Current global perspectives on silicosis—Convergence of old and newly emergent hazards

Ryan Hoy (1) , Mohamed Jeebhay (2, 3) , Catherine Cavalin (4, 5, 6, 7) , Weihong Chen (8) , Robert Cohen (9, 10) , Elizabeth Fireman (11, 12) , Leonard Go (9, 10) , Antonio León‐jiménez (13) , Alfredo Menéndez-Navarro (14) , Marcos Ribeiro (15) , Paul-André Rosental (16)

1 Monash University [Melbourne]
2 University of Cape Town
3 School of Public Health and Family Medicine
4 IRISSO - Institut de Recherche Interdisciplinaire en Sciences Sociales
5 MIAS - Madrid Institute for Advanced Study
6 LIEPP - Laboratoire interdisciplinaire d'évaluation des politiques publiques (Sciences Po)
7 CEET - Centre d'études de l'emploi et du travail
8 Tongji Medical College [HUST]
9 Northwestern University Feinberg School of Medicine
10 UIC - University of Illinois [Chicago]
11 Tel Aviv Sourasky Medical Center [Te Aviv]
12 Kfar Saba and Sackler School of Medicine
13 Puerta del Mar University Hospital
14 UGR - Universidad de Granada = University of Granada
15 State University of Londrina = Universidade Estadual de Londrina
16 CHSP - Centre d'histoire de Sciences Po (Sciences Po)

Silicosis not a disease of the past. It is an irreversible, fibrotic lung disease specifically caused by exposure to respirable crystalline silica (RCS) dust. Over 20,000 incident cases of silicosis were identified in 2017 and millions of workers continue to be exposed to RCS. Identified case numbers are however a substantial underestimation due to deficiencies in reporting systems and occupational respiratory health surveillance programmes in many countries. Insecure workers, immigrants and workers in small businesses are at particular risk of more intense RCS exposure. Much of the focus of research and prevention activities has been on the mining sector. Hazardous RCS exposure however occurs in a wide range of occupational setting which receive less attention, in particular the construction industry. Recent outbreaks of silicosis associated with the fabrication of domestic kitchen benchtops from high-silica content artificial stone have been particularly notable because of the young age of affected workers, short duration of RCS exposure and often rapid disease progression. Developments in nanotechnology and hydraulic fracking provide further examples of how rapid changes in technology and industrial processes require governments to maintain constant vigilance to identify and control potential sources of RCS exposure. Despite countries around the world dealing with similar issues related to RCS exposure, there is an absence of sustained global public health response including lack of consensus of an occupational exposure limit that would provide protection to workers. Although there are complex challenges, global elimination of silicosis must remain the goal.

Keywords: epidemiology; occupational medicine; prevention; public health; silicosis

Domains: Pulmonology and respiratory tract

Ryan Hoy, Mohamed Jeebhay, Catherine Cavalin, Weihong Chen, Robert Cohen, et al.. Current global perspectives on silicosis—Convergence of old and newly emergent hazards. Respirology, In press, 27 (6), pp.387-398. ⟨10.1111/resp.14242⟩. ⟨hal-03625855⟩