Silicosis: symptoms, causes and treatment

The NHS says symptoms usually take many years to develop, and you may not notice any problems until after you have stopped working with silica dust. They can continue to get worse even if you are no longer exposed. The main symptoms are as follows.

• A persistent cough.

• Persistent shortness of breath.

• Weakness and tiredness.

• In advanced disease, difficulty with simple activities such as walking or climbing stairs, and being largely confined to the house or bed.

Silica is a substance found naturally in certain types of stone, rock, sand and clay. The NHS explains that working with these materials can create a very fine dust that can be easily inhaled. Once inside the lungs it causes swelling and gradually leads to areas of hardened and scarred lung tissue, which does not function properly.

The HSE refers to respirable crystalline silica (RCS) and explains that exposure over a long period can cause fibrosis of lung tissue with loss of lung function. Different materials contain different amounts of silica: the HSE lists sandstone, gritstone and quartzite as containing more than 70%, concrete and mortar 25% to 70%, and slate up to 40%, while limestone, chalk and marble contain up to 2%.

Acute silicosis, according to the HSE, is a rare complication of short-term exposure to very large amounts of silica, and is life-threatening. The chronic form, which develops over years, is far more usual.

The NHS says people who work in the following industries are particularly at risk: stone masonry and stone cutting, especially with sandstone, construction and demolition because of concrete and paving materials, worktop manufacturing and fitting, pottery, ceramics and glass manufacturing, mining and quarrying, and sand blasting. The HSE adds slate works, foundries and industries using silica flour.

The HSE lists tasks that produce RCS particles, including sandblasting, mining, rock drilling, quarrying, brick cutting, glass manufacturing, tunnelling, foundry work, stoneworking, ceramic manufacturing and construction activities. If you have worked in any of these, it is worth telling your GP, even if you left the job years ago.

The NHS says to see your GP if you think there is a possibility that you could have silicosis. The GP will ask about your symptoms and work history, listen to your lungs, and want to know about any periods of exposure to silica and whether you were issued with safety equipment such as a mask.

If silicosis is suspected you may be referred to a specialist for tests, which can include a chest X-ray, a CT scan of the chest and lung function testing (spirometry). A test for TB may also be recommended, because you are more likely to get TB if you have silicosis.

There is no cure for silicosis because the lung damage cannot be reversed. The NHS says treatment aims to relieve symptoms and improve quality of life, and the condition may continue to get worse, though possibly very slowly over many years.

The NHS says to see your GP if you think there is a possibility you could have silicosis, even if you stopped working with silica years ago, because symptoms may only appear after exposure has ended.

For breathing problems the NHS advises calling 111 if you have difficulty breathing, are coughing up blood, feel sick or are being sick, or have pain or swelling in one leg. It says to call 999 or go to A&E immediately for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain spreading to the arms, back, neck or jaw, pale, blue or grey lips or skin, or sudden confusion. See a GP if you have been coughing for 3 weeks or more.

The NHS says 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 set a workplace exposure limit for silica. Your employer should warn you about risks to health, make sure you know the correct procedures to reduce exposure and provide the necessary protective equipment.

The HSE says health surveillance must be provided to workers who are regularly exposed to RCS dust where there is a reasonable likelihood that silicosis may develop, and should be considered for high-risk occupations including construction, foundry work, brick and tile work, ceramics, slate, manufacturing, quarries and stonework.

The NHS says that if you have been diagnosed with silicosis you may be able to claim compensation in several ways: industrial injuries disablement benefit, paid weekly to people with silicosis who were exposed to silica while in employment, a civil claim through the courts, for which you need legal advice, or a lump sum under the Pneumoconiosis etc. (Workers' Compensation) Act 1979 if the liable employer has stopped trading. Ask for advice early, because rules and time limits apply.

Diagnosis and long-term care usually go through a GP and a hospital respiratory team on the NHS, with occupational health services involved where there is current exposure.

Some people use private respiratory consultations or occupational health assessments, especially for work-related claims. Keep records of your work history and any previous scans, as they support both clinical decisions and benefits applications.