weight loss

Diagnosis

If you are at risk of silica dust exposure, your employer should organise and pay for you to undergo health monitoring. This is a legal requirement under work health and safety legislation. Health monitoring involves periodic check-ups by a certified doctor to monitor any possible changes in your health due to your exposure to hazardous agents, like silica dust, in the workplace. Health monitoring is important, particularly as a means of identifying workers with silicosis who often have no symptoms, and providing appropriate management. If changes are identified during health monitoring, you should be referred to a respiratory physician for further investigation and to confirm a diagnosis. If you are no longer working or participating in workplace health monitoring, the first step to diagnosing silicosis is a discussion with your GP about your work history, known exposures and symptoms (if present). To confirm a diagnosis, you will most probably need a referral to a respiratory physician.

Management

There is currently no treatment to reverse silicosis. However, there are management and treatment options available that may slow progression of the disease and may also help to reduce your symptoms. Management of silicosis is based on each person’s individual circumstances. Your treating healthcare team will work with you to determine the most appropriate options for you. Some management options include:

  • Access mental health support
  • Exercise
  • Quit smoking and vaping
  • Ensure your vaccinations are up to date
  • Make healthy choices

Treatment Options

Medication

  • Anti-fibrotic medication: Anti-scarring tablets may be used in some people with progressive silicosis. This medication has been shown to help slow the rate of progression of lung disease in other lung conditions such as Idiopathic Pulmonary Fibrosis and involves taking a tablet twice a day
  • Inhaled reliever medications: These may assist with other co-existing lung diseases, such as asthma or Chronic Obstructive Pulmonary Disease
  • Inhaled corticosteroids: These may assist with other co-existing lung diseases.
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Whole lung lavage

This is not a treatment that is readily available or recommended for all cases of silicosis and will depend on individual circumstances, such as disease stage, type and progression. Your treating respiratory physician may consider if this is a possible treatment option for you – it will require referral to a specialist centre with expertise in this procedure. This procedure involves a general anaesthetic and flushing several litres of a salt-water solution through each lung with the aim of “washing out” damaging silica crystals. 

Oxygen therapy

Oxygen therapy may be prescribed by your GP or respiratory physician if you have low blood oxygen levels. It can assist with shortness of breath and to help you stay active. Some people only use oxygen when walking or exercising; others may need to use it overnight or on a continuous basis. 

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Lung transplantation

Lung transplantation is not common and will be recommended by your respiratory physician based on individual circumstances. If you are suitable for lung transplantation, your respiratory physician will discuss the risks and benefits of the surgery, as it is a major procedure. 

Clinical trials

Clinical trials may be an option for some people with silicosis. Ask your treating respiratory physician if there are any clinical trials that may be available for you to participate in. 

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