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Silicosis: Causes, Symptoms, Diagnosis And Treatment

People who work in areas where they breathe in dust containing silica are subjected to a lung disease known as silicosis [1] . Silica is a tiny crystal that is found in rock, sand or mineral ores such as quartz. For people who work in silica dust-prone regions, the silica can build up in the lungs and breathing passages leading to scarring that can make it very difficult for the person to breathe normally [1] .

Read on to know more about the causes of silicosis, its symptoms, diagnosis, treatment and steps for prevention.

What Is Silicosis?

Silicosis is a lung disease that occurs when one inhales silica dust [2] . It is usually found to occur in workers who are exposed to silica dust due to their jobs. People who are employed in occupations such as mining, foundry work and glass manufacturing are most likely to suffer from silicosis. With extended exposure to silica particles, the lungs get scarred which eventually harms one's ability to breathe [3] .

The following are the three types of silicosis:

  • Acute [4] : Lungs become inflamed. They might be filled with fluid. It causes low blood oxygen levels and severe shortness of breath. Symptoms usually begin to occur between a few weeks up to 2 years after exposure to large amounts of silica.
  • Chronic: The accumulated silica dust leads to swelling in the lungs and chest lymph nodes [5] . This makes breathing extremely difficult. Sometimes problems may not show up until decades after the exposure. Symptoms might be mild at first and then worsen slowly.
  • Accelerated: There is severe swelling in the lungs. The signs begin to show up 5 to 10 years after extreme exposure to silica [6] . The symptoms worsen quickly.

Causes Of Silicosis

Heavy exposure to crystalline silica causes silicosis. Any occupation that deals with disturbing the earth's crust can lead to silicosis (such as cutting, drilling, chipping, grinding soil, sand or granite). The following occupations cause extreme exposure to silica [7] :

  • Glass manufacturing
  • Tunnel work
  • Construction work
  • Mining (coal or hard rock mining)
  • Masonry
  • Sandblasting
  • Ceramics work
  • Quarrying
  • Stone cutting
  • Steel industry work

Risk Factors Of Silicosis

The primary risk factor is exposure to silica dust. Limiting exposure to crystalline silica is the best way to prevent the occurrence of this ailment. Most of the occupations (wherein there is exposure to silica) have maintained a guideline on the exposure limits for a worker over his entire working lifetime.

Also, employers need to provide their workers with the perfect clothing and equipment so that they can protect themselves from exposure to silica effects [8] .

Patients who suffer from silicosis have an increased risk for other problems such as lung cancer, tuberculosis and chronic bronchitis.

Symptoms Of Silicosis

Early symptoms include the following [9] :

  • Phlegm
  • A nagging cough
  • Trouble breathing

Later symptoms include the following (in addition to the early symptoms) [10] :

  • Fatigue
  • Chest pain
  • Weight loss
  • Bluish discolouration of the lips
  • Swollen legs
  • Sudden fever
  • Shortness of breath

Diagnosis Of Silicosis

Once you approach a doctor with the symptoms of silicosis, you might need to undergo the following tests:

  • Chest x-ray or CT scan: The test is used to check the lungs for scars [11] .

  • Sputum test [12] : This is done to check for the presence of other lung diseases such as tuberculosis.
  • Biopsy: A lung tissue biopsy involves the doctor taking a sample of a nodule with the use of a needle that is guided through your chest and into your lungs [13] . This sample is checked under a microscope to look out for signs of silicosis.
  • Bronchoscopy [14] : A long, thin tube with a tiny camera is run through till the end into your lungs. This is performed to check for damages that might have occurred.

Treatment For Silicosis

There is no cure for silicosis. Once silicosis develops, your doctor would assess the degree of lung damage using tests. In extreme cases, some people might require oxygen and support for breathing. Treatment can help in the management of symptoms and ideally include the following:

Medications: Inhaled steroid can reduce lung mucus [15] . Bronchodilators can help in the breathing passages being relaxed [16] .

  • Oxygen therapy [17] : The portable oxygen tank is used to help a person fight and reduce fatigue.
  • Lung transplant surgery: In the case of advanced lung damage, surgical intervention might be required [18] .

Possible Complications Of Silicosis

Silicosis can lead to the following health problems [19] :

  • Tuberculosis
  • Respiratory failure
  • Lung cancer
  • Progressive massive fibrosis
  • Connective tissue disease (rheumatoid arthritis, systemic lupus erythematosus and scleroderma)

Prevention Of Silicosis

The simplest prevention steps include the following [20] :

  • Limit the time you are exposed to silica.

  • Wear a mask or protective clothing when you work around silica-dust areas.
  • Ask your employer for proper safety equipment.
  • Quit smoking. It worsens lung damage.
  • Avoid secondhand smoke.

  • Avoid areas with a lot of air pollution, dust and allergens.
  • Do not eat or drink near silica dust.
  • Use proper ventilation or blasting cabinets during work.
  • Use respirators that can protect you from inhaling silica.
  • Use wet methods to cut, chip or grind materials.
  • Wash your hands and face before you eat.
  • Shower and change your clothes immediately after work hours.
View Article References
  1. [1] Sato, T., Shimosato, T., & Klinman, D. M. (2018). Silicosis and lung cancer: current perspectives.Lung Cancer (Auckland, N.Z.),9, 91–101.
  2. [2] Leung, C. C., Yu, I. T. S., & Chen, W. (2012). Silicosis.The Lancet,379(9830), 2008-2018.
  3. [3] Chen, W., Liu, Y., Wang, H., Hnizdo, E., Sun, Y., Su, L., … Wu, T. (). Long-term exposure to silica dust and risk of total and cause-specific mortality in Chinese workers: a cohort study.PLoS medicine,9(4), e1001206.
  4. [4] Duchange, L., Brichet, A., Lamblin, C., Tillie, I., Tonnel, A. B., & Wallaert, B. (1998). Acute silicosis. Clinical, radiologic, functional, and cytologic characteristics of the broncho-alveolar fluids. Observations of 6 cases.Revue des maladies respiratoires,15(4), 527-534.
  5. [5] Cowie, R. L., & Mabena, S. K. (1991). Silicosis, chronic airflow limitation, and chronic bronchitis in South African gold miners.American Journal of Respiratory and Critical Care Medicine,143(1), 80-84.
  6. [6] Hutyrová, B., Smolková, P., Nakládalová, M., Tichý, T., & Kolek, V. (2015). Case of accelerated silicosis in a sandblaster.Industrial health,53(2), 178–183.
  7. [7] Ziskind, M., Jones, R. N., & Weill, H. (1976). Silicosis.American review of respiratory disease,113(5), 643-665.
  8. [8] Leso, V., Fontana, L., Romano, R., Gervetti, P., & Iavicoli, I. (2019). Artificial Stone Associated Silicosis: A Systematic Review.International journal of environmental research and public health,16(4), 568.
  9. [9] Lopes-Pacheco, M., Bandeira, E., & Morales, M. M. (2016). Cell-Based Therapy for Silicosis.Stem cells international,2016, 5091838.
  10. [10] Koskinen, H. (1985). Symptoms and clinical findings in patients with silicosis.Scandinavian journal of work, environment & health, 101-106.
  11. [11] Bégin, R., Ostiguy, G., Fillion, R., & Colman, N. (1991). Computed Tomography Scan in the Early Detection of Silicosis1, 2.Am Rev Respir Dis,144, 697-705.
  12. [12] Ryu Y. J. (2015). Diagnosis of pulmonary tuberculosis: recent advances and diagnostic algorithms.Tuberculosis and respiratory diseases,78(2), 64–71.
  13. [13] Tukiainen, P., Taskinen, E., Korhola, O., & Valle, M. (1978). TruCutR needle biopsy in asbestosis and silicosis: correlation of histological changes with radiographic changes and pulmonary function in 41 patients.British journal of industrial medicine,35(4), 292–304.
  14. [14] CONCINA, E., & ORLANDI, O. (1951). Bronchoscopic findings in silicosis and silicotuberculosis.Rassegna di medicina industriale e di igiene del lavoro,20(6), 424.
  15. [15] BEKLEMISHEV, N., RUBILINA, E., PODLESNOV, A., DVOIRIN, V., ZIABREV, I., NESIS, A., & PALKIN, V. (1963). INHALATION OF CORTICOSTEROIDS IN SILICOSIS THERAPY.Gigiena truda i professional'nye zabolevaniia,7, 30-34.
  16. [16] Yoon, H. Y., Kim, Y., Park, H. S., Kang, C. W., & Ryu, Y. J. (2018). Combined silicosis and mixed dust pneumoconiosis with rapid progression: A case report and literature review.World journal of clinical cases,6(16), 1164–1168.
  17. [17] ZORN, O., ENGELKE, H., FRIEHOFF, F., & KARRASCH, K. (1958). Oxygen inhalation therapy in chronic lung diseases, especially emphysema and severe silicosis.Beitrage zur Silikose-Forschung,118(51), 1-35.
  18. [18] Singer, J. P., Chen, H., Phelan, T., Kukreja, J., Golden, J. A., & Blanc, P. D. (2012). Survival following lung transplantation for silicosis and other occupational lung diseases.Occupational medicine (Oxford, England),62(2), 134–137.
  19. [19] Dreessen, W. C., Page, R. T., & Brinton, H. P. (1942). Silicosis and Other Health Problems of Metal Miners.American journal of public health and the nation's health,32(2), 142–150.
  20. [20] Kulkarni G. K. (2007). Prevention and control of silicosis: A national challenge.Indian journal of occupational and environmental medicine,11(3), 95–96.

Read more about: lung disease tuberculosis breathing
Story first published: Wednesday, May 29, 2019, 10:45 [IST]
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