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Silicosis: Australia’s ‘emerging occupational health epidemic’


Morgan Liotta


3/09/2019 3:30:31 PM

With barriers to early detection, the RACGP has developed a learning activity to better support GPs in diagnosis and management of silicosis.

Man dry cutting with dust
Silicosis can often be difficult to detect, given the many patients presenting to their GP with respiratory conditions.

In February this year the Federal Government, in collaboration with the Lung Foundation Australia, launched the National Strategic Action Plan for Lung Conditions, with the aim to accelerate diagnosis and improve treatment for Australians living with lung disease.
 
The action plan’s $4 million funding is opportune, given the recent resurgence of diagnoses of the deadly lung disease silicosis.
 
WorkSafe Victoria has this week introduced new regulations banning dry-stone cutting of engineered stone, in a bid to significantly reduce workers’ exposure to deadly silica dust and protect them from risk of developing silicosis.
 
Victorian Minister for Workplace Safety Jill Hennessy said the regulations would prevent workers from the ‘silent killer’ and ensure they ‘go home safe to their families every day’.
 
‘Our tough new regulations are now in effect and I encourage all stonemasons who have been exposed to silica dust to register for a free health assessment as soon as possible,’ she said.
 
Dry-stone cutting is one of the main causes linked to silicosis.

The RACGP’s new gplearning activity, ‘Australia’s emerging occupational health epidemic – Silicosis’, was launched on 31 August by Dr Kerry Hancock, Chair of the RACGP Specific Interests Respiratory Medicine network, at a WorkSafe Victoria summit in Melbourne.
 
The summit, ‘Silicosis: A medical approach’, was attended by medical professionals, lung-disease advocates and healthcare organisations. It focused on associated lung diseases, future initiatives, and how to address strategies of a national approach to the issue.
 
Dr Hancock co-presented on the important role GPs play in diagnosis, management and treatment of silicosis.
 
She said GPs are in the ideal situation to detect possible silicosis and refer patients appropriately by routine screening of occupational and environmental risk factors and patient history, as well as providing ongoing support for patients diagnosed with silicosis and their families.
 
Prevention is also a key factor, according to Dr Hancock, but detection of silicosis has its challenges in that it may initially present as asymptomatic.
 
Respiratory issues, such as cough or shortness of breath, are the second most common reason patients present to their GP, but silicosis is comparatively rare, so may be more difficult to detect during early stages. For this reason, Dr Hancock emphasised the ‘magnitude of the challenge of detecting silicosis-related lung disease’.
 
Dr Hancock also cited patient demographic as a potential challenge in early detection.
 
With the current ‘epidemic’ predominately affecting younger males coupled with the fact men are less likely to present to a GP, it is important that every opportunity for health promotion is utilised by assessing occupational risks and lifestyle habits.
 
Routine history screening can help GPs with the detection of risk factors for and symptoms of silicosis, as well as with referring potential cases early using the correct referral pathway, Dr Hancock said.
 
She also highlighted it is important to consider that routine chest X-ray and spirometry can easily miss an early diagnosis, and if a GP thinks a patient has been exposed to silica they need to be immediately referred to specialised imaging and accredited lung function testing services. These services are listed in the learning activity for every state and territory.
 
Upon completion of the RACGP’s gplearning activity, GPs should be able to:

  • outline the causes and types of silicosis and identify the presenting symptoms
  • describe the role of the GP in identifying potential cases, referring for assessment and ongoing management of silicosis, including providing psychosocial support to patients and their families
  • detect risk factors for silicosis when taking an occupational history and examination, including the risk of a false negative assessment of silicosis.
More information on the RACGP’s online activity, ‘Australia’s emerging occupational health epidemic – Silicosis’, is available on the gplearning website.



COPD lung disease online learning activity silicosis



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