What Is Silicosis?

A Disease Caused by Inhaled Silica Dust

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Silicosis is a lung disease caused by breathing in too much silica dust. It is a progressive disease that causes symptoms like cough and shortness of breath.  

Silicosis is one of a group of medical conditions known as pneumoconioses. These diseases are caused by breathing in different kinds of dust particles, usually in a work environment, that causes scarring inside the lung. 

You may be familiar with another disease in this group, asbestosis, caused by exposure to asbestos. In the U.S., it is the most common type of pneumoconiosis, but worldwide, silicosis is more common. Rates in the U.S. have declined as better protective measures have been employed in many work environments.

Stonecutter at his workshop

sanjeri / E+ / Getty Images

Silicosis Symptoms

The potential symptoms of silicosis in its early stages might include:

  • Dry cough 
  • Chest pain
  • Wheezing 
  • Abnormal shortness of breath with exercise

However, in the early stages of the disease, individuals often don’t have any symptoms at all. The symptoms of silicosis often don’t appear until 10 to 20 years of exposure to silica in a work environment. This is called chronic silicosis. 

Sometimes symptoms show up more quickly than that, especially for people who have been exposed to larger amounts of silica dust. Higher levels can cause symptoms in five to 10 years (accelerated silicosis).

Even higher exposure levels might cause symptoms in weeks or months, causing the most severe type of disease (acute silicosis).

Especially in someone otherwise young and healthy, a person might have undergone a lot of lung damage from silicosis before any obvious symptoms show up. 

Symptoms of Advanced Disease

In a person with advanced disease, these symptoms can become quite severe. The shortness of breath can get a lot worse.

An affected individual might develop new symptoms, like severe fatigue and swelling in their extremities. Some people develop pulmonary hypertension—elevated blood pressure in the blood vessels that lead to the heart. 

Eventually, this may cause the right side of your heart not to pump as much blood as it should. This is known as right-side heart failure. This can lead to life-threatening respiratory failure, in which your blood might not have enough oxygen and might have too much carbon dioxide.

Increased Risk of Other Medical Conditions

People with silicosis also have an increased risk of some other medical conditions. For example, people with silicosis have an increased risk of lung cancer. It also increases the risk that you will develop pulmonary tuberculosis if you are ever exposed to the bacteria that causes it. 

Silicosis seems to increase the risk of certain autoimmune diseases, including scleroderma, lupus, and rheumatoid arthritis. It also seems to increase the risk of kidney disease.

Some people exposed to silica dust also develop symptoms from chronic obstructive pulmonary disease (COPD). This might happen even if they don’t develop true silicosis. 

Many people also experience depression and anxiety related to their silicosis diagnosis. For many people, the disease poses a risk to their livelihood. Additionally, the condition can decrease your quality of life deeply, which naturally impacts your mood and outlook.

Cause

Silicosis is caused by inhaling too much of the crystalline form of silica (also called silicon dioxide). Especially when this happens over a period of years, silicosis can result.

Who Is Exposed to Inhaled Silica Dust?

Crystalline silica can be found in many different materials, including concrete, sand, mortar, other minerals, granite, and artificial stone. 

Some types of work require cutting, drilling, blasting, or grinding up materials containing this crystalline silica. This can release silica dust into the air. If proper health precautions aren’t taken, workers can breathe in hazardous levels of this silica dust.

Any person exposed to inhaled silica dust at work is at risk for silicosis. In the U.S., it is estimated that over 2 million people have some level of exposure to silica dust. Some professionals at risk of silicosis include:

  • Stonemasons
  • Quarry workers
  • Foundry workers
  • Miners
  • Demolition workers
  • Sandblasters
  • People working in oil and gas 
  • Cement and asphalt manufacturers
  • Certain construction workers (such as pavers)

Artificial stone—often used to make kitchen and bathroom benchtops—is an increasing cause of silicosis. Cutting or grinding this stone can cause very high levels of silica dust to be released. This can cause severe symptoms of silicosis to appear in weeks or months.

Why Don’t Symptoms Begin Right Away?

Silica dust doesn’t directly damage your lungs. It is different from chemical vapors, which might immediately injure your lungs and cause symptoms right away.

Instead, the silica dust can start up a damaging type of immune response. In trying to rid your body of foreign dust, your body sets off a lot of inflammation

Certain cells of the immune system get chronically turned on. Over time, your body’s immune response to silica can damage your lungs. Eventually, this can lead to severe lung scarring. This, in turn, can limit how well you can breathe.

This is why silicosis symptoms usually don’t go away, even if you aren’t still exposed to silica dust. Even after that is gone, your immune system may still be activated and causing further lung scarring. 

Diagnosis

Some people are first diagnosed after symptoms begin, and they seek medical treatment. Others are diagnosed as part of routine medical screenings provided by their employer. Clinicians need to distinguish silicosis from other diseases that can cause similar symptoms and X-ray findings, such as sarcoidosis.

If you are exposed to silica dust at work, you should be receiving regular medical screenings. These can help find people with silicosis before they’ve started having any symptoms.

The National Institute for Occupational Safety and Health (NIOSH) mandates that any worker potentially exposed to silica dust has regular medical examinations, which must include chest X-ray and lung function tests. If your employer hasn't provided such free screenings, it's still important to check with a doctor.

Medical history is a key part of the diagnosis. Your medical provider should ask you about any recent symptoms as well as your other medical problems. It’s especially important that they find out your work history and your potential exposure to silica dust. A medical exam may also give some helpful clues. 

A chest X-ray is also often an important part of forming a diagnosis. Chest computed tomography (CT) can also provide more detailed information about the lungs. 

Pulmonary function tests—non-invasive tests to check how well your lungs are functioning—are also helpful. Some people might need a lung biopsy as well. In this case, you’d need to have a tiny portion of your lung removed so that a laboratory specialist could examine it under a microscope.

If someone in your workplace has been diagnosed with silicosis, it's vital that everyone else is evaluated for the disease. The existing workplace safety precautions should be reviewed. Further protective measures, like better protective equipment, should be put in place.

Unfortunately, silicosis is not always successfully diagnosed, probably because some doctors aren't thinking about it as a possibility. If you have ever worked at a job with potential silica exposure, make sure all your doctors know that.

Treatment

Unfortunately, there aren't good treatments for silicosis. Even if the affected person completely avoids silica dust in the future, the disease usually gets worse over time. 

Some medications might help you manage your disease. These might include:

  • Bronchodilator medications like albuterol
  • Cough medications like Robitussin (dextromethorphan)  
  • Corticosteroids (for bronchitis symptoms)

A procedure called lung lavage may also decrease symptoms. Under general anesthesia, saltwater is used to wash out the lungs.

Supplemental oxygen may also be helpful, if needed. At first, you might only need it while exercising, but you might need to use it more often as the disease progresses.

Researchers have also investigated existing therapies that might be helpful in silicosis. For example, an early study reported benefits from the therapy Kineret (anakinra), which might help block some of the inflammation in silicosis. However, there is only limited data for these other treatments, so we don’t really know how effective they are. 

If the lung disease from silicosis becomes very severe, a lung transplant is the only option. However, lung transplantation comes with serious risks and side effects.

Other Treatment Considerations

It’s also essential to avoid any future exposure to silica dust in the future, even if you don’t have any symptoms now. This may help lessen your symptoms over the long-term.

Smoking is bad for everyone’s lungs, but it’s even more important to quit smoking if you have silicosis. Smoking worsens lung disease and may make your symptoms worse. It’s also an additional risk factor for lung cancer, which is already a risk for people with silicosis.

You should also avoid other potential lung irritants, like allergens or indoor and outdoor air pollution.

It's also important to stay active. Exercise regularly, but don't overdo it. For some people, a pulmonary rehabilitation program can help them maintain optimal levels of activity.

Lung infections are also more dangerous in people with silicosis, and they may be more difficult to treat. Because of this, it’s important to get vaccines for influenza (the flu), pneumococcus, and COVID-19, as recommended by your doctor. 

If you have any signs of infection, like fever or worsened cough, you should seek treatment right away. You might need antibiotics or other treatments to address an underlying infection. 

Because people with silicosis are more prone to getting tuberculosis, if exposed, you should be regularly screened for the disease. This might be done through a PPD skin test or other methods. If positive, you'd need treatment with drugs to treat latent or active tuberculosis, depending on the results of diagnostic tests.

It may be helpful to get the input of a lung specialist (pulmonologist) to manage your treatment plan optimally.

Prevention

It’s much easier to prevent silicosis than to treat it. If you are working in a field that exposes you to silica dust, know the risks and know your rights. Everyone deserves a safe work environment.

In June 2018, The Occupational Safety and Health Administration (OSHA) lowered its maximum limit for inhalable silica dust and mandated medical screenings for any workers potentially exposed to higher levels.

OSHA and NIOSH provide guidelines for safe practices in the workplace. Methods to reduce exposure include the following:

  • Using wet methods over dry methods at a site where silica dust is present
  • Using blasting cabinets and other methods to contain dust
  • Providing optimal ventilation methods
  • Switching to non-silica containing products, when possible
  • Only permitting potential exposure for very short periods
  • Giving workers additional respiratory protection, like special masks or respirators, if needed
  • Never eating, drinking, or smoking near silica dust
  • Washing your hands and face before eating, drinking, or smoking after exposure

Other precautions may be appropriate in specific industries. The full guidelines from OSHA and NIOSH provide even more detailed information.

If you are concerned about possible exposure to silica dust in your workplace, don’t hesitate to ask for advice from experts. You can contact NIOSH to request an evaluation of health hazards from silica dust at your workplace. Employers, employees, and union officials can request such a free assessment.

Coping

Many people find it helpful to connect with others dealing with silicosis. Through organizations such as the American Lung Association, you can find resources and ways to reach out to others. You might also benefit from a counselor who can help you navigate some of these challenges.

Someone on your medical team should also be able to give you information about pursuing a workers' compensation claim, which may provide you some income protection. Some people may also be interested in pursuing legal action against their employers.

A Word From Verywell

Silicosis is a devastating diagnosis, one which may require individuals to seek other work. That, and the worsening nature of the disease, make it a heavy blow. Get educated about the topic, so you can help make sure everyone in your workplace can stay safe. 

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