Silicosis Treatment & Management

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

Updated: Jan 26, 2011

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Medical Care
Surgical Care
Consultations
Diet
Activity
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References

Medical Care

Note the following:

Prevent further exposure to silica dust.
Strongly advise patients to quit smoking and provide help in smoking cessation efforts.
Immunize patients against influenza and pneumococcal pneumonia.
No specific therapy for silicosis cures or alters the course of the disease.
Corticosteroids may be of benefit in acute silicosis.^{[10, 11]}In chronic silicosis, they are unlikely to be of benefit, although pulmonary function improvement was noted in one study.^[12]
Selectively in patients with very advanced disease without other comorbid conditions, lung transplantation may be an option.
Experimental (unproven) approaches to treatment include whole-lung lavage, aluminum inhalation, and parenteral administration of polyvinyl pyridine N-oxide.
Latent tuberculosis infection (ie, positive tuberculin skin test result without active disease) should be treated with isoniazid (see Medication). A 10-mm induration is considered a positive test result in this population.
Active tuberculosis (ie, Mycobacterium tuberculosis identified in smear or culture) should be treated with appropriate multiple drugs (see Medication) according to the most recently established guidelines.^[13]
Complications (eg, airflow obstruction, cor pulmonale, respiratory failure), should they occur, should be treated appropriately.

Surgical Care

Selectively in patients with very advanced silicosis and without other significant comorbid conditions, lung transplantation should be considered.

Consultations

Consulting a pulmonologist is appropriate for evaluation of lung nodules, pulmonary function assessment, and disability evaluation, as well as treatment of mycobacterial disease and complications of advanced silicosis.

Diet

No dietary restrictions are necessary.

Activity

No restrictions on activity are necessary.

Proceed to Medication

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

Centers for Disease Control and Prevention. Silicosis-related years of potential life lost before age 65 years--United States, 1968-2005. MMWR Morb Mortal Wkly Rep. Jul 18 2008;57(28):771-5. [Medline].
Rosenman KD, Reilly MJ, Kalinowski DJ, Watt FC. Silicosis in the 1990s. Chest. Mar 1997;111(3):779-86. [Medline].
Sonnenberg P, Murray J, Glynn JR, Thomas RG, Godfrey-Faussett P, Shearer S. Risk factors for pulmonary disease due to culture-positive M. tuberculosis or nontuberculous mycobacteria in South African gold miners. Eur Respir J. Feb 2000;15(2):291-6. [Medline].
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].
Verma DK, Vacek PM, des Tombe K, et al. Silica exposure assessment in a mortality study of vermont granite workers. J Occup Environ Hyg. Feb 2011;8(2):71-9. [Medline].
Chaudhury N, Phatak A, Paliwal R, Raichaudhari C. Silicosis among agate workers at Shakarpur: An analysis of clinic-based data. Lung India. Oct 2010;27(4):221-4. [Medline]. [Full Text].
Linch KD. Respirable concrete dust--silicosis hazard in the construction industry. Appl Occup Environ Hyg. Mar 2002;17(3):209-21. [Medline].
Centers for Disease Control and Prevention. Silicosis in dental laboratory technicians--five states, 1994-2000. MMWR Morb Mortal Wkly Rep. Mar 12 2004;53(9):195-7. [Medline].
Goodman GB, Kaplan PD, Stachura I, Castranova V, Pailes WH, Lapp NL. Acute silicosis responding to corticosteroid therapy. Chest. Feb 1992;101(2):366-70. [Medline].
Gupta R, Vats M, Dadhich P, et a. Steroid pulse therapy in silicosis. Chest. 2003;124:2155.
Sharma SK, Pande JN, Verma K. Effect of prednisolone treatment in chronic silicosis. Am Rev Respir Dis. Apr 1991;143(4 Pt 1):814-21. [Medline].
American Thoracic Society, Centers for Disease Control and Prevention, Infectious Diseases Society of America. Treatment of tuberculosis. MMWR Recomm Rep. Jun 20 2003;52:1-77. [Medline].
Rosenman KD, Moore-Fuller M, Reilly MJ. Connective tissue disease and silicosis. Am J Ind Med. Apr 1999;35(4):375-81. [Medline].
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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