Heed the WARNING SIGNS

Silocosis, lung health, lung disease, cement, stone mason

Dr Julia Norris says the health crisis facing engineered stone benchtop makers in Australia is an early warning failure we all need to learn from.

By now many of you will have heard about the emergence of accelerated silicosis in engineered stone benchtop workers in Australia. Accelerated silicosis is a tragic disease, causing progressive fibrosis of the lungs and leaving affected workers severely short of breath.

But silicosis is not a new disease. It was first described in Australia in the early 1900s in workers building tunnels for the sewage system in Sydney. These workers, who were using hand tools to chip away at sand stone, worked in very dusty conditions and were observed to develop a debilitating lung condition that we now know as siicosis.  The rate of silicosis was alarming, with seven out of ten men dying of the disease during this time. Over the next few decades, legislation was passed and controls put in place to reduce silica dust exposure, seeing the rate of silicosis fall dramatically.

Now, more than a century later – and after we thought we had successfully reducing the incidence of silicosis in miners and stone workers throughout the 20th century – we are once again seeing workers die of this very same disease. WHY?

HIGH SILICA CONTENT

Engineered stone has been produced in significant quantities since the 1980s, but has really gained popularity in Australian in the 2000s. Engineered stone differs from natural stone in the way it is formed and its properties. Natural stone slabs are cut from larger naturally occurring stone blocks (e.g. granite, marble, sandstone). Engineered stone slabs are manufactured by combining approximately 93% quartz with 7% resins and pigments, to form standardised stone slabs. These are moulded, compressed and heated to give them superior durability and strength, with the added benefit of providing a consistent colour and texture of choice.

This makes engineering stone slabs excellent for use as kitchen and bathroom benchtops and they are commonly used throughout Australia. However, while the very high quartz concentration gives them strength and durability, it also makes them extremely hazardous to cut, grind or polish. The final engineered stone product contains over 90% silica, compared to marble with 3% silica and granite with 30% silica.

For the past 15 years or more in Australia, we have been importing engineered stone for use in the production of stone benchtops. It is known that this process requires cutting, polishing and bevelling of the stone surfaces. It is also well know that silica causes silicosis and scarring of the lungs.

WHY THE SUPRISE?

So why, in 2018, were we so surprised with 106 engineered stone benchtop workers – in Queensland alone – were diagnosed with accelerated silicosis? How did we not see this coming?

I am sure that some time in the past 15 years, a workers has looked at their workplace and thought, “Wow, this is dusty, is this really good for me?”. I’m sure that at some stage, an occupational hygienists or a WorkSafe inspector has visited one of these workshops and thought “Hang on, we have a problem here with silica”. I’m not equally sure that at some point, a doctor was a patient with shortness of breath and x-ray changes and thought “This is silicosis, where is that exposure coming from”?

Given all this collective knowledge, why did it take us so long to realise the extent of this tragedy? It’s an obvious question, with no obvious answer.

LESSON TO BE LEARNED

Perhaps there were many people with only a small piece of the puzzle, and no system to bring them all together. Perhaps there were some pieces of the puzzle missing. Perhaps we just got complacent. I don’t have the answer, but i am sure that if we don’t take the tie to look back and explore our failures, we won’t learn from them. We need to review and interrogate our systems and work out what went wrong. In this way, we can learn from the past and use these learning to guide our future.

We need to be innovative, we need to be curious, we need to be honest and we need to collaborate. But most importantly, we need to take action now, to prevent further cases of silicosis and ensure that we don’t become complacent and miss the multitude of new and emerging issues that are on our horizon.

Dr Julia Norris

GP, Certified Occupational Hygienist, president of the Australian Institute of Occupational Hygienists and Director of Occuhealth.

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