Silicosis: Definition, Types, Symptoms, Causes, Risk Factors, Diagnosis and Treatment

It is a lung disease caused by inhaling small pieces of silica, a mineral that is part of sand, rock, and minerals such as quartz.

It primarily affects workers exposed to silica dust in occupations such as mining, glassmaking, and foundry work. Over time, exposure to silica particles causes scarring of the lungs, which can damage your ability to breathe.

Key facts

  • There are three types of silicosis: acute, chronic, and accelerated.
  • It occurs in workers in mines, foundries, sandblasting and glass making.
  • About 2 million American workers continue to be exposed to occupational silica.
  • There is no cure for silicosis, but it can be prevented.

Types of silicosis

  • Acute Silicosis – which causes coughing, weight loss, and fatigue within a few weeks to years after exposure to inhaled silica.
  • Chronic silicosis: which appears 10 to 30 years after exposure and can affect the upper lungs and sometimes cause extensive scarring.
  • Accelerated Silicosis – Occurs within 10 years of high-level exposure.

Silicosis can develop within a few weeks or even decades after exposure. When people breathe in silica dust, they inhale tiny particles of the mineral silica.

This silica dust can cause fluid build-up and scar tissue in the lungs that reduces your ability to breathe. This can lead to scarring and coughing of the lungs, weight loss, and fatigue.

How Silicosis Affects Your Body

Silicosis affects the lungs by damaging the lining of the lung alveoli. Once this begins, it leads to scarring and, in some situations, a condition called progressive massive fibrosis.

This condition occurs when there is severe scarring and stiffness of the lung, making it difficult to breathe.

People with acute silicosis experience a cough, weight loss, tiredness, and may have a fever or severe chest pain. You may also have shortness of breath over time, especially with chronic silicosis.

Your healthcare provider may hear cracking or wheezing when they listen to your lungs. Having silicosis increases your risk for other problems, such as tuberculosis, lung cancer, and chronic bronchitis.

Each type of silicosis affects the body somewhat differently:

  • In acute silicosis, the lungs become very inflamed and can fill with fluid, causing severe shortness of breath and low oxygen levels in the blood.
  • In chronic silicosis, silica dust causes swollen areas in the lungs and lymph nodes in the chest, making it difficult to breathe.
  • In accelerated silicosis, swelling in the lungs and symptoms occur faster than in chronic silicosis.

Over time, lung capacity decreases, and people with silicosis may need support with oxygen and other devices to help them breathe.

How serious is silicosis?

Silicosis can cause significant lung damage and accounts for more than 100 deaths each year in the United States.

What are the symptoms of silicosis?

Silicosis symptoms can appear from a few weeks to many years after exposure to silica dust. Symptoms generally get worse over time as scarring occurs in the lungs.

Coughing is an early symptom and develops over time with exposure to inhaled silica.

In acute silicosis, you may experience a fever and sharp chest pain along with shortness of breath. These symptoms can appear suddenly.

In chronic silicosis, you may only have an abnormal chest X-ray at first and then slowly develop a cough and shortness of breath.

More than a third of people with silicosis have phlegm production and a cough. Symptoms similar to chronic bronchitis may appear, and the lungs have additional sounds called wheezing and crackles.

As healing progresses over time, you may see signs of chronic lung disease, such as leg swelling, increased breathing rate, and bluish discoloration of the lips.

What Causes Silicosis?

Silicosis is caused by exposure to crystalline silica, which comes from chipping, cutting, drilling, or grinding dirt, sand, granite, or other minerals.

Any occupation where the earth’s crust is disturbed can cause silicosis. A long list of occupations is known to expose workers to inhaled crystalline silica. These include:

  • Various forms of mining, such as coal and hard rock mining.
  • Construction work.
  • Tunnel work.
  • Brickwork.
  • Sandblast.
  • Manufacture of glass.
  • Ceramic work.
  • Steel industry work.
  • Extraction.
  • Stone cutting.

What are the risk factors for silicosis?

Breathing crystalline silica causes silicosis and the main risk factor is exposure to silica dust.

You can prevent silicosis by limiting exposure. There are national guidelines on lifetime exposure limits of the job.

If you work at a job that exposes you to silica dust, your employer must, by law, provide you with the correct clothing and equipment you need to protect yourself. You are responsible for always wearing it and taking other steps to protect yourself and your family when leaving the workplace and returning home.

It is also recommended that medical examinations occur prior to job placement or upon entering a trade, and at least every 3 years thereafter.

Silicosis patients are at increased risk for other problems, such as tuberculosis, lung cancer, and chronic bronchitis. If you are a smoker, quitting can help, as smoking damages your lungs.

When to see your doctor

Anyone working in industries with exposure to inhaled silica should undergo regular health checks and should be monitored for signs and symptoms of lung disease.

Also, if you have a cough, phlegm, or shortness of breath that does not improve, you should be closely evaluated by your doctor. Some people with acute silicosis also have a fever, weight loss, and fatigue.

How is it diagnosed

Having worked in an industry at risk is the best clue for your doctor, and a chest X-ray is crucial in diagnosing the type of silicosis. Your visit will include a physical exam (your healthcare provider will listen to your lungs) and a chest X-ray.

X-rays of your chest may be normal, or you may have a lot of scarring on your lungs. There may be a number of tests, such as:

  • Breathing tests.
  • High-resolution computed tomography of the chest.
  • A bronchoscopy to evaluate the inside of the lungs.
  • A biopsy of the lungs.
  • Additional tests, such as evaluation of mucus (sputum), may be needed to evaluate associated diseases, such as tuberculosis (TB).

How is silicosis treated

There is no cure for silicosis. Prevention is still the best way to avoid disease. Once silicosis has developed, your doctor will evaluate the degree of lung damage with tests. Some people may need urgent oxygen treatment and breathing support.

Others may need medications to decrease sputum production, such as inhaled steroids. Some may need inhaled bronchodilators, which relax the air tubes.

Once the disease progresses, treatment is similar to many other chronic lung diseases and requires a multidisciplinary or team approach.

To prevent the disease from getting worse, it is important to stay away from any additional sources of silica and other lung irritants, such as indoor and outdoor air pollution, allergens, and smoke. You may consider counseling to analyze changing occupations.

Acute silicosis may need steroid treatment, and a lung transplant may need to be considered.