Silica is the most abundant mineral in the earth’s crust. Unfortunately, breathing in silica dust caused by chipping, cutting, drilling, or grinding soil, granite, slate, sandstone or other natural materials can lead to chronic lung disease. As a thoracic surgeon at West Virginia University Hospital, Dr. Robert Herron has treated a wide variety of lung conditions. Being in the western panhandle means that many of his patients are current or former coal miners, and have been exposed to coal and silica dust for years, putting them at great risk for respiratory disease. Because of this, Dr. Herron treats more patients with pulmonary fibrosis including coal workers pneumoconiosis (also known as black lung) and silicosis than many of his colleagues elsewhere in the United States.

Recently, the U.S. Department of Labor and Mine Safety Health Administration proposed a rule to lower the limit of exposure to silica for miners. If finalized, this rule would help ensure that miners have at least the same level of protection as other industry workers. “Though mining is the main profession people associate these problems with, they are not the only ones at risk. I have seen the same lung damage in patients who work at glass and steel factories and construction. Really any job where there are chemical exposures and where there is dust in the air could be a cause for concern,” Dr. Herron explained.

Understanding Silicosis

Why Is Silica So Dangerous?

Silica exposure can cause a wide range of diseases, many of which are progressive. When silica dust is inhaled over time, the tiny particles cause scarring and inflammation. This leads to the formation of lung nodules, which may be a sign of lung cancer. The scarring can also become so severe it stiffens the lungs and makes it difficult to breathe, leading to pulmonary fibrosis or COPD. Silica exposure also increases the risk of bacterial infections, such as tuberculosis.  “Depending on the disease and symptoms ranging anywhere from shortness of breath to the need to be on supplemental oxygen full-time. The course of treatment, which normally includes inhalers and steroids, is up to the pulmonologist but many times patients need surgery, which is when they are referred to me,” said Dr. Herron.

When considering surgery, Dr. Herron must evaluate how much lung function the patient has and whether they can tolerate the strain surgery puts on the body. A minimally invasive lobectomy would be used in cases where a nodule has formed. Lung volume reduction surgery will be considered in rare and severe situations. However, unfortunately many times the lung damage is permanent, and though the cancer can be treated, nothing can be done to treat the underlying black lung or silicosis comorbidity.

What Can Be Done?

“This is not something that is going away, even though many coal workers have respirators and other equipment to protect their lungs, I still see lots of cases. These government protection measures are huge, and they need to continue to evolve both at the state and the federal level,” Dr. Herron said.

Even though this new proposed rule would be a step in the right direction to protect coal miner and other industry workers, Dr. Herron strongly encourages wearing all protective gear, including respirators, in any situation where you may be exposed to these dangerous dusts. “Protective measures need to stay at the forefront in the treatment of pulmonary disease in my opinion. Because once the damage is done, the lung tissue cannot regenerate. It is hard to recover and if you are diagnosed you will have to manage the lung disease for the rest of your life. That is why the best form of treatment is prevention.”

Learn more about what you can to do to protect your lungs from occupational pollutants.


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