Silicosis

Silicosis silica dust

Last Updated May 15th, 2019

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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How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
Oxidative Stress: Understanding the most lethal phenomenon happening in your body right now Free radicals cause damage to the body, which is known as oxidation.  The amount of oxidation caused by…
Hydroquinone: Is it the best topical treatment for hyperpigmentation? Darkening of the skin due to high melanin levels is called hyperpigmentation.  Hydroquinone interferes with melanin production thus treating…
11 unbelievable health benefits of thyme you didn’t know! Thyme is a herb that has been used in alternative medicine.It is a well known seasoning in the…
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…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
Tissue Transglutaminase Antibody (tTG) Test Transglutaminase is an enzyme present in our body and is involved in protein metabolism. A tTg test is…
immunoglobulin M
Immunoglobulin M Test Immunoglobulin M is the largest and the first produced antibody which helps in the prevention or fighting of…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
hidden causes obesity
8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
Beware of these common foods that cause high bodily inflammation! Maybe its the long list of inflammatory foods in your diet that is making you frequently sick. Find…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
lp-pla2
LP-PLA2 Test The LP-PLA2 test is a test which is carried out to assess the levels of Lipoprotein-Associated Phospholipase A2…
quinoa salad
Quinoa : A prodigious superfood you need to include in your diet today! Quinoa - what is so special about this native South American grain that has taken the world by…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
bananas exercise
10 health reasons why you should go “bananas” over bananas! Bananas:The world's most popular fruit comes with a host of unbelievable health benefits. Find out how you can…
ashwagandha brain
Ashwagandha: The best-kept secret of Ayurveda now revealed! Ashwagandha literally means "smell of horse". Don't get bogged down by that one tiny detail because this ayurveduic…
Salt dangers
Sodium chloride: The wonders and dangers of the simple table salt Sodium chloride is a salt containing sodium and chlorine ions at a 1:1 ratio. It is edible and…
Coconut sugar: What is it and is it healthier than table sugar? In the long list of things that the wonderful coconut gives us, coconut sugar is another remarkable addition.…
The right way to prepare Alfalfa sprouts at home Alfalfa or lusan ghas is not just a nutritious animal fodder. This flavonoid-rich herb has some amazing health…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
thyroid_scan
Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
shoudler exercises
Keep your shoulders pain-free with these shoulder exercises Shoulder exercises are important in order to prevent chronic back and neck pain. Learn more about how you…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…