To All Construction Workers at Risk of Developing Silicosis:

Many construction workers are at risk of being exposed to crystalline silica dust through their work, or because they work in areas where this dust is being produced. Crystalline silica is found in brick, concrete products, stone, rock and abrasives. The dust is released from these materials through dry cutting, grinding, chipping, blasting and sweeping. Many trades perform these tasks and are at a high risk of being made ill by the dust many years after initial exposure. Trades affected include, but are not limited to: masonry and stone workers, abrasive blasters, laborers, painters, operating engineers, plasterers, plumbers and truck drivers.

Exposure to crystalline silica dust can result in serious illnesses - even death. Workers that breathe in crystalline silica dust are at an increased risk of developing silicosis (a respiratory lung disease), tuberculosis and lung cancer. Although most cases of silicosis are found in older workers and retirees, silicosis related deaths have been documented in workers as young as age 30.

Unfortunately, many cases of silicosis are misdiagnosed because physicians are unaware of their patient’s work history and unfamiliar with the signs associated with this occupational illness. As a result these cases go unreported.[1] Without proper diagnosis and reporting, workers cannot receive suitable medical treatment and advice. In addition, silicosis is a compensable disease in some states. Therefore, workers with silicosis may be entitled to workers’ compensation depending on the state they are in.

Attached is a physician’s alert entitled “What Physicians Need to Know about Silicosis in Construction, Demolition and Renovation Workers.” The New Jersey Department of Health, with input from the Center to Protect Workers’ Rights and the building trades unions, developed this alert as part of a project funded by the National Institute for Occupational Safety and Health (NIOSH). It was developed to help ensure that all construction workers at risk of developing silicosis are properly diagnosed, and that cases of silicosis are documented and reported to the appropriate state health agencies.

This physician’s alert will only be effective in improving the diagnosis and documentation of silicosis and related illnesses if:

• Workers make their doctor(s) aware of their work history and unique exposure risk. Workers need to give this alert to their doctor(s), and let them know how they have been exposed to silica dust - construction materials used and tasks performed that may have exposed them to silica dust.
• Doctors become familiar with the information in the attached physician’s alert and emphasize the respiratory system in the worker’s annual physical exam. Medical exams should include: a pulmonary function test (PFT) to look for evidence of respiratory impairment, a baseline PPD skin test for tuberculosis, and chest x-rays (at the frequency recommended in this ‘alert’ or by OSHA in future regulations). It is important that the chest x-rays be read by a certified class “B” reader because silicosis is sometimes confused with sarcoidosis, asbestosis, coal miner’s pneumoconiosis, and other pneumoconiosis. Cases of silicosis should then be reported to the state health department. Doctors should be aware that there is no medical treatment to reverse silicosis. Corticosteroids are not useful to reduce the progression of the disease; however, appropriate treatment for heart failure and tuberculosis should be begun if these complications exist. In addition, because the risk of silicosis increases if a person smokes, all individuals should be strongly advised to stop smoking and offered smoking cessation information and support.

While this physician’s alert deals with the proper diagnosis and reporting of silicosis cases, as noted earlier, it is important to understand this is a disease that can be prevented. It is the goal of the International Union of Bricklayers and Allied Craftworkers, as well as all building trades unions to prevent silicosis by eliminating or reducing the risk of exposure through changes in work practices and the use of dust control mechanisms. We are working towards that goal both through the collective bargaining process and better OSHA regulations.

Until such control mechanisms and better standards are in place, protect yourself and your family by:

• Not dry-cutting masonry products or stone: always use water. This is the best way to limit dust. If you can't use water, use a vacuum with a high efficiency particulate air (HEPA) filter or another dust control system. If this is not possible, use a full-face respirator as part of a complete respiratory protection program that includes proper selection of respiratory cartridges, training and fit-testing to see if you are able to wear a respirator.
• Minimizing dust that is carried home on clothes and personal belongings such as cars and tool boxes.
• Not smoking, because smoking in combination with silica dust exposure increases your risk of lung cancer.

Fraternally,
John J. Flynn
BAC President

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[1] Goodwin, Susan, “Undercounting Silicosis: An Example of Physician failure to Recognize Occupational Disease”; disertation presented at the School of Hygene and Public Health Johns Hopkins University; 1998.