Update on "The good, the bad, and the ugly," Silica revisited

It has been approximately four years since the International Agency for Research on Cancer (IARC) reclassified crystalline silica as a "group one" substance. Since then, crystalline silica has been considered a human carcinogen. Silicosis is a preventable disease, and several aggressive campaigns have been developed to increase awareness of silica-dust-related problems in the industrial environment. New analytical techniques are now being developed to determine quantitatively the amount of crystalline silica in materials. Yet, still much is to be learned about the surface properties of silica and the way in which the disease progresses into full-blown silicosis. This paper discusses the interaction of free radicals generated by the mineral particles and lung tissue. It is the cell injury and DNA damage that progresses to fibrogenesis. Freshly fractured surfaces of silica contain free radicals. These free radicals play an important role in the stimulation of the alveolar macrophage and the development of the inflammatory reactions leading to the fibrotic response caused by silica. Engineers, scientists and physicians need to discuss the mineralogy of silica and the technical issues concerning the development of silicosis.