Ban dry processing to halt spread of accelerated silicosis, expert warns

Australia should ban dry processing of silica to halt the spread of deadly lung disease, silicosis, according to an expert.
 
Dr Graeme Edwards, Regional Chair of the Faculty of Occupation Environmental Medicine Royal Australian College of Physicians told newsGP he was expecting to see 300 cases by December just in Queensland.
 
‘For every 100 workers in this kitchen bench-making industry [in Queensland], 30 will have this life-shortening disease,’ Dr Edwards said.
 
‘I know there are cases coming out of Victoria, NSW, SA and Western Australia and Tasmania.
 
‘This is a national issue. The college is calling upon [all the states and territories] to … ban dry processing.’

Silicosis mostly affects stonemasons who inhale silica dust while working with engineered stones used for kitchen benches. Unlike natural stone such as granite, which comprise approximately 30% silica, artificial stone materials typically contain over 90% silica, leading to an accelerated form of silicosis.
 
‘The white sand on our public beaches is crystalline silica quartz, but the size of those sand particles are not so big, so therefore they are not getting down into the depths of our lung to cause harm,’ Dr Edwards said.
 
‘But if you have a process that grinds up those silica quartz, and when you freshly break them up using a mechanical saw, grinder or polisher and it’s done in a dry fashion, it can create a lot of dust.
 
‘And that dust is the size ... [of] less than 10 micrometres in diameter … and that can float down and get into the depths of the lung and it’s of a size that will cause harm, and when it is fresh it can be more fibrogenic.’
 
Dr Edwards said traditionally the disease presented as ‘chronic silicosis’ with a development period of more than 10 years. However, now medical practitioners are seeing ‘accelerated silicosis’ and ‘acute silicosis’, with a time frame of between one and 10 years and less than one year, respectively.
 
‘Historically acute and accelerated burdens were exceptionally rare. Because the nature of the product you are working with is relatively low in quartz or crystalline silica. So we are not making enough to actually cause the harm quickly enough,’ he said.
 
‘With the advent of the engineered stones … as a cheaper alternative to the slate and the granite for the kitchen benchtop … what the manufacturers overseas are doing is they are taking aggregate quartz and mixing it with a resin, breaking it, making it hard then cutting it into slabs so it is a much cheaper product. But the concentration of the quartz can be 97%.’
 
‘So because we now talking 97% constituency of the stuff we are working with, and we are talking about modern technology in terms of high speed grinders, the saws and the polishers, we are in a new world order in terms of creating potential for harm.’


Dr Graeme Edwards says silicosis is a national issue that needs to be dealt with urgently.

Dr Edwards said the rarity of accelerated silicosis meant that medical practitioners lacked case experience, with lung transplants as the only intervention for those severely affected.
 
Last month, the Queensland Government issued a safety alert for workers and employers in the state’s stone benchtop manufacturing industry.
 
Industrial Relations Minister Grace Grace said dry cutting of engineered stone is prohibited and action will be taken against any employer who fails to protect workers.

She said the decision was taken due to a sudden spike in the number of confirmed cases of silicosis for workers in this industry.
 
‘Workplace Health and Safety Queensland recently conducted a compliance campaign involving an audit of 10 engineered stone benchtop manufacturers which uncovered disturbing and unsafe work practices – including dry cutting of stone, poor ventilation of work areas and a lack of personal protection equipment,’ Ms Grace said.
 
She said the audits also included health checks for workers.
 
‘To date, WorkCover Queensland has received 26 workers’ compensation claims for silicosis, including 22 claims lodged within the past three weeks,’ Ms Grace said.
 
‘Tragically, at least six of the confirmed cases have Progressive Massive Fibrosis (PMF), which is the end stage of the disease.’
 
Lung Foundation Australia Chief Executive Mark Brooke told newsGP occupational exposure contributes substantially to the burden of lung disease in Australia and is a growing issue that needs attention.
 
‘Symptoms from silicosis may not be obvious and can initially include shortness of breath, chest pain, and/or a persistent cough. The condition can be severe enough to cause respiratory failure, which may eventually lead to death,’ Mr Brooke said.
 
‘While prevention is the ultimate goal, the role of GPs in identifying these symptoms to support early diagnosis and treatment is also critical.’
 
Thoracic Society of Australia and New Zealand Chief Executive, Tanya Buchanan told newsGP greater awareness is needed about the risks, symptoms and prevention of occupational lung diseases, such as silicosis. 
 
‘Addressing occupational lung disease is a key priority for the Thoracic Society of Australia and New Zealand and we are committed to supporting GPs in identifying and diagnosing conditions such as silicosis through our education initiatives,’ Ms Buchanan said.
 
‘We encourage GPs who want to find out further information about the silicosis and occupational lung disease to join our webinar on “Accelerated Silicosis, kitchen benchtops and the emerging epidemic” with Dr Ryan Hoy and Dr Graeme Edwards”,’ she said.

Government Lung Foundation Australia Queensland silicosis Thoracic Society of Australia and New Zealand