Silicosis

Silicosis silica dust

Last Updated December 20th, 2021

Overview of Silicosis

Pulmonary diseases are very common in different parts of the world, particularly the tropics and the subtropics. The situation is quite alarming in India, where the prevalence rate of Chronic Obstructive Pulmonary Disease and other lung diseases is about 7%. Nearly 11% of the total deaths in the country are attributed to pulmonary diseases. At present India ranks the highest in the total number of deaths due to lung diseases.

A number of these lung diseases arise from environmental factors and industrial pollution. Silicosis is one such disease. It is essentially an occupational disease that arises due to the inhalation of crystalline silica dust. In the year 2013, silicosis resulted in 46,000 deaths all over the world.

 

What is silicosis?

Silicosis silica dustA silicosis is a severe form of lung disease that arises from the inhalation of particles of silica dust on a regular basis. It is mainly an occupational disease and is more common in factory, blast furnace or construction site workers. It is also known as Potter’s rot, Grinder’s asthma or Miner’s Phthisis, based on the kind of profession the patient is in. The disease is characterized by the scarring, inflammation, and formation of nodular lesions in the upper lobes of the lungs. It is actually a type of pneumoconiosis. The patients are found to suffer from a cough, fever, breathlessness, pulmonary edema, pneumonia and tuberculosis.

 

Pathophysiology of silicosis

As discussed earlier, silicosis is caused by the inhalation of the fine silica particles. When very minute silica dust particles are inhaled, they settle within the tiny alveolar ducts and sacs in the lungs, at the site of exchange of oxygen and carbon dioxide gases. From these locations, it becomes impossible for the lungs to expel the dust through mucous secretion or coughing.

After getting deposited in the lungs, the silica particles are slowly ingested by the macrophages. This causes an inflammation of the alveolar walls due to the release of certain harmful chemicals like- cytokines, interlukin-1, leukotriene B4 and tumor necrosis factors. This consequently leads to the stimulation of the fibroblasts, which then proliferate and form collagen around the silica particle. This results in fibrosis and the formation of nodular lesions. The inflammatory response is also elicited by NALP3 inflammasome.

Certain prominent clinical features include –

  • Fibrotic nodules
  • Collagen fibers arranged in concentric rings
  • A cellular peripheral zone surrounding a central hyalinization

It is worth mentioning in this regard that certain autoimmune diseases like scleroderma, nephritis and Lupus Erythematosus can make a person more susceptible to silicosis.

 

What kind of silica components normally contribute to silicosis?

Silicosis is mainly caused by the following forms of silica-

  • Crystalline silica: It has 7 different polymorphs, based on the temperature of the formation. Three of the most important forms are- quartz, cristobalite, and tridymite.
  • Microcrystalline silica: It is made up of tiny crystals of quartz bonded together with amorphous silica. Two common examples are- flint and chert.
  • Amorphous silica: It is formed of diatomite and vitreous silica.

Silicosis can take place due to the deposition of fine respirable dust (of any of the aforementioned forms). Mostly these dust contain crystalline silicon dioxide in the form of tridymite, cristobalite or alpha-quartz.

 

How to tell if a person has silicosis?

Silicosis miningIf a person works at an industrial site, factory, blast furnace or mine and exhibits any of the following symptoms, it is advisable to get him checked for silicosis-

  • Shortness of breath (Dyspnea) which worsens on exertion
  • Persistent and severe cough (productive or non-productive)
  • Laboured and rapid breathing (Tachypnea)
  • Loss of appetite, followed by weight loss (Anorexia)
  • Pain, discomfort and tightness around the chest
  • Frequent fever
  • Bluish discolouration of the skin (cyanosis)
  • Dark and shallow rifts and ridges on the nails, which may even open up as fissures (due to the destruction of the protein fibres within the nail-beds)
  • Presence of fluid in the lungs (pulmonary oedema)
  • Tuberculosis-like symptoms
  • Right ventricular heart disease (Cor pulmonale)
  • Difficulty completing a full respiratory cycle

 

What are the different types of silicosis?

The classification of silicosis is done based on the radiographic results, a degree of infection, onset and the rate of progression. The following categories have been identified so far-

  • Acute silicosis: This type of silicosis develops after a few weeks to a few years of direct exposure to silica dust. This is also known as silicoproteinosis.
  • Chronic simple silicosis: This is the commonly observed form of silicosis. It occurs after a prolonged and direct exposure to silica dust (low concentration silica). It normally appears around 10-30 years of exposure to the silica particles. In this type, the patients do not exhibit identifiable signs of the disease, although the infection can be detected via X-ray examination. The common manifestations at a more advanced stage are- a chronic cough and exertional dyspnea. Radiographic examinations reveal lesions less than 10 mm diameter in the upper lungs.
  • Accelerated silicosis: It is a consequence of exposure to high concentrations of silica dust for continuously for about 5-10 years. It occurs much earlier than chronic simple silicosis and advances at a very rapid rate. These patients have greater risks of developing more complicated diseases in future like Progressive Massive Fibrosis (PMF).
  • Complicated silicosis: The disease is termed complicated when excessive scarring results along with the formation of nodules that are greater than 1 cm. It is often accompanied by Progressive Massive Fibrosis and is also known as Conglomerate silicosis. Very often, the smaller nodules combine to form larger inflammatory nodules. This condition can be exacerbated by other pulmonary diseases like a fungal infection, tuberculosis, non-tuberculous mycobacterial infection and lung cancer.

 

Diagnosis, treatment, & prevention

The common diagnostic tests for silicosis are as follows-

  • Chest X-ray
  • Pulmonary function tests
  • CT scan

Silicosis xraySilicosis is an untreatable disease. It can be managed by providing symptomatic relief.

Cough medications, oxygen supply, and bronchodilators are used to manage a cough and make the airway patent and wide. Antibiotics are prescribed in case of any respiratory infection. Corticosteroids can be administered in case of acute silicosis. In advanced cases of silicosis, a lung transplant can be considered as an option in case of absence of any comorbid lung condition.

Individuals with silicosis are highly susceptible to tuberculosis. Silica might interfere with the body’s immune response to the TB bacteria (Mycobacterium tuberculosis). Latent TB infections should be tested using anti-tubercular drugs such as isoniazid. Complications such as airflow obstruction, respiratory failure etc. should be taken care of.

Eliminating further exposure to silica is essential to prevent the worsening of the condition. It is advised to quit smoking and avoid exposure to irritants. Prevention of the disease is mainly by eliminating exposure to airborne silica dust. It can be limited by using protective equipment at the workplace. It is advised to stay away from mining areas, construction sites, and other places where there is a lot of dust in the air.

Precautions can be taken to minimize the amount of dust in the surrounding air by use of water sprayers, tools or equipment with a water supply etc. Wearing disposable clothes at work, using separate clothes at work, avoiding parking vehicles in dusty areas, avoiding eating and drinking in dusty areas, maintaining hygiene etc. are some measures which can prevent the contamination of the residential space.

 

Facts

  • Silica has been classified as a human carcinogen by the U.S. government (International Agency for Research on Cancer (IARC)) since 2000.
  • Silica is principally made up of quartz dust.
  • Silicosis is an untreatable condition. However, it is preventable.

Facts

  • The size of respirable particles ranges from less than 1 micrometer to as big as 30 micrometers.
  • During the years 1968–2002, approximately 74 million deaths in the U.S. occurred due to silicosis. Out of the total number of deaths, 98% were males.

Facts

  • As per the information furnished by the U.S. Bureau of Mines, silica is present in almost all of the mining operations.
  • As per the data furnished by the Occupational Safety and Health Administration (OSHA) Department of the United States, exposure to silica risks the lives of almost 2 million American employees annually.

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Dos and Don'ts

Dos
  • Use water sprays, saws which add water to the blades, drills which add water to the stem, and types of equipments with a dust collection system. This will prevent the dust from becoming airborne.
  • Have proper ventilation when you are working in closed spaces so as to minimize the inhalation of dust.
  • Use properly fitted respirators (particulate filter or airline supplied air respirator) that can protect you from crystalline silica.
  • Go for lung screenings or health check-ups regularly, if you are exposed to silica dust.
Don'ts
  • Eat or drink in the dusty areas. Eat or drink (outside the dusty areas) only after washing hands.
  • Go home without changing dusty clothes. Use disposable clothes or separate work clothes. This will prevent the contamination of other work areas, cars, residential space etc.
  • Keep a mustache or beard. This will prevent the respirator from getting sealed to your face and let the dust inside.

 

 

 

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Nutritional Yeast : How can a fungi culture be good for your body? Nutritional yeast: How a simple culture of fungi can transform your skin, digestion, immunity , and much more.…
Epley maneuver: Why is this the best protection from the symptoms of vertigo? Epley maneuver is an exercise that can treat the symptoms of benign paroxysmal positional vertigo (BPPV).  It was…
What to eat, what not to eat in the South Beach Diet? The South Beach Diet is one among the most popular weight loss programs that have been the talk…
Erythritol: A healthy sugar substitute or yet another marketing ploy? Erythritol is a popular choice of a healthy alternative sweetening agent in foods. But how healthy can a…
Carb Cycling: Weighing the pros vs the cons of this diet routine Completely discarding carbs from your life will do you more harm than good. Read more about carb cycling,…
Ear pain model
Easy and safe tips for ear wax removal you can do at home Cerumen impaction generally occurs when an external object like cotton swabs are used to remove the ear wax.…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
AUTOIMMUNE HEPATITIS liver
Hepatitis Profile A hepatitis profile or a hepatitis panel is a blood test that checks for markers of hepatitis infection…
Hepatitis A virus infected liver
Hepatitis A Virus (HAV) Total Blood test to look for IgM antibodies to know if you are infected with Hepatitis A virus (HAV),…
carrageenan seaweed
Carrageenan: How a simple seaweed extract could better your gut health & immunity Eat more ice cream to prevent cold and flu? –With carrageenan you get one simple seaweed extract that…
dance health benefits
5 unbelievable effects of dance on your overall health! You enjoy dancing, but did you know what else it does to your body? Dancing is not only…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
How seitan proved to be a blessing in disguise for vegans worldwide Can only meat-eaters enjoy delicious juicy steaks and burgers? With seitan, the best meat substitute available today,even vegans…
Appendix pain: Recent findings on this not-so vestigial organ The exact function of the appendix is still not clear. Some consider it as an organ that once…
Surgery or home-remedy; what is the right way to treat a burn The treatment of a burn injury depends on its severity. You can save a life by offering the…
liver cleanse detox
14 go-to foods that are best for a complete natural liver detox Liver cleanse can be achieved by just choosing or avoiding certain types of food. Liver itself is a detoxifying…
Chest X-Ray A chest x-ray is a diagnostic test that uses x-rays to visualize the structures inside your chest. It…
Strep throat pain
Anti-Streptolysin-O Test The ASO or Anti-Streptolysin-O is a blood test designed to check for the presence of streptococcus bacterial infection…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
AHBC Igm
Anti-Hepatitis B Core Antigen (AHBc) IgM Anti-hepatitis B core antigen (AHBC) IgM is an investigative procedure to detect the presence of IgM antibodies in…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
Unbelievable health benefits of gooseberries (and a few tasty recipes) Gooseberries are antioxidant-rich tasty fruits that can be easily added in daily diet to improve overall health and…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
cancer facts
8 hard-hitting truths no one tells you about cancer Did you know that 1.5 million new cases of cancer are reported every year? Can second-hand smoking kill…
50 common health conditions
What are the top 50 deadly and widespread diseases? A complete list of the top 50 most common and deadly diseases that plague humanity. Which disease is…