Silicosis

Silicosis (sil-eh-KOH-sis) is a type of interstitial lung disease that can occur from breathing in very tiny silicon dioxide particles (silica dust). Silica is a natural compound that’s in things like:

• Plants, including dark, leafy greens, bell peppers and other vegetables
• Rocks, including quartz and granite
• Sand
• Soil
• Water

Manufacturers often include silicon dioxide (silica gel) packets in packages to absorb moisture.

Silica is nontoxic if you drink it or eat it. But inhaling certain kinds of silica dust can cause problems with your respiratory system. It damages the immune cells in the tiny air sacs in your lungs (alveolar macrophages). Alveolar macrophages (al-VEE-uh-ler MAK-ruh-feyj-es) are part of your immune system — they’re part of your respiratory system’s core line of defense.

Most people get silicosis because they breathe in silica dust at their jobs. Symptoms aren’t usually noticeable right away. But over time, silica can damage your lungs. For some kinds of silica, this can take about 10 years of regular exposure. With higher levels of exposure, lung damage can happen faster. Silicosis rates have improved with safety regulations. But in the past five years, a large number of people have developed silicosis from working with engineered stone products.

You can’t cure or reverse silicosis. But healthcare providers can help you manage symptoms. Severe cases can affect your ability to do daily activities. It can also be fatal.

Types of silicosis

Silicosis may develop in three ways:

• Acute (sudden) silicosis: You can get this type by having an intense silica dust exposure — the dust you breathe in consists of a lot of silica. It usually takes five years or less to develop. But you may develop acute silicosis within several months.
• Chronic (long-term) silicosis: This is the most common type. It usually develops after exposure to breathable dust for more than 10 years. The amount of silica in the dust is also a factor. Simple silicosis is the most common type of chronic silicosis. Progressive massive silicosis is another type that causes a lot of scarring.
• Subacute silicosis (accelerated silicosis): This type typically develops over two to five years. It develops faster because of heavier exposure to silica dust.

What are the symptoms of silicosis?

The main silicosis symptoms include:

• Long-lasting (persistent) cough, especially coughing up phlegm
• Inflammation in your lung tissue
• Scarring in your lung tissue (pulmonary fibrosis)

These symptoms can also cause:

• Fatigue
• Muscle weakness
• Shortness of breath
• Unexplained weight loss

What is the main cause of silicosis?

Damage to your lungs from breathing in silica dust causes silicosis. This usually happens in a work-related setting.

Risk factors

Silicosis is a work-related lung disease. You’re at greater risk of developing silicosis if you work in the following industries:

• Construction, building and demolition
• Foundry work
• Mining and quarrying
• Pottery, ceramics and glassmaking
• Sandblasting
• Stone work, including making stone countertops

What are the long-term effects of silicosis?

People who have silicosis are at an increased risk of the following:

• Autoimmune diseases like scleroderma, rheumatoid arthritis and lupus
• Chronic bronchitis
• Chronic kidney disease (CKD)
• Lung cancer
• Tuberculosis and other lung infections

How doctors diagnose silicosis

A healthcare provider will:

• Review your medical history
• Ask about your symptoms
• Perform a physical exam, including listening to your lungs with a stethoscope (auscultation)

They may also ask about your job history. If they suspect silicosis or another lung condition, they’ll recommend additional testing.

Tests that are used

Healthcare providers may recommend the following tests to help diagnose silicosis:

• Bronchoalveolar lavage: This test “washes” your lungs and examines the fluid they pull out.
• Imaging tests: Chest X-rays and CT scans can provide detailed images of your lungs.
• Lab tests: Lab tests can’t diagnose silicosis. But they can help providers rule out other conditions, like some types of infections. One test may include a tuberculosis skin test.
• Lung biopsy: Providers remove a small piece of your lung tissue for examination. Providers rarely recommend a lung biopsy to help diagnose silicosis.
• Pulmonary function tests: These tests evaluate how well your lungs work.
• Sputum culture: A sputum culture examines mucus that you cough up.

Can lungs recover from silica dust?

No. There’s no cure for silicosis. Healthcare providers can’t reverse lung damage from silica dust. They can only help manage your symptoms.

What are the treatment options for silicosis?

You can’t treat silicosis. But you can help manage your symptoms by:

• Changing jobs
• Doing pulmonary rehab
• Quitting smoking, vaping and using tobacco products
• Taking a bronchodilator to improve airflow
• Using supplemental oxygen

In severe cases, healthcare providers may recommend a lung transplant.

Are there silicosis clinical trials?

Yes, there are ongoing clinical trials for silicosis treatments. Researchers use antifibrotic drugs to treat some forms of silicosis. Some of these drugs are experimental. But one drug — nintedanib (OFEV®) — has approval from the U.S. Food and Drug Administration (FDA) to treat pulmonary fibrosis.

If your healthcare providers think you’re a good candidate, they may suggest that you participate.

When should I see my healthcare provider?

You should have regular checkups with a healthcare provider if you work around silica dust. Schedule an appointment right away if you have a cough or trouble breathing.

Call a provider right away if you have silicosis and notice new symptoms that concern you.

During your appointment, you may wish to ask your provider:

• Will my condition get worse?
• What can I do to feel better?
• How can I protect my lungs?
• Am I a good candidate for a silicosis clinical trial?
• Can you recommend a silicosis support group?
• Do I need to think about a lung transplant, and what does this process look like?

What can I expect if I have silicosis?

Your outlook depends on many factors, including:

• How much silica you’ve been exposed to
• How long you’ve been exposed to silica dust
• Whether you’re still exposed to silica dust
• Your age
• Any other conditions you may have

Your healthcare providers will give you a better idea of what to expect, according to your situation. But in general, your outlook is better if your symptoms don’t get worse.

If silicosis causes progressive massive fibrosis, your outlook is poor. You’re more likely to have permanent breathing problems and a reduced quality of life. It’s also more likely to cause premature death.

What is the life expectancy?

It depends on the severity of your condition, your age and your overall health. Some people can live 10-20 years or longer after receiving a silicosis diagnosis. Your healthcare provider will give you a better idea of what to expect.

Can silicosis be prevented?

Yes, you can prevent silicosis. If you work around respirable crystalline silica dust, you can help lower your risk of developing silicosis by:

• Changing out of dusty clothes
• Making sure job sites have air-monitoring equipment
• Using equipment that helps reduce the amount of dust in the air, including exhaust ventilation, dust-collecting systems, spraying water on surfaces and using “wet drills” to keep dust down
• Using vacuums with high-efficiency particulate air (HEPA) filters or wet mops to clean worksites instead of a dry broom
• Wearing the proper PPE, including a tight-fitting respirator

It’s also a good idea to get regular silicosis screenings through your employer. Screenings are tests that check for signs of silicosis before you have symptoms. Early detection is key to preventing severe symptoms.

Is silicosis the same as cancer?

No, silicosis isn’t cancer. It doesn’t cause your cells to grow out of control. But silicosis may be a factor in developing lung cancer.

Can exercise help?

Exercise may be helpful if you have silicosis. Discuss your exercise plans with a healthcare provider. They may suggest pulmonary rehab, which includes exercises that can help improve your breathing.