One of I-MED’s NIOSH accredited B Readers, Dr Catherine Jones MBBS, BSc, FRCR, FRANZCR, talks to Fairfax about the alarming increase in cases of silicosis.

In recent years in Australia, there has been an alarming increase in people presenting with occupational lung disease – broadly known as pneumoconiosis. 

An increase in local coal mining, along with more intensive methods of extraction, and a dramatic rise in the use of manufactured stone in both commercial and residential construction has produced a silicosis epidemic.

The number of silicosis cases has significantly increased in the past 12 months,” says Dr Catherine Jones, specialist chest radiologist with I-MED Radiology. “Workers who are exposed to really high levels – in some cases thousands of times the recommended safe levels of silica in the air – can develop accelerated silicosis and become very symptomatic within three-to-five years of exposure. Their prognosis is very poor.”

“Simple” silicosis traditionally affected stonemasons and miners, who would typically develop symptoms 10 years after initial exposure, which in many cases wouldn’t  progress for several more decades, if at all. 

By cutting and drilling the manufactured stone that is now such a popular, cheap alternative in modern kitchens and bathrooms – but contains up to 95 percent silica compared to the 10-20 percent of traditional stone – workers are being put at enormous risk.

“Hold a block of silica in your hand and it’s fine,” Dr Jones says. “But once you use a drill or saw into it, it becomes respirable – you’re able to inhale it. It lodges inside the lungs and creates an inflammatory reaction. When that happens it starts to scar and pull the lungs together, it produces progressive silicosis.”

Dr Jones is one of four chest radiologists working for I-MED who holds a B-reader qualification as recognised by the International Labor Organisation; there are currently only 14 Australia-wide. She implores workers who are concerned that they may have been exposed to silica to discuss with their medical practitioner the need to undergo chest screening.

If your medical practitioner recommends further screening, attending a radiology clinic with radiologists with B-reader qualifications is important. “You shouldn’t go to a radiology company that doesn’t have expertise in this, because it’s easy to miss unless you've had additional advanced training in lung radiology.  It doesn’t matter which of our clinics you go to in Australia, the x-ray will be reported by a B-reader qualified radiologist.” says Dr Jones.

The process is simple – workers should visit their medical practitioner for an occupational health history assessment and obtain a referral for a chest x-ray, which can be performed at any I-MED clinic across Australia.  The results are available within 24-48 hours.

“If you detect the disease early, it allows you to stop the continued exposure,” Dr Jones says. “Once you have simple silicosis, ongoing exposure can make it worse. If you have accelerated silicosis, you may be able to claim compensation, and you may be able to benefit from the evolving treatment techniques that are being researched.”

Any worker who may have been occupationally exposed to silica should consult with their doctor to discuss chest screening, including those who have retired or left the industry. Quarry workers, concreters, construction workers and miners – including above-ground – can also have been exposed without realising.

“Anyone who has worked or is working in construction and been exposed to products that have a very high silica content should discuss this with their medical practitioner,” Dr Jones says. “That includes not only stonemasons, but if you’ve cut or grinded products on a construction site or been involved with concreting.”

This is a transcript of an article that ran in Fairfax newspapers 22 March 2019