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What is Silicosis?

Question:

Discuss About The Relating Occupational Exposure Reparable?

Silicosis is a condition caused by inhaling of silica or free crystalline silicon oxide over a period. Silica is composed of quartz and is a common mineral contained in the earth's crust which is commonly found in fine gravel, rock and most metal ores. Inhaling of dirt with crystal like silica is hazardous to human health and has continually proved to be deadly if precautionary measures are not employed.  Silicosis is progressive hence may get more severe over time. Symptoms may start as loss of breath, weakness or an acute cough with other symptoms being chest pain, fever, sweating, weight loss and respiratory breakdown (Breckenridge, 2015). Since this occupational disease is caused by inhaling silicon oxide or silica, people that work in mining, masonry, sandblasting, asphalt manufacturing and glass manufacturing industries just to name a few are at high risk of contracting silica because they deal with silica in their line of work.

Silicosis comes about due to working environment exposing an individual to crystalline silica. This continues all through the world regardless of information on the causes and successful means of counteractive action. Silicosis as occupational diseases is alarmingly high among individuals overexposed to dust in different ventures and occupations, for example, mining, construction, and building maintenance among others. Silicosis is incurable and might be dynamic even after dust exposure has stopped. Hence early recognition and effective mediations are vital. Albeit current ailment is a consequence of past exposures, compelling control of current work environment exposures is the best way to prevent continued occurrence of these possibly crippling illnesses. Doctors and professional health caregivers can add to this exertion through precise analysis and give more information on the management and preventive measures of the diseases (Perkins, Peeters, Wouters, Reynaert, & Mossman, 2014).

When silica is inhaled, the cells in the lungs incorporates the crystalline silica particles by drawing them into the vacuole of its cytoplasm (Luna-Gomes, Santana, & Coutinho-Silva, 2015). This causes lysosomal damage activating inflammasome which is responsible for inflammatory processes known for inducing programmed cell death. Additionally, the crystalline silica dust particles act as small sharp objects like blades on the lungs. These blade-like silica particles make cuts that injure the lung tissue when inhaled through the airways, that is, mouth or nose which leads to difficulty in closing and opening of the lungs hence consequential breathing-related complications (Rosner, 2014).

Causes of Silicosis

 Further, the major imperative agent in the progression of silicosis is "the yield of the concentration of dirt with crystalline silica in working environment aura and the amount of crystalline silica in the entire dust"("National Institute of Occupational Safety and Health (NIOSH), U.S.A," 1976). The ailment comprises of congestion of the respiratory framework tissues that inevitably resulting to fibrosis, the toughening of the lungs, lessening the capacity to inhaling with ease (Glenn DD, 2008). Being exposed to crystalline silica will likewise wax the danger of advancing tuberculosis and other nonmalignant respiratory-related infections and adding to renal and immune system respiratory sicknesses. It's also important that the International Agency for Research on Cancer (IARC) and the government of United States has classified crystalline silica as a known human carcinogen hence resulting to lung cancer (Mazurek, Wood, Schleiff, & Weissman, 2017)

 According to "Silicosis and lung cancer in U.S. metal miners," 1991, any level of silica exposure can lead to silicosis where it is progressive from one type to another. The types include acute, accelerated and chronic silicosis depending on the level of exposure. Chronic silicosis, the commonly recognized type of the sickness, commonly progresses following at least ten years of presentation to moderately low dirt concentration. Accelerated silicosis comes about due to exposure to elevated concentration of silica for a period of 5 to 10-years. Lastly, acute silicosis is an uncommon however exceptionally lethal sickness the source being a concise yet enormous exposure to dust containing crystalline silica with elevated quartz capacity (Esteban, 2004).

 Silicosis is as old as human activities on the earth's crust. Hence conclusive studies have been done on the ailment giving more insight on it. According to Silicosis Mortality, Prevention, and Control—United States, 1968-2002 (2005), silicosis is an occupational ailment which is preventable but effective treatment of the ailment is yet to be known hence more protective measures should be put in place. The studies show a decline in silicosis death rate in the recent past. Nonetheless, silicosis fatalities and recent conditions still happen in equal proportion  to youthful workers. Since effective diagnosis for silicosis is largely unavailable, successful management of crystalline silica exposure in the work environment is vital (Silicosis Deaths Among Young Adults—the United States, 1968-1994, 1998)

Recognizing silicosis as a deadly health hazard is an initial step in protecting workers exposed to silica from its exposure, and this should be done by assessing the unrealized ability of employee exposure before beginning a job. Consequently, identifying any job or operation that could lead to exposure of dust is inevitable in seeking to protect the worker from the diseases ("Silica... It's not just dust," 1997). Such a precaution will reduce silicosis mortality and reduce the number of workers contracting the occupational disease and other related respiratory associated sicknesses which are majorly tuberculosis and cancer.

Symptoms of Silicosis


Other preventive or precautionary steps in counteracting silicosis according to National Institute for Occupational Safety and Health (NIOSH) include dust control, personal hygiene, protective clothing, air monitoring and respiratory protection. Dust control involves utilizing the dust gathering systems accessible for several types of dust producing equipment. Also, the employer should look for dust controls when obtaining equipment and when constructing a structure for working environment, ventilation should be put in place to ensure dust is not discharged into the air to protect workers and locals from being exposed to crystalline silica. Another crucial dust control mechanism is using water through the penetrating stem during drilling or utilizing a drill with a dust accumulation system to lessen the amount of dust noticeable in the air or surrounding. Lastly, using abrasives containing under 1% crystalline silica amid rough impacting to keep quartz dust from being discharged in the air. On personal hygiene as a counteractive measure for silicosis, individuals should avoid eating, drinking or smoking in dusty areas together with parking cars where they will be little or zero contamination with silica. Rinsing of the hands and face before eating or drinking outside dusty areas is also vital for shielding workers from respirable crystalline silica and different contaminants, for example, lead especially amid rough impacting operation (NIOSH 1991). Another fundamental preventive measure is ensuring dusty garments do not sully cars, homes, or worksites outside the dusty range. This can be achieved by showering and changing into clean attire before leaving the working environment and changing into washable or disposable working clothes at the site. Lastly, monitoring of air is needed to quantify precentation to reparable crystalline silica and to choose suitable engineering controls and respiratory protection.

Apart from the preventive measures applied in the workplace where one is exposed and personal responsibilities to minimize silica exposure, Cowie, Murray, & Becklake (2010) suggests that physicians or specialists in occupational diseases, in this case, being silicosis have a crucial role to play in monitoring the conditions of those exposed. This involves doing examinations and tests on individuals exposed to crystalline silica with symptoms like coughing, shortness of breath and mass depreciation. Since silicosis is a respiratory-related condition test like chest X-ray, chest CT scan, pulmonary function tests, skin tests for tuberculosis and serologic tests for connective tissue sickness should be done to ascertain the diagnosis and rule out alike ailments (Samet, 1996). The information from the tests enables the affected to take precautionary measures to prevent the disease from being severe. Other side treatments such as cough medicine and antibiotics are also prescribed together with having routine tuberculosis skin tests

Preventing Silicosis

Teaching laborers about silicosis are critical since there can be health inconveniences and even lethal outcomes (Pandey, 2014). Some countries like the USA have put government organizations, for example, NIOSH, the Mining Safety and Health Administration (MSHA), the Occupational Safety and Health Administration (OSHA), and some neighborhood Department of Labor (DOL) workplaces where information can be easily accessed. There are a few successful anticipation recordings accessible, for example, Silicosis: Incurable however Preventable and educating employees earlier enabling them to begin laboring is vital, yet prior training is similarly critical. MSHA requires whole day of general security training prior to another worker working time, alongside 8 hours of refresher preparing one day every year. This ensures the threats of silica is on the bleeding edge of the employees' brains (Reis, 2006).

Utilization of respirators ought to be the last line of the barrier and not intensely depended upon, especially if respirator utilize is, for the most part, manifests random behavior unless somebody is guiding the laborers and respirators are seldom powerful in larger concentrations (Thomas & Kelley, 2010)

As silicosis isn't a reparable illness, it is of keen interest and viable result to explore the probability of utilizing clinical procedures such as CT scans, X-rays and respiratory medicine prescription in monitoring silicosis. This treatments and procedures help in indicating initial stages of exposure to crystalline silica or time in advance beginning of silicosis. Moreover, it is additionally of significance to access these clinical checkups before the edge weight of crystalline silica in the lung is surpassed. Of late, demonstrations have indicated that the moment an individual has been exposed to silica over a period for instance 10-15 years, silica-actuated aspiratory illness advances without continued exposure to silica (Gulumian et al., 2006). Hence proving how treatment and silicosis diagnosis is vital as a counteractive measure in the management and reduction of silicosis as an occupational disease among the workers that are exposed to silica.

Further, silicosis is a well-established work-related sickness and remains a noteworthy work-related medical issue in most parts of the world. It is in charge of high dismalness and mortality in workers (Kulkarni, 2007). Albeit, alarming statistics depicting the dangers of silica exposure, governmental and non-governmental organization have been in forefront in educating and giving information to workers and industries owners on how to counter the ailment. It has been noted that there has been significant drop of individuals suffering from the diseases statistically. The knowledge provided and the awareness created has been important in this noted drop in mortality among workers exposed to dust in their working environment. Also, information provided by the disease prevention and its application to counter it comes with monetary benefits, for example, expanded production by healthy laborers, lessening of illness absenteeism and less consumption of therapeutic services and above all the easing of human suffering (Jindal, 2013).

Role of Physicians in Preventing Silicosis

According to the Occupational Safety and Health Administration (OSHA), 2.3 million workers are not protected from crystalline silica causing silicosis and other respiratory complications in the USA alone. This insinuates that the number will grow if statistics are shared from other countries which silicosis and other silica exposure-related disease are a concern. The organization further notes that 2 million more are workers who engage in construction workers where drilling, crushing, or grinding silica-containing materials is in there line duty. From the statistics, a relatively high population is at risk of contracting silicosis, lung cancer, tuberculosis and other respiratory diseases if appropriate and workable silica exposure standards are not in place. It is projected by OSHA that if the rules put in place are adhered to, a monetary benefit of $7.7 billion annually will be registered in the USA.

Although some responsible employees have been in the forefront in shielding workers from hazardous presentation to respirable crystalline silica for a long period, projected results have not been met yet (Occupational Safety and Health Administration, 2016). This is due to neglect of most employees hence the coming up with standards that are governed by the law of the land to ensure every individual exposed to dust is protected. Measures that have been put in place in some countries like the USA include a reasonable exposure point of confinement of 50 micrograms crystalline silica per cubic meter of aura. The standard also incorporates different arrangements to protect workers, for example, requirement for exposure appraisal, techniques for managing exposure, respiratory guarding, therapeutic surveillance, risk information sharing and recordkeeping (Practice for Health Requirements Relating to Occupational Exposure to Respirable Crystalline Silica). With the rules in place, workplace protection from hazards will be increased. The estimation in projection is that the rules will prevent or rather reduce the silicosis cases and other respiratory diseases thus helpful to ones exposed to dust in their workplaces.

With increased knowledge and standards in place on the cause and prevention of silicosis, the rate at which silicosis is being eradicated is notably slow. Though mortality numbers caused by silicosis and other related diseases is decreasing, the death rate is still high. According to WHO, this scenario has been observed chiefly because of lack of risk perception. This entails disbelief that dust can cause serious harm and severe underestimation of the real threat of silicosis. Other reasons include financial aspects being prioritized over health concerns and small studies on low cost and simple control solutions (Mulanovich, Lescano, Gonzaga, & Blazes, 2007).

Thus, for the world to be silicosis free, non-governmental and governmental organizations without power to enforce recommendations and standards should not be left alone in ensuring a change is effected. The governments of the various countries where silicosis is a concern should provide the recommendations in place and the standards set are adhered to by the stakeholders. Laws should be put in place to prosecute those that violate the set standards to minimize dust emission consequently reducing or preventing silicosis and other dust-related diseases.

Conclusion

The monetary benefit being the motivation of the globe, industries are emerging daily to utilize any resources available to maximize profits. Most of the coming up industries deal with dust producing raw materials. Also with increasing population with fewer jobs to absorb the increasing population, most will find it hard to resist from seeking employment in this industries for survival. Albeit there is enough knowledge on the danger of dust exposure, one will sacrifice health at the altar of financial benefit. Having stated that silicosis is caused by dust containing silica, it translates to more people contracting silicosis, lung cancer, and tuberculosis among other with increasing number of industries dealing with dust. Countering the ailment, therefore, must involve the collective responsibility of stakeholders. The government should take its part in ensuring that the standards in place are adhered to without fail. The employers should also guarantee the application of recommendations and standards is active in their industries. Employees should ensure personal hygiene is paramount especially after work and lastly, physicians should educate the public on related respiratory diseases and provide the precise diagnosis for the treatment and prevention of silicosis

References

Breckenridge, K. D. (2015). Conspicuous disease: The surveillance of silicosis in South Africa, 1910-1970. American Journal of Industrial Medicine, 58(S1), 15-22. doi:10.1002/ajim.22505

Cowie, R. L., Murray, J., & Becklake, M. R. (2010). Pneumoconioses and Other Mineral Dust–Related Diseases. Murray and Nadel's Textbook of Respiratory Medicine, 1554-1586. doi:10.1016/b978-1-4160-4710-0.00065-1

Esteban, J. (2004). Tuberculosis in Special Groups and Occupational Hazards. Tuberculosis, 93-111. doi:10.1007/978-3-642-18937-1_7

Gulumian, M., Borm, P. J., Vallyathan, V., Castranova, V., Donaldson, K., Nelson, G., & Murray, J. (2006). Mechanistically Identified Suitable Biomarkers of Exposure, Effect, and Susceptibility for Silicosis and Coal-Worker'S Pneumoconiosis: A Comprehensive Review. Journal of Toxicology and Environmental Health, Part B, 9(5), 357-395. doi:10.1080/15287390500196537

Jindal, S. K. (2013). Silicosis in India: past and present. Current opinion in pulmonary medicine, 19(2), 163-168.

Kulkarni, G. (2007). Prevention and control of silicosis: A national challenge. Indian Journal of Occupational and Environmental Medicine, 11(3), 95. doi:10.4103/0019-5278.38456

Luna-Gomes, T., Santana, P. T., & Coutinho-Silva, R. (2015). Silica-induced inflammasome activation in macrophages: role of ATP and P2X7 receptor. Immunobiology, 220(9), 1101-1106. doi:10.1016/j.imbio.2015.05.004

Mazurek, J. M., Wood, J. M., Schleiff, P. L., & Weissman, D. N. (2017). Surveillance for Silicosis Deaths Among Persons Aged 15–44 Years — United States, 1999–2015. MMWR. Morbidity and Mortality Weekly Report, 66(28), 747-752. doi:10.15585/mmwr.mm6628a2

Mulanovich, G. S., Lescano, A. G., Gonzaga, V. E., & Blazes, D. L. (2007). Occupational Health in the Developing World: A Role for the Medical Research Community? Journal of Occupational and Environmental Medicine, 49(11), 1184-1188. doi:10.1097/jom.0b013e31815b5672

National Institute of Occupational Safety and Health (NIOSH), U.S.A. (1976). The Annals of Occupational Hygiene. doi:10.1093/annhyg/19.2.174

Occupational Safety and Health Administration. (2016). OSHA’s Final Rule to Protect Workers from Exposure to Respirable Crystalline Silica. Occupational Safety and Health Administration, US Department of Labor.

Pandey, A. (2014). Addressing the Problem of Silicosis: A Human Rights Issue. SSRN Electronic Journal. doi:10.2139/ssrn.2402225

Perkins, T., Peeters, P., Wouters, E., Reynaert, N., & Mossman, B. (2014). Pathogenesis and Mechanisms of Asbestosis and Silicosis. Pathobiology of Human Disease, 2654-2664. doi:10.1016/b978-0-12-386456-7.05308-9

Practice for Health Requirements Relating to Occupational Exposure to Respirable Crystalline Silica. (n.d.). doi:10.1520/e1132

Reis, M. (2006). Silicosis: dangerous from many angles. Stone World, 23(5), 16-21.

ROSNER, D. (2014). The Long Struggle to Protect Workers’ Lungs Against Silicosis. Milbank Quarterly, 92(2), 191-194. doi:10.1111/1468-0009.12051

Samet, J. M. (1996). Occupational Lung Cancer. Clinical Pulmonary Medicine, 3(1), 15-21. doi:10.1097/00045413-199601000-00003

Silica... It's not just dust. (1997). doi:10.26616/nioshpub97118

Silicosis and lung cancer in U.S. metal miners. (1991). Lung Cancer, 7(5), 329. doi:10.1016/0169-5002(91)90032-2

Silicosis Deaths Among Young Adults—United States, 1968-1994. (1998). JAMA, 280(1), 13. doi:10.1001/jama.280.1.13

Silicosis Mortality, Prevention, and Control—United States, 1968-2002. (2005). JAMA, 293(21), 2585. doi:10.1001/jama.293.21.2585

Thomas, C. R., & Kelley, T. R. (2010). A brief review of silicosis in the United States. Environmental health insights, 4, 21.

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