shing, and denim production) have become exposed to high levels of silica, leading to the development of acute and accelerated silicosis. Acute silicosis can develop in as little as a few months, and accelerated silicosis can develop in as little as 2 years. No cure exists for any form of silicosis, and lung transplantation is the only lifesaving treatment. Primary care clinicians must understand when patients are at risk for developing silicosis and not assume that a short time of exposure precludes the development of silicosis....

Silica dust exposure is one of the earliest recognized causes of lung disease. Hippocrates first recognized silica’s effect on respiratory function in 430 B.C.

In the 1550s, Georgius Agricola wrote about men dying of pulmonary disease after working in the mining industry in Central Europe.

In 1770, Italian physician Bernardino Ramazzini identified silicotic nodules in the lungs of stone cutters. In the mid to late 1800s, mechanization in the mining industry resulted in rapidly increasing levels of silica exposure and cases of silicosis.

Silicosis was first recognized as a chronic disease that occurred primarily in miners and stone workers after at least 10 years of exposure to respirable crystalline silica dust.

Several diseases are associated with silicosis, which also can complicate the diagnosis. Studies have shown that silica dust exposure is associated with emphysema in smokers and nonsmokers alike. Thus, silicosis should not be ruled out in patients with obstructive pulmonary symptoms.

Silica exposure also is associated with an increased risk for TB.Silica and silicosis are risk factors for developing mycobacterial lung infections

Silicosis is associated with an increased risk of developing autoimmune diseases and lung cancer. Specific autoantibodies have not been identified, but studies have demonstrated an association between silica exposure and systemic sclerosis, rheumatoid arthritis, antineutrophil cytoplasmic antibody-related vasculitis, and systemic lupus erythematosus. Silica dust is believed to promote or accelerate disease development, break immune tolerance, initiate autoimmunity, or magnify autoimmune vulnerability.

Respirable crystalline silica was recognized as early as 1997 by the International Agency for Research on Cancer as a human carcinogen, and its carcinogenicity was reconfirmed in a 2009 report