About Your Diagnosis

The inhalation of silica dust may cause lung disease called silicosis. Silica exposures usually occur in the workplace. Industries where workers are potentially at risk include foundries, mining, excavation, quarrying, sandblasting, stoneworking, and ceramics manufacturing. Initially, small rounded nodules develop when the silica deposits in the lung. Later, the number and size of the nodules may increase. The nodules eventually can join together to form large masses and lung scarring, which can interfere with lung function. This condition is called progressive, massive fibrosis. Diagnosis is usually established by occupational history and chest x-ray. Occasionally a lung biopsy is necessary to make the diagnosis or to exclude such complications as tuberculosis or lung cancer. Breathing tests may be obtained to help assess the impact of silicosis on lung function.

Living With Your Diagnosis
The risk of developing silicosis is determined primarily by the intensity and duration of silica exposure. Years of exposure are usually necessary for development of illness, yet symptoms may occur in months with shorter but more intense inhalations. The symptoms may vary. Early in the disease, silicosis does not cause symptoms or impair lung function. The disease may stay at this point and never threaten life span. In some individuals, the disease may progress, even after silica exposures have stopped. Shortness of breath and dry cough are the most common symptoms associated with progressive, massive fibrosis. Severe respiratory disability may lead to premature death.

Treatment
There are no treatments known to decrease the number of silica nodules in the lung, or to reliably prevent the development of progressive, massive fibrosis. Lung transplantation is considered in certain individuals. Those workers whose chest x-rays reveal silicosis changes should take the necessary steps to avoid further silica exposures. Silicosis is known to increase the risk of tuberculosis. If silicosis is diagnosed, a tuberculin skin test should be performed. If the test is positive (meaning there has been a prior exposure to the organism that causes tuberculosis), a course of medications is required to help prevent the development of tuberculosis.

The DOs
• Obtain an influenza vaccination each fall.
• Obtain/update the pneumococcal vaccination.
• Maintain good cardiovascular fitness by participating in an exercise program.
• Maintain close contact with your health care provider.
• No special diet requirements.

The DON’Ts
• Avoid all further exposures to inhaled silica by following special industrial protection measures, such as wearing dust masks.
• Avoid individuals with acute respiratory tract infections.
• Avoid other conditions known to irritate the lungs, such as exposures to smoke, fumes, and very cold or very humid air.
• Stop smoking.

When to Call Your Doctor
• If you suspect that you have a lung infection as suggested by an abrupt worsening of cough, yellow or green sputum production, increased shortness of breath, and fever or chills.
• If you have weight loss, chest pain, or blood in the sputum (tests may be necessary to make sure tuberculosis or cancer is not present).
• If you have dusky-colored skin, fingertips, or lips.
• If you have new ankle swelling.

Websites:
American Lung Association
www.lungusa.org