Silicosis Follow-up

Author: Basil Varkey, MD, FCCP; Chief Editor: Zab Mosenifar, MD more...

Updated: Jan 26, 2011

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Deterrence/Prevention
Complications
Prognosis
Patient Education
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Deterrence/Prevention

Monitoring of air quality and dust concentration in the workplace is essential to prevent silicosis and other pneumoconioses.

Limiting exposure to harmful dusts can be achieved further by suppressing dust generation, filtering or capturing dust particles, diluting the concentration with fresh air, and using personal protective respiratory equipment as further possible means of preventing silicosis.

The Occupational Safety and Health Administration (OSHA) has set a permissible exposure limit for respirable silica of 10 mg/m³. The National Institute for Occupational Safety and Health (NIOSH) standard is a more stringent exposure limit of 0.05 mg/m³.

In addition to the primary prevention measures, secondary methods include monitoring workers with chest radiograph and spirometry to identify early disease and to stop further exposure to silica.

Complications

Complications are as follows:

Airflow obstruction
Chronic bronchitis
Cor pulmonale
Respiratory failure
Increased incidence of mycobacterial diseases
Increased risk of lung cancer (see the Medscape Lung Cancer Resource Center)
Association with connective-tissue disorders (eg, rheumatoid arthritis, scleroderma, systemic lupus erythematosus, mixed connective-tissue disease,^[14]systemic vasculitis^{[15, 16]}

Prognosis

The clinical presentation at the time of diagnosis is somewhat predictive of the prognosis, but the rate of progression varies. Silicoproteinosis worsens quickly, and death may occur in months. Progressive massive fibrosis causes gradual worsening of symptoms, deterioration of lung function, and increasing disability. On the other hand, patients with simple silicosis may be asymptomatic and may remain stable for many years both clinically and radiographically.

Patient Education

Prevent further exposure to silica dust. Strongly advise patients to quit smoking and provide help in smoking cessation efforts.

Contributor Information and Disclosures

Author

Basil Varkey, MD, FCCP Professor Emeritus, Department of Internal Medicine, Division of Pulmonary and Critical Care, Medical College of Wisconsin; Consulting Pulmonologist, Froedtert Memorial Lutheran Hospital

Basil Varkey, MD, FCCP is a member of the following medical societies: American Association of Physicians of Indian Origin and American College of Chest Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Anita B Varkey, MD Assistant Professor, Department of Medicine, Loyola University Medical Center; Associate Program Director, Internal Medicine Residency; Medical Director, General Internal Medicine Clinic, Loyola Outpatient Center

Anita B Varkey, MD is a member of the following medical societies: American College of Physicians and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Gregory Tino, MD Director of Pulmonary Outpatient Practices, Associate Professor, Department of Medicine, Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania Medical Center and Hospital

Gregory Tino, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and American Thoracic Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Om Prakash Sharma, MD, FRCP, FCCP, DTM&H Professor, Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Southern California Keck School of Medicine

Om Prakash Sharma, MD, FRCP, FCCP, DTM&H is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, American Osler Society, American Thoracic Society, New York Academy of Medicine, and Royal Society of Medicine

Disclosure: Nothing to disclose.

Timothy D Rice, MD Associate Professor, Departments of Internal Medicine and Pediatrics and Adolescent Medicine, St Louis University School of Medicine

Timothy D Rice, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Physicians

Disclosure: Nothing to disclose.

Chief Editor

Zab Mosenifar, MD Director, Division of Pulmonary and Critical Care Medicine, Director, Women's Guild Pulmonary Disease Institute, professor and Executive Vice Chair, Department of Medicine, Cedars Sinai Medical Center.David Geffen School of Medicine at UCLA.

Zab Mosenifar, MD, is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, and American Thoracic Society

Disclosure: Nothing to disclose.

References

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Caplan A, Payne RB, Withley JL. A broadened concept of Caplan's syndrome related to rheumatoid factors. Thorax. 1962;17:205-209.
Yucesoy B, Vallyathan V, Landsittel DP, et al. Polymorphisms of the IL-1 gene complex in coal miners with silicosis. Am J Ind Med. Mar 2001;39(3):286-91. [Medline].
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Mulloy KB. Silica exposure and systemic vasculitis. Environ Health Perspect. Dec 2003;111(16):1933-8. [Medline].
Hogan SL, Cooper GS, Savitz DA, et al. Association of silica exposure with anti-neutrophil cytoplasmic autoantibody small-vessel vasculitis: a population-based, case-control study. Clin J Am Soc Nephrol. Mar 2007;2(2):290-9. [Medline].

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