Silicosis: Stop the dust and protect your lungs
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The bottom line
Silica is a mineral found in natural stone and engineered (artificial) stone. Silicosis is a lung disease caused by breathing in silica dust. Cutting stone creates silica dust particles that get trapped in the lungs, leading to inflammation and scarring. Symptoms include cough, shortness of breath, wheezing, and weakness. Workplace safety steps can lower the risk.
Prevention tips
Use water suppression (wet cutting tools and water sprays) to keep dust out of the air.
Use special high-efficiency vacuums at work to remove dust.
Use local exhaust ventilation to pull dust away from the work area.
Wear a tight-fitting, approved respirator.
Never dry sweep the area.
Wash your hands and face before eating.
Wash your hands, face, and other exposed skin before going home.
Change clothes before going home.
Do not smoke or vape since this worsens lung damage.
This really happened
A 44-year-old man had 8 months of worsening trouble breathing, cough, and chest tightness. Before this, he had been healthy, and he did not smoke. He was a stone worker who cut, polished, and installed kitchen countertops made of marble and, more recently, artificial stone. Four months after his symptoms began, a pulmonologist ordered a chest CT scan that showed many tiny nodules and swollen lymph nodes in the chest. A biopsy showed inflammation. He was diagnosed with sarcoidosis, an inflammatory disease, and started on a steroid, but his symptoms did not improve.
Four months later he was still sick and a repeat CT scan showed new hazy areas in his lungs. When he was admitted to the hospital, his heart rate was high and his blood oxygen level was low. After more tests, doctors determined that the sarcoidosis diagnosis was wrong. A worsening CT scan, poor lung function tests, and a lung biopsy showing scarred nodules with needle-shaped crystals led to the correct diagnosis: silicoproteinosis, an acute form of silicosis. He had a whole-lung lavage, a procedure that washes out the lungs, and a second one 3 weeks later. After that, he no longer needed extra oxygen. At a follow-up visit, doctors learned he had gone back to work as a stone worker and needed oxygen again.
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What is silicosis?
Silicosis is a lung disease caused by breathing in silica dust. It is a long-term disease with no cure. Depending on how much silica dust a person breathes in, it can develop rapidly (within months), gradually (5 to 15 years), or chronically (10 to 20 years).
Silica is a mineral found in natural stone such as sandstone, granite, and slate, in engineered or artificial stone (used for countertops), and in construction materials including bricks, concrete, mortar, and tile.
What are engineered stone and quartz countertops?
Both are manmade composite surfaces. Engineered stone is made from crushed stone with polymer resin or cement holding it together. The crushed material can include glass, granite, marble, and quartz. Engineered quartz is 90% to 95% crushed natural quartz crystals mixed with pigments, polymers, and resins.
These countertops are popular because they are not porous, look the same from slab to slab, and are durable and easy to clean. However, high heat can discolor or scorch them.
What to do if you have been exposed to silica dust
If you are accidentally exposed to silica dust one time, leave the area, breathe fresh air, wash your hands and face with soap and water, and change your clothes. See a doctor if you develop coughing, shortness of breath, or chest pain. If you are exposed to silica dust at work, see a doctor about tests such as a chest CT scan and spirometry (lung function tests). Be sure to use all required personal protective equipment (PPE) to minimize your exposure.
Get expert help
If you breathe in silica dust or have questions about its health risks, use the webPOISONCONTROL® online tool to get help, or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.
Why are quartz countertop workers getting silicosis?
Engineered quartz countertops are made of more than 90% crystalline silica. Workers who cut these slabs create fine silica dust particles, which they then breathe in. Because workers do this day after day for potentially many years, a lot of dust is inhaled over time. This greatly increases their risk of developing silicosis compared with people who do not work in this industry.
Symptoms of silicosis
When silica dust particles are inhaled, they become trapped in the lungs, where they cause inflammation, permanent scarring, and stiffening of lung tissue (pulmonary fibrosis). This can lead to respiratory failure and death. Symptoms include persistent cough, shortness of breath, wheezing, weakness, and feeling tired. Shortness of breath often happens during physical activity. Chest or back pain may occur when taking a deep breath.
How is silicosis diagnosed and treated?
Silicosis is diagnosed based on work history, a lung exam, a chest X-ray, a high-resolution computed tomography (CT) scan, and spirometry (lung function tests). In chronic silicosis, the CT scan shows small spots (nodules) in the lungs that can grow into large scars. Lymph nodes in the center of the chest may be enlarged, and the lining of the lungs can thicken. In acute silicosis, caused by very heavy exposure over a short time, the lungs look like frosted glass on the scan.
There is no cure for silicosis. Lung damage cannot be reversed. Treatment aims to slow the disease and relieve symptoms. Treatment involves stopping exposure and avoiding irritants such as cigarette smoke and air pollution. Treatments include inhalers that open the airways and oxygen therapy. Vaccines can help prevent lung infections. Short-term steroids may help decrease inflammation. Antifibrotics or biologics, such as Ofev® (nintedanib) or Esbriet® (pirfenidone), may help slow the progression of inflammation and scarring. Research is ongoing. Pulmonary rehabilitation, a supervised exercise and breathing program, helps people stay as active as possible. For end-stage disease, a lung transplant is an option.
Who is most at risk for silica dust exposure?
Occupational exposure is the greatest risk. Cutting, grinding, drilling, or crushing materials that contain silica increases the risk of silica dust exposure. High-risk workers include construction workers, engineered stone countertop fabricators and installers, miners, sandblasters, and foundry workers. Work conditions are an important factor. Risk is high if the worker is in a poorly ventilated area, is exposed to high levels of silica, or has been exposed for many years.
Workplace precautions lower the risk of silicosis. These include spraying water to suppress dust when working with the stone, using local exhaust ventilation to remove silica dust from the air, and isolating workers from sources of dust. Workers should also wear protective equipment and clothing and change out of dusty work clothes before leaving the worksite. Employers should offer chest X-rays and lung function testing for those who work with silica dust regularly.