Safe Work Australia has recently published a report Occupational Lung Diseases in Australia 2006-2019. Regarding the report prepared by the Monash Centre for Occupational and Environmental Health, it presents changes in the extent and incidence of occupational lung diseases since 2006.
In addition to providing an overview of occupational lung diseases in Australia, the report identifies industries and occupations where workers may be at risk of developing an occupational lung disease. Moreover, these industries include construction, mining and quarrying industries, and those working with engineered stone.
To sum up, the report highlights several significant trends, including:
- a substantial increase in:
– pneumoconiosis, especially coal workers pneumoconiosis, and
– silicosis from working with engineered stone - a decline in workers’ compensation claims for asbestos-related occupational lung diseases, such as asbestosis
- an increase in the understanding of the role of occupational exposure and the risk of developing coal workers pneumoconiosis, and
- an apparent decline in work-related asthma cases as evidenced by fewer compensation claims.
In conclusion, the report shows that occupational lung diseases continue to be a health concern in Australia and substantially contribute to the burden of lung disease.
WHAT WORKERS ARE AT RISK?
Quartz is the most common type of crystalline silica. That is, quartz is the second most abundant mineral in the earth’s crust. In other words, silica is found in most rock beds and their sands.
Consequently, fine silica dust is formed during breaking, cutting, dressing and polishing stone. For example, tools used to perform these tasks include saws, hammers, chisels, pitchers, airguns and angle grinders.
Indeed, workers at risk include those in:
- Mining
- Quarrying
- Tunneling
- Construction
- Stone cutting and installation including composite stone used in kitchen, bathrooms, laundries.
- Glass manufacture
- Sand blasters
- Abrasives manufacturing
- Slate works
- Foundries
- Pottery and ceramic manufacture
- Brick and tile manufacture
- Landscapers who cut stone.
As a result, The World Health Organization (WHO) recommends all workers exposed to crystalline silica should undergo lifelong health surveillance with annual questionnaire and spirometry and periodic chest x-rays.
HOW DOES SILICA CAUSE DISEASE?
Respirable Crystalline Silica damages lungs in a number of ways. There is a direct cytotoxic action by the crystals on lung tissue. Also, the crystals are swallowed by immune cells (macrophages)in the lungs. Furthermore, they attempt to chemically destroy the crystals but they themselves die and the toxic chemicals release further damage the lung tissue. New immune cells come to try the same process with the same result. This creates on ongoing cycle of scarring and swelling in the lungs and the chest lymph nodes that continues after silica exposure ceases.
Specifically, three types of silicosis occur:
Chronic silicosis
Results from long-term exposure to low concentrations of silica dust for periods more than 20 years. This is the most common form of silicosis.
Accelerated silicosis
Occurs after exposure to higher concentrations of silica over a shorter period of time such as 5 to 15 years.
Acute silicosis
Results from short-term exposure to very high concentrations of silica. The lungs become very inflamed and can fill with fluid, causing severe shortness of breath and a low blood oxygen levels.
SYMPTOMS OF SILICOSIS
Most importantly, the symptoms are subtle at first and gradually increase as the scarring of the lungs progresses.
Symptoms include:
- Cough
- Excess phlegm production
- Susceptibility to chest infections
- Shortness of breath
- Weight loss
Additionally, silicosis creates other health problems. These include:
- Autoimmune Connective tissue diseases, including rheumatoid arthritis, scleroderma and systemic lupus erythematosus. These can affect all body organs
- Lung cancer
- A high susceptibility to contract Tuberculosis
MONITORING AND DIAGNOSIS
A Jobfit health practitioner will take a medical and occupational history to understand if silica exposure may have occurred in the past. Also, this includes worker hobbies.
A physical exam will be performed with a Lung Function test (spirometry) and a chest x-ray. Furthermore, workers are to attend their chest x-ray a week prior to the appointment so the result can be discussed.
After that, further testing will be advised if required. For instance, a High Resolution Chest CT scan may be requested.
CAN SILICOSIS BE TREATED?
No. There is no specific treatment for silicosis. Importantly, once diagnosed removing the worker from dust exposure and any other respiratory irritants is critical to prevent the disease from getting worse. Workers should quit smoking and receive regular flu and pneumonia vaccines. Supportive treatments are used to minimise symptoms including cough medicine, puffers (if effective) and oxygen. People with severe silicosis may need to have a lung transplant.
PREVENTION IS KEY
- Recognise what materials contain silica, move to non or low silica content materials where possible
- Use low dust methods of work (wet cutting)
- Use of extraction ventilation
- Good housekeeping – regular removal of surface dust with vacuum.
- Dust monitoring
- All workers should wear effective respiratory protection when working with Respirable Crystalline Silica products
Please contact us for more information on our Crystalline Silica Health Screening services, or call 1300 61 61 65.
