Silicosis: Description
Silicosis is a scarring change in the lung tissue. It occurs when quartz dust is inhaled and settles in the lungs. Quartz is the main component of the earth’s crust. However, it is also found in combination with other substances such as magnesium, iron or aluminum. These so-called silicate salts do not cause silicosis, but can also cause minor lung scarring.
Occupational disease
If a worker has been diagnosed with silicosis, occupational and medical measures are initiated to alleviate the sufferer’s symptoms. If, despite these measures, sufferers have permanent physical impairments and can no longer work, a pension is paid.
Forms of silicosis
Doctors distinguish between different forms of silicosis (silica dust lung) depending on the course of the disease:
- Accelerated silicosis: This less frequent form of silicosis can occur if a fairly high quantity of quartz dust is inhaled. The first signs of silicosis then appear after only four to nine years. The risk of complications and severe, progressive pulmonary fibrosis is increased.
Silicosis: Symptoms
The signs of silicosis can appear within a few months or only after years or decades, depending on the course of the disease. In general, the shorter the period between exposure to quartz dust and the onset of the first symptoms, the more severe the symptoms.
Chronic silicosis
In the later course of silicosis, some sufferers complain of dark sputum. This occurs when the scar tissue containing silica dust dies, softens and is coughed up. The lack of oxygen due to impaired lung function may be manifested by a bluish discoloration of the ends of the fingers and lips.
Accelerated silicosis
Acute silicosis
In this form of silicosis, symptoms such as shortness of breath, fatigue, and weight loss present themselves within a few weeks or years and increase rapidly. Coughing and chest pain also occur. As with the other forms – only more quickly – oxygen deficiency can occur in the body, which is noticeable via a bluish discoloration of the skin and mucous membranes (cyanosis).
Silicosis: Causes and risk factors
Particularly at risk for quartz dust lung are ore and coal miners, tunnel builders, cast cleaners (cleaning and smoothing of castings), sandblasters, kiln masons, dental technicians and persons who extract, process or manufacture metal, glass, stone, clay and glass ceramics. Activities such as grinding, casting or scouring release increased amounts of quartz dust into the ambient air, thereby significantly increasing the risk of contracting silicosis.
Silicosis: examinations and diagnosis
If you have any symptoms of silicosis, you should consult an occupational physician. In an initial consultation, the doctor will take your medical history and try to assess how likely you are to have silicosis. Among other things, he will ask the following questions:
- What are your symptoms and how long have you had them?
- What is your profession? How long have you been working in this profession?
- Do you have to inhale dust at your workplace?
- Have fine dust measurements been carried out at your workplace in this respect?
- Are there any protective measures in place at your workplace, such as wearing a protective mask or goggles?
Imaging of the chest by means of X-ray examination (X-ray thorax) or computer tomography (thorax CT) is important for the diagnosis. Characteristic changes in the lungs can be seen in silicosis.
Silicosis is diagnosed when exposure to quartz dust at the workplace is secured and typical changes are visible in the X-ray or computed tomography of the lungs.
In addition, there are other examinations that can be informative:
- Pulmonary function test: It is used to monitor progress.
- Taking and analyzing a tissue sample from the lungs (lung biopsy): This examination is sometimes necessary to confirm the diagnosis of silicosis.
Silicosis: Treatment
Silicosis is not curable: the progression of the underlying lung scarring (pulmonary fibrosis) cannot be influenced therapeutically. In any case, however, further inhalation of quartz dust should be avoided, especially in early stages of the disease.
Sometimes doctors recommend lung lavage (bronchoalveolar lavage). This involves filling saline solution into the lungs and then sucking it out again – together with substances present in the airways.
The last therapeutic option is the insertion of a donor lung (lung transplantation).
Additional respiratory infections caused by bacteria or fungi are treated with antibiotics or antifungals, respectively, to prevent further impairment of lung function.
The prognosis of silicosis depends primarily on the onset of its symptoms. Acute silicosis usually ends in death. The culprit is the rapidly progressing respiratory weakness. Chronic silicosis, on the other hand, usually breaks out decades after exposure to quartz dust. As a result, the underlying pulmonary fibrosis rarely shortens the life of those affected. However, silicosis usually worsens over time.
Complications and secondary diseases
Silicosis and tuberculosis
Silicosis patients are susceptible to respiratory infections. Thus, they have about a 30-fold increased risk of contracting tuberculosis (TB). If doctors can detect both silicosis and active tuberculosis, they refer to it as silico-tuberculosis. If the affected person had a previous TB infection, it can be reactivated by the quartz dust particles.
Chronic obstructive bronchitis and emphysema
Cor pulmonale
Signs of a “pulmonary heart” include water retention in the legs and protruding neck veins. Because blood also backs up in the liver and other organs due to the heart failure, these can also suffer damage.
