Silica lung disease
Silicosis - NHS Silicosis is a long-term lung disease caused by inhaling large amounts of crystalline silica dust, usually over many years. Silica is a substance naturally found in certain types of stone, rock, sand and clay. Working with these materials can create a very fine dust that can be easily inhaled. Once inside the lungs, it causes swelling (inflammation) and gradually leads to areas of hardened and scarred lung tissue (fibrosis). Lung tissue that's scarred in this way doesn't function properly. People who work in the following industries are particularly at risk: - stone masonry and stone cutting – especially with sandstone
- construction and demolition – as a result of exposure to concrete and paving materials
- worktop manufacturing and fitting
- pottery, ceramics and glass manufacturing
- mining and quarrying
- sand blasting
Signs and symptoms The symptoms of silicosis usually take many years to develop, and you may not notice any problems until after you've stopped working with silica dust.![]() The symptoms can also continue to get worse, even if you're no longer exposed. Silicosis usually develops after being exposed to silica for 10-20 years, although it can sometimes develop after 5-10 years of exposure. Occasionally, it can occur after only a few months of very heavy exposure. Main symptomsThe main symptoms of silicosis are: - a persistent cough
- persistent shortness of breath
- weakness and tiredness
If the condition continues to get worse, these symptoms may become more severe. Some people may eventually find simple activities such as walking or climbing stairs very difficult and may be largely confined to their house or bed. The condition can ultimately be fatal if the lungs stop working properly (respiratory failure) or serious complications develop, but this is rare in the UK. Further problemsSilicosis can also increase your risk of getting other serious and potentially life-threatening conditions, including: - tuberculosis (TB) and other chest infections
- pulmonary hypertension
- heart failure
- arthritis
- kidney disease
- chronic obstructive pulmonary disease (COPD)
- lung cancer
When to see your GP See your GP if you think there's a possibility you could have silicosis. They'll ask you about your symptoms and work history, and listen to your lungs with a stethoscope. They'll want to know about any periods when you may have been exposed to silica and whether you were issued with any safety equipment, such as a face mask, when you were working. If silicosis is suspected, you may be referred to a specialist for further tests to confirm the diagnosis. Tests you may have include: - a chest X-ray to detect abnormalities in the structure of your lungs
- a computerised tomography (CT) scan of your chest to produce more detailed images of your lungs
- lung function testing (spirometry), which involves breathing into a machine called a spirometer to assess how well your lungs are working
A test for TB may also be recommended because you're more likely to get TB if you have silicosis. Treating silicosis There's no cure for silicosis because the lung damage can't be reversed. Treatment aims to relieve symptoms and improve quality of life. The condition may continue to get worse, leading to further lung damage and serious disability, although this may happen very slowly over many years. The risk of complications may be reduced if you: - ensure you're not exposed to any more silica
- stop smoking (if you smoke)
- have regular tests to check for TB, if advised by your doctor
- have the annual flu vaccine and the pneumococcal vaccine
You may be offered long-term oxygen therapy if you're having difficulty breathing and have low levels of oxygen in your blood. Bronchodilator medicines may also be prescribed to widen your airways and make breathing easier. You'll be given a course of antibiotics if you develop a bacterial chest infection. In very severe cases, a lung transplant may be an option, although there are strict health requirements to meet before this will be considered. Preventing silicosis Silicosis can be prevented by avoiding prolonged exposure to silica dust. In the UK, all workplaces must comply with The Control of Substances Hazardous to Health Regulations 2002, which sets a workplace exposure limit for silica. Your employer should: - warn you about any risks to your health
- make sure you're aware of the correct procedures to reduce your risk of exposure to silica dust
- supply you with the necessary equipment to protect you
You can read more detailed information about the control of exposure to silica dust on the Health and Safety Executive website. Claiming compensation If you've been diagnosed with silicosis, you may be able to claim compensation in one of the following ways: - industrial injuries disablement benefit – a sum of money paid weekly to people with silicosis who were exposed to silica while in employment (but not self-employment) and to people who have silicosis and lung cancer
- launch a civil claim for compensation through the courts (you'll need to get legal advice about how to do this)
- claim a lump sum in compensation under the Pneumoconiosis etc.
 (Workers' Compensation) Act 1979 – if you have silicosis, or you're the dependant of someone who has died from the condition, and you haven't been able to get compensation through the courts because the employer liable has stopped trading
You can read more about Industrial Injuries Disablement Benefit on the GOV.UK website. Page last reviewed: 01 July 2021
Next review due: 01 July 2024 Silicosis Symptoms and Diagnosis | American Lung Association What Are the Symptoms of Silicosis?Symptoms of silicosis usually appear after many years of exposure. In early stages, symptoms are mild and include cough, sputum and progressive shortness of breath. As the scarring continues to worsen, the first real signs of a problem may be an abnormal chest X-ray and a slowly developing cough. Once the lung scarring has become more severe, there are a variety of symptoms that may appear. These commonly include bronchitis-like symptoms such as persistent cough, shortness of breath and difficulty breathing. People also suffer from weakness, fatigue, fever, night sweats, leg swelling and bluish discoloration of the lips. The longer silicosis goes without treatment, the more likely it is to develop a complication. Because the disease affects the immune system, silicosis patients are vulnerable to developing tuberculosis, lung cancer, COPD and kidney disease. How Silicosis Is DiagnosedThere is no specific test for silicosis, so it may take multiple doctor’s visits and tests to diagnose. During the visit, your doctor will ask about your breathing, both at rest and during exercise. Your doctor will also ask about your job history in detail to determine the likelihood of silica exposure. It may be a good idea to prepare the following information in advance: - Your symptoms and the time they started
- Treatments given before for the symptoms and how they helped
- The work you have done over your entire career; the length of time you spent in each job; the nature of the work you performed.
 - The products you were in contact with at work and whether or not you wore protective equipment
- Smoking history
- Any old medical records, including chest X-rays or CT scans
After a physical exam where your doctor listens to your lungs, there several tests that they may suggest to determine whether you may have silicosis. These include: - Imaging tests: A chest X-ray or CT scan can give your doctor a better picture of the lungs so they can assess how much damage has been done and whether or not silica dust is the likely cause.
- Lung function tests: These tests measure your lungs’ ability to breathe properly and to get oxygen into the blood. These measurements are made by two separate tests: spirometry and diffusion capacity. They are also used to determine how much damage has been done to your lungs.
- Sputum test: Collecting coughed up mucus for evaluation
- Bronchoscopy: Your doctor will pass a bronchoscope (small flexible tube with a video camera attached at its end) either through your nose or mouth and into your windpipe and lung.
 This tool can be used to collect tissue samples from your lung for further testing. - Surgical lung biopsy: Performed by a cardiothoracic surgeon under general anesthesia, this is another way to get a sample of lung tissue for further testing.
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When else should you see a pulmonologist? The following symptoms may be related to a lung condition and a lung specialist can help you: - Chest pain or tightness
- Dizziness, weakness or fainting
- Difficulty breathing, especially after exercise.
 - Unexplained fatigue
- Sensation of wheezing in the chest
- Recurrent or chronic bronchitis or cold recurring monthly.
- Asthma that is poorly controlled or has unidentified triggers
Pulmonary medicine is a subspecialty of internal medicine that focuses on the prevention, diagnosis, and treatment of conditions that affect the lungs and airways. Here are some of the most common conditions that our pulmonologists diagnose and treat: Asthma. A chronic illness characterized by shortness of breath and cough, occasional wheezing, chest tightness. Asthma attacks occur when inflammation of the lining of the airways causes them to narrow, restricting the flow of air in and out of the lungs. Attacks can last minutes or days and can be dangerous if airflow is severely restricted and if help is not provided in time. Bronchiectasis. A disease resulting from damage and enlargement of the walls of the large airways. The bronchi expand, form small pockets in which the secret accumulates and the infection joins. A person may be born with bronchiectasis or acquire it later in life, usually as a result of recurrent lung infections, especially during childhood. Bronchitis. Inflammation of the airways, usually due to infection. It can be short-term (acute) or chronic. Symptoms include mucus-producing cough, wheezing, shortness of breath, fatigue, and low fever. Acute bronchitis often occurs after a viral respiratory infection such as SARS or the flu. Chronic obstructive pulmonary disease (COPD). COPD is a preventable and treatable lung disease that is associated with airflow limitation and chronic inflammation of the bronchial walls in response to exposure to smoke, gases. In COPD, the bronchi (tubes) that carry air into and out of the lungs are partially blocked, such as by mucus, making breathing difficult. Cigarette smoking is the main cause of COPD, although long-term exposure to other lung irritants such as dust, chemicals, and pollution can also cause or contribute to the development of COPD. The main complaints in COPD are shortness of breath, chronic cough, chronic sputum discharge. Chronic bronchitis. Chronic bronchitis can be diagnosed if the patient has a mucus-producing cough for at least 3 months of the year. Emphysema. Emphysema is characterized by the destruction of lung tissue due to damage to the air sacs (alveoli) in the lungs. The air sacs lose elasticity and cannot fully deflate, preventing them from being filled with fresh air to adequately supply the body with oxygen. Interstitial lung disease. Interstitial lung disease (ILD) is a broad term that includes a long list of chronic lung diseases. While symptoms vary depending on the specific type of ILD, shortness of breath and dry cough are common to many of these conditions. ILD is usually a progressive disease that begins with inflammation of the deep tissues of the lungs and eventually leads to the replacement of the alveoli (air sacs) and their supporting structures (interstitium) with connective tissue. This process leads to fibrosis and causes the normally elastic tissues of the lungs to become stiff, which interferes with normal breathing and can make it difficult to perform routine activities without shortness of breath. Occupational lung disease. Illness caused by exposure to irritants or toxic substances in the workplace. These substances can cause acute or chronic respiratory problems with a single severe exposure or, more commonly, with prolonged or repeated exposure. Asbestosis. Progressive change in lung tissue caused by exposure to microscopic asbestos fibers. Asbestosis is most common in construction and industrial workers. Hypersensitivity pneumonitis. Acute or chronic inflammation of the airways caused by exposure to an inhaled allergen such as mold, bacteria or fungi. The air sacs of the lungs become inflamed and can form fibrous scar tissue that interferes with normal functioning and causes shortness of breath and coughing. Silicosis. Lung disease caused by exposure to silica dust in mines, foundries, blasting, and stone, clay and glass production. Scar tissue forms in the lungs, which greatly increases the risk of tuberculosis. Pulmonary fibrosis. Thickening and scarring of the lungs, especially the interstitium (areas in and around small blood vessels and air sacs where oxygen and carbon dioxide are exchanged). This leads to a decrease in the ability of the lungs to extract oxygen from the air. Rheumatoid lung disease. Rheumatoid arthritis is an inflammatory disease that primarily affects the joints and surrounding tissues. However, it can also damage the lungs, causing inflammation of the lining of the lungs (pleurisy), accumulation of fluid around the lungs (pleural effusion), rheumatoid nodules (small lumps) in the lungs, and scarring of the lungs (pulmonary fibrosis). ). Sarcoidosis. An inflammatory disorder characterized by granulomas (tiny collections of immune cells) that can grow and accumulate in organs, affecting their function. | 
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