1. Silica; the basics and beyond
LUNGS AT WORK

2. What causes silicosis?
silicon
silica
silicone
rcs

3. What causes silicosis?
silicon = Si, the element
silica
silicone
rcs

4. What causes silicosis? silicon = Si, the element
silica – silicon dioxide (SiO2 - ‘quartz’)
silicone
rcs

5. What causes silicosis? silicon = Si, the element
silica – silicon dioxide (SiO2 - ‘quartz’)
silicone = polymer of O2 and Si
rcs

6. What causes silicosis? silicon = Si, the element
silica – silicon dioxide (SiO2 - ‘quartz’)
silicone = polymer of O2 and Si
rcs = respirable crystalline silica

7. Why don’t you get silicosis lying on the beach?

8. Silicosis; ‘simple’
no symptoms
no loss of lung function

9. silicosis: Dorset tunneller

10. The Dorset tunneller

11. The Polish stonemason
‘complicated’ silicosis (PMF): breathless + loss of lung function (‘restrictive’)

13. fork grinders: Sheffield 1843
age
Sheffield men
(n=549)
fork grinders
(n=1000)
20-29
160
475
30-39
136
410
40-49
126
115
50-59
127

14. More weirdly
There are quite strong epidemiological associations between silica exposure and: RA
SLE
scleroderma

15. Hence, silica ‘simple’ pneumoconiosis (silicosis)
‘complicated’ pneumoconiosis
tuberculosis
RA/SLE/scleroderma
alveolar proteinosis
lung cancer
(COPD)

16. In practice

17. Mortar
Mortar is used to hold building materials such as brick or stone together. It is composed of a thick mixture of water, sand, and cement. The water is used to hydrate the cement and hold the mix together. The water to cement ratio is higher in mortar than in concrete in order to form its bonding element. When mixed, it is a much thicker substance than concrete, making it ideal as a glue for building materials like brick. Because mortar must be replaced every years, it isn’t practical for structural projects.

18. Mortar
Mortar is used to hold building materials such as brick or stone together. It is composed of a thick mixture of water, sand, and cement. The water is used to hydrate the cement and hold the mix together. The water to cement ratio is higher in mortar than in concrete in order to form its bonding element. When mixed, it is a much thicker substance than concrete, making it ideal as a glue for building materials like brick. Because mortar must be replaced every years, it isn’t practical for structural projects.
Concrete
Like mortar, concrete is a mixture of sand, cement, and water, but it also contains rock chippings or gravel which makes it much stronger and more durable than mortar. Because it needs a low water to cement ratio, it is much thinner when mixed, making it difficult to use as a bonding element. Concrete is used in structural projects and is often reinforced with steel rebar to maintain its structural integrity as the soil beneath it settles. It is best used for support, such as beams, walls, or other building foundations.

19. SWORD:
10 years of silicosis
in ‘construction’

23. 59 year old train driver
no respiratory symptoms
job entails filling a sandbox under his locomotive

24. spirometry c.35% predicted …..
Clinical details: History of exposure to silica. “There are multiple small dense nodules in the mid and lower perihilar regions which may represent calcified pulmonary nodules. Linear atelectasis in the right mid zone but otherwise no other lung change. The above described findings may represent previous exposure to silica.” Reported By: Dr X Consultant Radiology
spirometry c.35% predicted …..