In our mind’s eye, when we think of the occupational hazards of these jobs we often think of mine collapses and other sudden and dramatic forms of injury or death.
However, what is often overlooked is silicosis, also known as Grinder’s disease. To put the importance of this disease into perspective, during the construction of Hawk’s nest tunnel near Gauley Bridge, more than 400 people died because of Grinder’s disease.
Grinder’s disease is caused by chronic exposure to silica. Silica is a mineral found in rocks, sand, granite, sandstone, flint, slate, soil and some coal.
Fine silica particles are released during the drilling, cutting, breaking, crushing or blasting of any materials containing silica. These manipulations of silica containing material allow for fine silica particles to be released in the air which are then subsequently inhaled and deposited in the lungs of those exposed to the dust.
Because of the small size of these silica particles, coughing, sneezing and exhaling air fail to remove these particles from the breathing passages and lung. Over time these deposited silica particles will start to cause an inflammatory reaction in the lung tissue which will cause fibrosis (hardening and thickening) of the lungs. This interferes with the ability of the lung to expand and contract and limits the amount of oxygen that the lungs can deliver to the blood.
This hardening of the lung because of silica exposure can be detected by chest X-rays. However, it generally takes 10 years of chronic exposure to silica for the lung to be damaged enough for the X-rays to be able to pick up the damage to the lung. At this time, Grinder’s disease may also be misdiagnosed as pulmonary edema, pneumonia or tuberculosis.
Clinical signs of respiratory damage may occur much sooner than 10 years and may present as chronic airflow limitation, mucus hypersecretion, chronic bronchitis, small airway disease and emphysema.
Once the lung becomes clinically fibrotic as determined by chest X-ray one may begin to suffer from loss of appetite, fever, chronic fatigue, breathlessness after mild exertion, darkening of the finger nails and chronic coughing.
Later in the disease, those with Grinder’s disease may become cyanotic, suffer from heart failure and eventually die. Another consideration is that those who develop Grinder’s disease are at increased risk for tuberculosis and lung cancer. This may be because of the suppression of the immune system by silica and the constant damaging and attempted repair of lung tissue.
Grinder’s disease is not limited to those who have undertaken the associated occupational risk. As silica particles may be very small they can follow the flow of air and affect the surrounding communities.
Hence, like second-hand smoke those in the surrounding communities are put at risk. According to OSHA, even if the air has 5 millionth of a gram of silica dust in a cubic meter of air in a town of 100,000 people up to 100 people might come down with Grinder’s disease.
At the other extreme, based on worldwide averages, after 15 years those involved in mining and rock quarrying have a 45 percent chance of developing silicosis. The consistent use of respirators can dramatically cut down on the development of Grinder’s disease.
Treatment of Grinder’s disease includes cough medicine, bronchodilators and oxygen. Antibiotics are prescribed for respiratory infections as needed. Late stage Grinder’s disease may necessitate a lung transplant. This said, there still remains a lack of public awareness of Grinder’s disease.
— Joseph A. De Soto of Gerrardstown received his M.D. and Ph.D. from Howard University, is a former fellow of the National Institutes of Health and is a physician/scientist and principal investigator at the Uniformed Services University of the Health Sciences.