SILICOSIS

I. DESCRIPTION

Silicosis is a long-term lung disease caused by inhaling large amounts of crystalline

silica dust, usually over many years. That’s a tiny crystal found in sand, rock, or
mineral ores like quartz. Over time, silica can build up in your lungs and breathing
passages. This leads to scarring that makes it hard to breathe.
There are three types:
Acute: Symptoms happen a few weeks up to 2 years after exposure to a large
amount of silica.
Chronic: Problems may not show up until decades after you’re exposed to low or
moderate amounts of silica. It’s the most common type of silicosis. Symptoms may be
mild at first and slowly worsen.
Accelerated: You’ll notice signs about 5 to 10 years after heavy exposure to silica.
They’ll worsen quickly.

II. RISK FACTORS

Silicosis is mostly related to the job that you do. If you work in the following industries,
you’re more likely to develop silicosis than other people.
 Mining and quarrying.
 Construction, building and demolition.
 Stone work, including stone countertop manufacturing.
 Pottery, ceramics and glassmaking.
 Sandblasting.
 Foundry work.
III. PATHOPHYSIOLOGY

Inhalation of crystalline silica

Interact with epithelial cells & macrophages

Activation of inflammasome

Release of mediators

Fibrosis

IV. SIGNS AND SYMPTOMS

There are three main symptoms of silicosis:
 Persistent coughing.
 Coughing that brings up sputum.
 Inflammation (swelling).
 Fibrosis (scarring).
These signs and symptoms can cause:
 Shortness of breath (dyspnea).
 Fatigue.
 Weakness.
 Unintended weight loss.
Silicosis is caused by the damage to your lungs that happens when you breathe in
silica dust. This usually happens in an occupational (job-related) setting.

V. DIAGNOSTIC / LABORATORY TESTS

Your healthcare provider will begin by taking a medical history and making a physical
examination. Asking questions about how long you may have worked in a job known
to cause silicosis will be an important part of the process.
Your provider might find silicosis on an imaging test even if you don’t have symptoms.
They might hear abnormal breath sounds while they examine you.
You may have the following tests:
 Imaging tests: These include chest X-rays and high-resolution computed
tomography (CT) scans. There are certain things that a provider can see on
these types of tests that will lead to a diagnosis of silicosis.
 Pulmonary function tests: These tests evaluate how well your lungs are
working.
  Laboratory tests: These tests may be done to rule out other conditions like
some types of infections. This may include a tuberculosis skin test. There’s no
lab test to prove you have silicosis.
 Bronchoalveolar lavage: This test ‘washes’ your lungs and examines the fluid
that is extracted.
 Lung biopsy: This test, which involves removing a small bit of tissue from your
lungs, is ordered only rarely.

VI. MEDICAL AND SURGICAL MANAGEMENT

There is no cure for silicosis and once the damage is done it cannot be reversed.
Treatment is focused on slowing down the progression of the disease and relieving
symptoms. Avoiding further exposure to silica and other irritants such as cigarette
smoke is crucial. Testing for tuberculosis is important because the disease tends to be
more severe in persons with silicosis.
Once your doctor determines the degree of lung damage that has been done, they will
be able to provide you with a treatment plan. This may include:
 Using a bronchodilator to help relax your air tubes and decrease inflammation.
 Quitting smoking as soon as possible. Smoking can increase the damage done
by silica and speed up the progression of the disease. The American Lung
Association offers proven-effective smoking cessation programs to give people
trying to quit the support they need.
 Supplemental oxygen may be prescribed to help you get more air into your
lungs when needed. Though you may need it only while exercising at the
beginning, as the disease progresses you may need it at all times. Learn more
about oxygen therapy.
 Pulmonary rehabilitation is an exercise program designed to help all patients
with chronic lung conditions maintain optimal activity levels.
 In very severe situations, your doctor may suggest surgery and refer you to a
lung transplant specialist.
Managing Silicosis
To keep the disease from getting worse, all silicosis patients need to eliminate any
more exposure to silica. Other lung irritants, such as indoor and outdoor air pollution,
allergens and smoke, should also be avoided.
Your doctor can help manage your symptoms, but you can also take steps to keep
yourself healthy by doing the following:
 Maintain weight and nutrition with a well-balanced diet.
 Stay as active as you can by exercising regularly but be careful not to overexert
yourself.
 Prevent respiratory infections that can make your lungs worse. Get vaccinated
against the flu every year, and pneumococcal pneumonia as recommended by
your doctor.
 Be vigilant about watching for the development of TB or other infections and
see your doctor immediately if one develops.
 Have a plan to manage flare-ups of the disease.
VII. NURSING MANAGEMENT
 Monitor vital signs.
 Administer supplemental oxygen as prescribed.
 Assist with bronchodilator therapy or inhaled corticosteroids as ordered.
 Monitor for signs of respiratory distress.
 Perform regular pulmonary function tests (PFTs) to assess the progression of the
disease.
 Encourage deep breathing exercises and use of incentive spirometry to improve
lung function.
 Position the patient to optimize breathing, typically in a semi-Fowler's or
Fowler's position.
 Monitor for signs of cor pulmonale, including peripheral edema, jugular vein
distention, and liver enlargement.
 Check chest x-ray or CT scan reports for evidence of progressive fibrosis or
other complications.
 Encourage hydration to help thin secretions and facilitate easier expectoration.
 Provide a quiet and comfortable environment to reduce anxiety and promote
relaxation.
 Educate the patient on avoiding further exposure to silica dust and the
importance of using protective equipment.
 Administer prescribed medications such as corticosteroids, bronchodilators, or
antibiotics.
 Assist with pulmonary rehabilitation if prescribed, to improve respiratory muscle
strength and endurance.
 Assess for signs of infection, such as fever, increased sputum production, or
changes in sputum color.
 Provide psychosocial support to address the emotional and psychological impact
of living with a chronic respiratory disease.