The Experience in the United Kingdom

Silicosis – causes and risk controls

Respirable crystalline silica (RCS) is found in stone, rocks, sands and clays. Exposure to RCS over a long period can cause fibrosis (hardening or scarring) of the lung tissue with a consequent loss of lung function.

Chronic obstructive pulmonary disease (COPD)

Exposure to RCS may also cause chronic obstructive pulmonary disease (COPD). The symptoms are chronic cough, sputum production and breathlessness. The condition is slow to develop and is rarely seen in people under 40. It can be very disabling and is a leading cause of death. Severe unremitting asthma is classed as a COPD.

You can find more information on how to protect workers from COPD.

Exposure to RCS

Occupations with exposure to RCS include:

quarrying
slate works
foundries
potteries
stonemasonry
construction (when cutting or breaking stone, concrete or brick)
industries using silica flour to manufacture goods

Amounts of silica in different types of stone

RCS particles are produced during many work tasks, including sandblasting, mining, rock drilling, quarrying, brick cutting, glass manufacturing, tunnelling, foundry work, stoneworking, ceramic manufacturing and construction activities.

Controlling the risks of RCS

In Britain, RCS exposure has a workplace exposure limit (WEL), which contains exposure below a set limit, preventing excessive exposure. The WEL for RCS is 0.1 mg/m3 expressed as an 8-hour time-weighted average (TWA). Exposure to RCS is also subject to the Control of Substances Hazardous to Health Regulations 2002 (COSHH).

Health surveillance must be provided to workers who are regularly exposed to RCS dust and there is a reasonable likelihood that silicosis may develop.

You should consider health surveillance for silicosis for workers who are involved in high-risk occupations, including construction, foundry work, brick and tile work, ceramics, slate, manufacturing, quarries and stonework.

Find out more

Guidance for workers is available on control of exposure to silica dust.
There is also detailed guidance in the COSHH essentials sheets.
For occupational health professionals, there is separate guidance on health surveillance for those exposed to respirable crystalline silica (RCS).
There is general information about silicosis on the NHS website.

Artificial stone silicosis: a UK case series

Abstract

Silicosis due to artificial stone (AS) has emerged over the last decade as an increasing global issue. We report the first eight UK cases. All were men; median age was 34 years (range 27–56) and median stone dust exposure was 12.5 years (range 4–40) but in 4 cases was 4–8 years. One is deceased; two were referred for lung transplant assessment. All cases were dry cutting and polishing AS worktops with inadequate safety measures. Clinical features of silicosis can closely mimic sarcoidosis. UK cases are likely to increase, with urgent action needed to identify cases and enforce regulations.

References

Health and Safety Executive – United Kingdom: Silicosis – causes and risk controls

Artificial stone silicosis: a UK case series

Johanna Feary, Anand Devaraj, Matthew Burton, Felix Chua, Robina K Coker, Arnab Datta, Richard J Hewitt, Maria Kokosi, Vaslis Kouranos, Carl Jonathan Reynolds, Clare L Ross, Veronica Smith, Katie Ward, Melissa Wickremasinghe, Joanna Szram.

Thorax 2024;79:979-981

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