1.10. Does silicosis still occur and why?
Yes, although it is in decline, silicosis is not yet completely eliminated.
Peaking with industrialisation at the beginning of the 19th Century, silicosis prevalence has since seriously declined (more than 90% since 1960). The main reasons of this decline are:
- Closure of coal mines,
- Health surveillance and medical progress in early diagnosis,
- Medical progress,
- Continuous improvement of hygiene measures in the workplace: development of new processes and ventilation systems, improved personal protective equipment, greater awareness of health and safety requirements (such as the introduction of occupational exposure limits).
Silicosis is not yet completely eliminated because the disease has a long latency period and any new cases which are diagnosed today in Europe are the consequences of the overexposures experienced 20 or 30 years ago which were significantly heavier. In addition, thanks to the development of improved diagnostic methods, silicosis is nowadays detected and reported sooner and more frequently than in the past.
European silicosis figures are difficult to compare. Although some national data are available, no harmonised European silicosis statistics yet exist. Due to the differences in Member States’ social security approaches, notably in occupational disease recognition criteria and compensation systems, any comparison is difficult and the total number of silicosis cases reported annually in the EU is difficult to assess.
According to World Health Organisation estimates, the global number of silicotics in the world could reach a total of 5 million individuals. The situation according to health experts is really worrying in developing countries, but almost under control in the EU.
Whatever the exact figures, and in spite of its continuous decline, silicosis remains an occupational health issue.
Occupational exposure limits have been implemented for respirable crystalline silica to help protect workers from silicosis. These limits are set primarily on the basis of scientific evidence but may also take into account social, economic and measurement factors. Strict observance of occupational exposure limits will reduce the risk of disease to a low level but, for some susceptible individuals who are exposed for many years, there may still be a residual risk. It is important that exposure to respirable crystalline silica dust is reduced to the lowest levels possible. Therefore, silicosis prevention programmes such as the European “Social Dialogue Agreement on workers’ health protection through the good handling and use of crystalline silica and products containing it“ are very important. This Agreement, which promotes strict compliance with existing regulatory limits and requires implementation of good practice preventive measures to further reduce dust exposure, should be highly effective in eliminating silicosis. Full information is available at www.nepsi.eu.
Similar initiatives exist in the US where the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has launched a National Emphasis Program (NEP) targeting silicosis. The National Industrial Sand Association (NISA) launched a Silicosis Prevention Programme many years ago and, very recently, in January 2008, the Industrial Minerals Association – North America and the Mine Safety and Health Administration developed together “A Practical Guide to an Occupational Health Program for Respirable Crystalline Silica”, http://www.msha.gov/alliances/formed/IG103.pdf
The ILO/WHO Joint Committee on Occupational Health launched in 1995 a Global Programme on the Elimination of Silicosis from the world by 2030, see http://www.who.int/mediacentre/factsheets/fs238/en/.