Silicosis : An Ancient Malady in a Modern Setting

Long before recorded history, man began to dig into the earth's crust in a never ending search for useful materials. It is well known that more than half of the earth's crust is composed of silicon dioxide (SiO2), also known as silica. Silica and silica-containing material have a great many uses in modern society. This material, however, is potentially an extreme health hazard. Silicosis: Not a New Disease Centuries before the Christian Era, Hippocrates wrote of a lung disease common to those who mined in hard rock. He was obviously describing silicosis. It is also apparent from ancient writings that the Egyptians were aware of this malady. Dioscorides also wrote on this subject in the fifth century B.C. It is undoubtedly the oldest and best studied of the occupational lung diseases. Silicosis was certainly described by Agricola in his De Re Metallica published in 1556. Here he described lung disease among hard-rock miners. The original document was written in Latin and then translated in 1912 by Hoover and Hoover. One of these translators was Herbert L. Hoover, a former US president who once made his living as a mining engineer. More recently, there are numerous references in medical literature in the 19th and 20th centuries relating silica exposure to silicosis. There are specific references to mining in hard rock, as well as to sandblasting and a host of other industrial exposures. In 1919, Winslow described standards for measuring the efficiency of exhaust systems in polishing shops using sandblasting. These standards were equally applicable in the mining industry. As early as 1920, Winslow explored the efficiency of certain devices used to protect sand-blasters against the dust hazard. These devices were equally applicable in the hard-rock mining industry. The medical community recognized the silica health hazard in the early 1900s. Middleton described the illness in the British Medical Journal in 1929. He noted the danger to health at that time. D. Hunter mentions in his book, The Diseases of Occupations (1969), the monumental work of Merryweather in 1936, in which he surveyed the silicosis risk in Great Britain. He showed statistically that the average employment length of sandblasters who ultimately died of silicosis was 10.3 years, compared to 40.1 years for all fatal cases, irrespective of occupation. Sandblasting and hard-rock mining and drilling, obviously, are very hazardous occupations. Weil and Zisking of Tulane University wrote in 1975 that "it was known as early as 1935 that the course of silicosis is much more rapid in sandblasters than in miners or foundry workers. This can be explained by the fact that sandblasters are exposed to an almost pure siliceous dust containing high concentrations of respirable particles within the range of 1 to 3 micron size." Protecting the Worker The medical community recognized in the early 1900s the need for proper protective equipment for all of those who worked with siliceous materials. Middleton, writing in 1929, said: "The worker is then protected by a close fitting helmet with an air feed, much as in the case of an underwater diver. In spite of these precautions, cases of silicosis among sandblasters are being met with today. It is a matter for serious consideration whether a substitute, such as steel or iron grit, could not be used to replace the siliceous grit as the abrading material." C. E. A. Winslow, a professor of public health at Yale School of Medicine, and others wrote of the need to protect sandblasters by