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Please read this letter. Please print out this
letter and the ‘physician’s alert’ document
on the next page. Give them both to your doctor for your
medical
records. 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.
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