The Silica-Associated Lung Disease Projects

The Silica-associated Lung Disease Projects

Chief Investigators

Funding

WorkSafe Victoria, 2019

Estimated completion date

Ongoing

Summary

Since 2015 there has been an alarming re-emergence of silicosis in Australia, primarily affecting workers who fabricate and install kitchen benchtops from high silica content artificial stone materials. Cutting, grinding and polishing artificial stone can result in generation of high levels of very fine silica dust particles. When inhaled by workers these particles can cause lung scarring (silicosis), which may require lung transplantation or lead to premature death. Silica dust exposure also increases the risk of autoimmune diseases such as scleroderma, as well as lung cancer.

WorkSafe Victoria has commissioned MonCOEH to fill gaps in evidence related to this re-emergence of silicosis around prevalence, burden of illness and risk factors. This evidence will assist WorkSafe Victoria to address the occupational health issues in this industry and to inform the advice provided to employers about their occupational health and safety obligations.

WorkSafe Victoria launched a free health assessment program in 2019, with the aim of screening all Victorian stone benchtop industry workers for silica-related diseases. MonCOEH’s work comprises two project domains, both of which leverage data from this screening program.

1. Screening Registry: records relevant occupational and health information from workers participating in the WorkSafe Victoria free health assessment program.

2. Silica-associated Disease Registry: captures medical information on workers with possible or diagnosed silicosis and other silica-associated conditions from all industries.

MonCOEH staff work closely with a multi-disciplinary advisory board and a network of experienced occupational and respiratory physicians around Victoria.

Impact

Victoria has an estimated 1,400 workers in the stone benchtop industry who may be exposed to silica dust through work-related activities. These projects will help WorkSafe Victoria deliver evidence-based advice to employers to support their health through better prevention strategies, improved health screening and early diagnosis. The data captured by the registries may also inform further epidemiological studies into the emerging condition.

Key findings to date

Silica-associated Disease Registry

In the first twelve months of the disease registry operation, 86 stone benchtop industry workers had been reported to the Registry with a diagnosis of silicosis, 65 of which were caught at an early stage (simple silicosis), and 21 with more advanced, complicated silicosis.

Data has also revealed a strong association between exposure to dry processing of artificial stone and disease development, flagging the hazardous work conditions many stone benchtop industry workers have experienced. Analysis of the Registry has also found that most workers diagnosed with silicosis had normal lung function and no noticeable symptoms, highlighting the important role of respiratory health screening in driving early detection. Preliminary results also indicated a high prevalence of detectable antinuclear antibodies (37% of those with silicosis) suggesting significant potential for autoimmune disease in this occupational group.

Key outputs

Hoy RF, Glass DC, Dimitriadis C, Hansen J, Hore-Lacy F, Sim MR. Identification of early-stage silicosis through health screening of stone benchtop industry workers in Victoria, Australia. Occup Environ Med. 2020 Oct 28:oemed-2020-106897. doi: 10.1136/oemed-2020-106897. Epub ahead of print. PMID: 33115923.

Glass DC, Dimitriadis C, Hansen J, Hoy RF, Hore-Lacy F, Sim MR. Silica Exposure Estimates in Artificial Stone Benchtop Fabrication and Adverse Respiratory Outcomes. Annals of Work Exposures and Health. 2021; wxab044. doi: 10.1093/annweh/wxab044.

Contact

Ryan.Hoy@monash.edu