Victoria pushes for a start on silicosis by measuring the problem (a journalism exercise)

One of the important principles of modern governance is using evidence to guide decision making. Victoria’s Andrews Government has acted in accordance with this principle by proposing the urgent establishment of a national registry and review of the current standards to reduce the risk of stonemasons contracting silicosis.

Silicosis, a term first used in 1870, is an occupational lung disease “caused by inhalation of crystalline  silica dust, and is marked by inflammation and scarring in the form of nodular lesions in the upper lobes of the lungs. It is a type of pneumoconiosis”.

Victoria’s Minister for Health will raise the issue at today’s meeting of the Health Council of the Coalition of Australian Governments (COAG, a governmental cooperation and coordination organisation). Victoria will also supplement its existing Worksafe silica inspection program by introducing a notification system, to ensure data on silicosis is captured at the point of diagnosis.

Recent media reports have highlighted this problem’s occurrence in manufacture of kitchen benchtops from artificial stone, which has a substantially higher silica content than natural stone, and described it as “the worst occupational lung disease crisis since the peak of the asbestos disaster”, with predictions of another 300 cases in Queensland “by December”.

Exposure to asbestos fibres can cause the untreatable lung disease asbestosis or the cancer mesothelioma. One source indicates 10,000 Australians have died from mesothelioma since the 1980s, with a further 18,000 - 25,000 deaths predicted over the next four decades. Hospitalisations for asbestosis have ranged from “62 in 1997–98 to a maximum of 147 in 2004–05” (from here). The use of asbestos was phased out in 1989 and banned entirely in December 2003.

Some Australian guidelines on managing the risk of silicosis date back to at least 2012. The US Department of Labor’s Occupational Safety and Health Administration (OSHA) warns that “Respirable crystalline silica – very small particles at least 100 times smaller than ordinary sand you might find on beaches and playgrounds – is created when cutting, sawing, grinding, drilling, and crushing stone, rock, concrete, brick, block, and mortar”, and lists the manufacture “stone countertops” as one specific example of such activities. OSHA implemented a rule on this in 2016, and one US state implemented a rule in 1998.

Wikipedia states that silicosis:

“(particularly the acute form) is characterised by shortness of breath, cough, fever, and cyanosis (bluish skin). It may often be misdiagnosed as pulmonary oedema (fluid in the lungs), pneumonia, or tuberculosis.

Silicosis resulted in 46,000 deaths globally in 2013 down from 55,000 deaths in 1990.”

and

“Protective measures such as respirators have brought a steady decline in death rates due to silicosis in Western countries. However, this is not true of less developed countries where work conditions are poor and respiratory equipment is seldom used. For instance, life expectancy for silver miners in Potosí, Bolivia is around 40 years due to silicosis.”

Another historical occupational lung disease is “black lung disease”, or “coal worker's pneumoconiosis”. Unlike asbestos, where health risks have been known since 1899, and silicosis, black lung was not well understood until the 1950s. Wikipedia states that “In 2013 CWP resulted in 25,000 deaths down from 29,000 deaths in 1990”.

Comment: Improved data collection certainly facilitates the possibility of improved management of a problem, but the necessary actions still have to be taken at all levels of government.

(Had I been doing this in reality, the Wikipedia quotes would be replaced by comments from experts.)