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e-Toolkit

Silicosis and dust-related diseases

A note from our CEO
Section I: Taking action to eliminate silicosis and dust-related diseases
Ideal management approaches
Current challenges and uncertainties
National action plans and strategies for silicosis/dust diseases
Potential issues arising from action
Section II: Country summaries, case studies and resources
Silica country summaries – Australia
Silica country summaries – International
Pneumoconiosis case studies
Research on silicosis and dust-related diseases
Section III: What silica and other occupational dusts are and the risks they pose
Mineralogical features of silica
Other dust/fume-related exposures
Exposure pathways
Historical progression of silica and other dust-related diseases
Section IV: Health impacts of exposure to asbestos
What are dust/fume-related diseases?
How are dust-related diseases diagnosed?
Clinical features of silicosis and other dust-related diseases
Patient support, care and information
Reporting, coding and registration of occupational dust-related diseases

Silicosis Diagnosed Using Transbronchial Lung Biopsy: The Pivotal Role of Occupational History – January 2026

Abstract

Pulmonary silicosis, a preventable occupational lung disease caused by chronic inhalation of crystalline silica dust in industries like construction, mining, and stone masonry, remains underdiagnosed in TB-endemic regions due to overlapping clinical and radiological features. A 63-year-old man presented with upper gastrointestinal bleeding, but a silent lung abnormality stole the clinical spotlight. In a TB-endemic setting, incidental reticulonodular opacities triggered a full tuberculosis work-up, even in the absence of cough or respiratory symptoms. Yet it was only after a delayed occupational history revealed three decades of unprotected mosaic tiling that silicosis was considered. High-resolution CT and transbronchial lung biopsy later confirmed the diagnosis, but not before the patient’s course was complicated by obstructive uropathy and sepsis. This case highlights the diagnostic pitfalls of radiologic overlap between silicosis and tuberculosis, as well as the crucial role of occupational exposure history in reaching the correct diagnosis.

Key Clinical Message

In TB-endemic regions, incidental lung findings may be misleading. This case highlights the diagnostic challenge of distinguishing silicosis from tuberculosis and emphasizes that a thorough occupational exposure history, coupled with transbronchial lung biopsy, is essential for accurate diagnosis, especially when radiologic features overlap and respiratory symptoms are absent.

Reference

Silicosis Diagnosed Using Transbronchial Lung Biopsy: The Pivotal Role of Occupational History

Boon Hau Ng, Nor Safiqah Sharil, Hsueh Jing Low, Nik Nuratiqah Nik Abeed, Badrul Iskandar Abdul Wahab, Rose Azzlinda Osman, Andrea Yu-Lin Ban.

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