silicose

Silicose, also known as silicosis, is a fibrosing lung disease caused by inhalation of respirable crystalline silica. It most often arises after prolonged exposure in occupations such as mining, quarrying, sandblasting, construction, ceramics, glass manufacture, and foundry work.

Pathology and forms: Inhaled silica particles trigger a chronic inflammatory response that leads to the development of silicotic nodules and, over time, fibrotic scarring of the lungs. The disease is categorized into chronic (develops after years of lower exposure), accelerated (5–15 years of exposure), and acute (weeks to months after heavy exposure) forms.

Symptoms and diagnosis: Early disease may be asymptomatic. As fibrosis advances, patients experience progressive dyspnea on exertion, cough, and fatigue. Diagnosis relies on occupational history, chest radiography (ILO classification), CT, and pulmonary function testing; exclusion of other causes. Silicosis increases susceptibility to pulmonary tuberculosis and can complicate infections.

Treatment and prognosis: There is no cure. Management focuses on preventing further exposure and treating complications. Supportive care includes smoking cessation, vaccinations, bronchodilators if indicated, oxygen therapy, pulmonary rehabilitation, and treatment of infections. Advanced cases with extensive fibrosis may progress to respiratory failure; lung transplantation is a consideration in selected patients.

Prevention and public health: Primary prevention is through dust control (wet methods, ventilation, enclosed processes) and appropriate respiratory protection. Medical surveillance and early detection are recommended for workers with silica exposure. Education on safe work practices and TB screening are important.

Global burden and epidemiology: Silicosis remains a concern in industries with silica dust exposure and is identifiable by radiographic features and a history of exposure.