The American Public Health Association,
Recognizing that silicosis is the most common type of pneumoconiosis and that it is caused by inhalation of respirable silica dust (or quartz dust or silicon dioxide), the most common mineral in the earth's surface;1 and
Recognizing that silicosis is usually a chronic disease, developing over several years, and may be complicated with tuberculosis, and that massive exposure to silica can cause acute silicosis, a rapidly fatal disease that can develop in less than a year;2 and
Noting that cases of silicosis, even of acute silicosis, still appear in rock drill operators working on surface mines or highways, construction workers who use sand in abrasive blasting, and foundry workers who make sand castings and that recent deaths have occurred to men in their thirties;2-4 and
Recalling that between 1968 and 1990, there were 13,744 deaths in the United States with silicosis as a primary or contributing cause of death;5 and
Recognizing that the age-adjusted death rate in 1990 was 2.05 per million white men and 4.24 per million for black men, and that these rates have remained unchanged over the past ten years;5 and
Remembering that from 1985 to 1990, many different industries were recorded on silicosis death certificates, the most common being coal and metal mining (combined) (13.8 percent of cases), steelmaking (6.9 percent), miscellaneous non-mineral and stone products (6.1 percent), and iron foundries (5.4 percent);5 and
Noting that the Mine Safety and Health Administration (MSHA) and the Occupational Safety and Health Administration (OSHA) have both the mandate and the authority to regulate workers' exposure to silica; and
Recognizing that 26.9 percent of MSHA samples of mine air for respirable dust in 1991 exceeded the permissible exposure limit (PEL) and that this exposure limit is twice the value recommended by NIOSH (100 v. 50 micrograms per cubic meter);5 and
Acknowledging that silicosis is entirely preventable with known, effective, and conventional public health methods such as medical surveillance leading to secondary prevention and exposure surveillance leading to primary prevention; and
Noting that feasible and effective dust control methods include, from most to least adequate, use of less hazardous materials, dust suppression with water or enclosure of drill bits,6 local exhaust ventilation, or use of respirators that have been fit-tested and worn by informed and trained workers who are physically able to wear them; and
Recognizing that several countries in Europe (Sweden, United Kingdom, Germany) prohibit or restrict the use of sand in abrasive blasting; 7 therefore
- Urges OSHA and MSHA to improve regulations and their enforcement for preventing silicosis by requiring exposure and medical monitoring, including surveillance for tuberculosis; improving exposure limits; restricting the use of silica; and enforcing these regulations vigorously;
- Urges OSHA and MSHA to adopt the exposure limits recommended by NIOSH;
- Suggests that OSHA and MSHA should require medical and exposure monitoring of workers exposed to silica and should prohibit the use of silica in abrasive blasting;
- Urges OSHA and other agencies to investigate the use of safe alternative materials in foundries and to promote research that would identify substitute materials for abrasive blasting and sand casting, with additional funds being made available to these agencies if necessary;
- Recommends that NIOSH continue and expand its efforts to identify cases through surveillance, investigating death certificates, and other means; and
- Recommends health education of workers and families about prevention and treatment of silicosis.
- Balaan MR, Banks DR. Silicosis. In Rom WN, ed., Environmental and Occupational Medicine, 2d ed. Boston: Little, Brown and Co., 1992;345-358.
- National Institute for Occupational Safety and Health. Alert-Request for Assistance in Preventing Silicosis and Deaths among Rock Drillers. Cincinnati: U.S. Department of Health and Human Services, Public Health Service, 1992. DHHS (NIOSH) Publication No. 92-107.
- National Institute for Occupational Safety and Health. Alert-Request for Assistance in Preventing Silicosis and Deaths from Sandblasting. Cincinnati: U.S. Department of Health and Human Services, Public Health Service, 1992. DHHS (NIOSH) Publication No. 92-102.
- Morris J. Worked to Death. Houston Chronicle, Fall, 1994.
- National Institute for Occupational Safety and Health, Division of Respiratory Disease Surveillance. Work-Related Lung Disease Surveillance Report, 1994. Cincinnati: U.S. Department of Health and Human Service, Public Health Service, 1994. DHHS (NIOSH) Publication No. 94-120.
- National Institute for Occupational Safety and Health. Industrial Health and Safety Criteria for Abrasive Blast Cleaning Operations. Washington, DC: U.S. Department of Health, Education, and Welfare (DHEW) (NIOSH) Pub. No 75-122.
- PEI Associates, Inc. Investigation of Quartz Dust Sources and Control Mechanisms on Surface Coal Mine Operations. Vol. I, Results, Analysis, and Conclusions. A mining research contract report, Contract No. J03348032. Pittsburgh: U.S. Department of the Interior, Bureau of Mines. March 1986.
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