What are the Health Effects?
Screening & Treatment
To make sure your doctor is aware that you may have been exposed to silica on the job, and is well informed on the signs, symptoms, and diagnosis of silica related illness, we recommend bringing a Physician’s Alert (English and Spanish) to your appointment.
Your medical examinations should include:
- Chest x-ray – classified according to the International Labour Office (ILO) International Classification of Radiographs for Pneumoconioses
- Pulmonary function test
- Annual evaluation for tuberculosis – Purified protein derivative (PPD) skin test – for everyone with silicosis
There is no specific treatment for silicosis. Workers are advised to avoid further exposures to silica to prevent the disease from getting worse, limit exposure to irritants, and quit smoking. Antibiotics are prescribed for respiratory infections as needed. Those with a positive skin test for tuberculosis (TB) generally need treatment with anti-TB drugs. Any change in the appearance of the chest x-ray may be a sign of TB. Patients with severe silicosis may need to have a lung transplant.
Treatment of COPD includes inhaled bronchodilators, anti-cholinergic agents or steroids, with antibiotics prescribed for respiratory infections as needed. As with silicosis, it is important to limit exposure to irritants and quit smoking.
Employers must offer medical surveillance to those who are highly exposed to respirable crystalline silica at no cost to the employee. For more information on how to set up a medical monitoring program or when it must be offered see the Medical Monitoring Under the OSHA Silica Standard for the Construction Industry - Guide For Employers.
In 1996, the World Health Organization – International Agency on Cancer Research (IARC) first classified silica as a known human carcinogen and in 2009, IARC reaffirmed its position noting “[an] increased risk of lung cancer [from silica exposure] was observed across various industries and processes.”
The National Cancer Institute completed a study in 2011 showing that lung cancer screening saves lives. Based on that study the American Lung Association recommends lung cancer screening with low-dose CT scans for current or former smokers who are between 55 to 74 years, with a smoking history of at least 30 pack-years (that is, an average of a pack a day for 30 years) and with no history of lung cancer.
The National Comprehensive Cancer Network (NCCN) refined the guidelines, recommending that individuals with significant occupational exposure to a carcinogen be screened beginning at age 50 if they have a smoking history of at least 20 pack years. People with high exposures to silica and who meet these smoking criteria should be screened. These American Lung Association documents provide additional information but do not include the NCCN recommendations about occupational exposure: LUNG CANCER CT SCREENING: IS IT RIGHT FOR ME? and Lung Cancer Screening.
To learn more about the health effects…
- Silicosis Health Effects (video clip), Dr. Linda Rosentock, [former Director of NIOSH 1994-2000]
- Physician’s Alert - Occupational Silicosis and Silica-Related Illnesses among Construction Workers
- Alerta a los médicos:Silicosis ocupacional y enfermedades relacionadas con la sílice entre los trabajadores de la construcción (Physicians' Alert in Spanish)
- Health Effects of Occupational Exposure to Respirable Crystalline Silica
- Preventing Silicosis and Deaths in Construction Workers (NIOSH Pub# 96-112)
- OSHA Fact Sheet: OSHA’s Respirable Crystalline Silica Standard for Construction
- Deaths from silicosis by trade
- Pulmonary Fibrosis Types
