Respirable crystalline silica (RCS) is the ‘next asbestos’.
At least, this was the allegation made by the All Party Parliamentary Group (APPG) for Respiratory Health, in a March 2020 report, which can be accessed here.
RCS is created when silica-containing materials are ‘fractured’, i.e. cut, drilled into, or polished. Such materials include:
- Sandstone, gritstone and quartzite (more than 70% silica);
- Concrete and mortar (25-70% silica);
- Shale (40-60% silica);
- China stone (up to 50% silica)
- Slate (up to 40% silica);
- Brick (up to 30% silica);
- Granite (up to 30% silica);
- Ironstone (up to 15% silica);
- Basalt and dolerite (up to 5% silica);
- Limestone, marble and chalk (up to 2% silica).
Of the estimated 600,000 British workers exposed to RCS on an annual basis, 81% are in construction (building residential and non-residential property, civil engineering, plumbing, joinery, stonemasonry, demolition, etc.), or manufacture products for the construction industry. Dependent upon duration and levels of exposure, construction workers face an increased risk of developing silicosis, tuberculosis, kidney disease, arthritis, chronic obstructive pulmonary disease (COPD), lung cancer and chronic bronchitis.
Silicosis, being the most common occupational lung disease worldwide (an ‘emerging occupational health epidemic’, in Australia), is caused by the body’s immune response to foreign RCS particulates. Attempted removal of RCS causes fibrosis (swelling and scarring of lung tissue), a physiological change which induces coughing, shortness of breath, weakness and loss of mobility. Initial symptoms may take 10 to 20 years to emerge (the latency period can be much shorter if there is a history of ‘heavy’ RCS exposure) and will worsen over time, due to the progressive and irreversible nature of the condition. At its worst, silicosis can be fatal, or onset significant co-morbidities.
In edition 280 of BC Disease News (here), we reported that the APPG had launched an extensive inquiry into the disease burden of silicosis on the construction industry, in collaboration with not-for-profit organisation, B&CE.
This prompted 6-months of evidence gathering from a range of stakeholders, which, according to B&CE, revealed a ‘profound lack of awareness among construction workers about the risk of RCS exposure’. ‘Low’ levels of understanding have been primarily attributed to the reality that the construction sector is saturated with ‘small and micro businesses’, with 90% of workers employed by companies whose workforce totals 7 people or fewer. There is often some correlation between business size and uptake of protective health and safety measures.
The intention behind: ‘Silica – the next asbestos?’, was to start a ‘long-overdue’ conversation about how to tackle the adverse and ‘under-documented’ health risks among affected workers and it recommends that the Government:
- Make silicosis a reportable condition for those who are currently in work and exposed to RCS, under The Reporting of Injuries, Diseases, and Dangerous Occurrences Regulations (RIDDOR) 2013.
- Amend The Health Protection (Notification) Regulations 2010 to make silicosis notifiable through Public Health England, thereby creating a compulsory national silicosis register – in edition 283 (here), we reported that Unite and Thompsons Solicitors had created their own silica dust register.
- Develop and implement a targeted industry awareness campaign for those at risk of developing silicosis.
- Allow workers to hold their own occupational health records to encourage workers to make associations between symptoms and exposures.
- Merge occupational health services into GP surgeries to allow for occupational histories to be accounted for where work-related ill health is suspected.
- Introduce new Governmental health and safety regulations [outside of the Control of Substances Hazardous to Health Regulations 2002 (COSHH)] specifically relating to the control of respirable crystalline silica (RCS), so that it is afforded the same level of protection as asbestos.
- Investigate (through the NHS) a screening programme for those exposed to RCS.
- Provide access to occupational health services for RCS-generating industries.
- Halve the workplace exposure limit (WEL) for RCS in the UK from 0.1mg/m3 to 0.05mg/m3 (see the 4th edition of EH40/2005), in line with the 2003 recommended exposure standard from the Scientific Committee on Occupation Exposure Limits (SCOEL), and ensure that statutory monitoring requirements are in place to reduce over-exposure.
- Implement Health and Safety Executive (HSE) requirements, compelling compulsory use of masks, dust extraction and water suppression, along with annual reporting of inspection and compliance levels.
- Increase HSE resources to raise the volume of on-site inspections of building contractors of all sizes.
Jim Shannon MP, Chair of the APPG, summarised the outcomes of the Group’s review in the Evening Standard, as follows:
‘Our recent joint parliamentary inquiry heard expert evidence that workplace exposure limits for RCS are too high, there are difficulties in diagnosis due to pressure on GPs’ time and problems accessing expert specialists, and there is a widespread lack of understanding among construction workers and employers of the risks around RCS. We’re calling on the Government to take crucial steps to address these issues and protect construction workers from what could develop into a future occupational health epidemic’.
 ‘Cross-party group warns Government must act to prevent ‘next asbestos’ taking more lives in UK’ (4 March 2020 B&CE) <https://bandce.co.uk/cross-party-group-warns-government-must-act-to-prevent-next-asbestos-taking-more-lives-in-uk/> accessed 13 May 2020.
 IOSH, ‘Respirable Crystalline Silica: The Facts’ (2015 No Time To Lose) <https://www.notimetolose.org.uk/wp-content/uploads/2018/03/Factsheet_Respirable_crystalline_silica_the_facts_MKT2730.pdf> accessed 13 May 2020.
 Allyson Horn, ‘Silicosis death dust audit reveals “major epidemic worse than asbestos”’ (21 February 2019 ABC News) <https://www.abc.net.au/news/2019-02-21/silicosis-death-dust-audit-reveals-major-epidemic-worse-asbestos/10830452> accessed 13 May 2020.
 Nola M and Dotlic S, ‘The Respiratory System’ in Damjanov I’s ‘Pathology Secrets’ (3rd edition), at p.203. Published by Mosby Elsvier, in 2008 <https://morfopatologie.usmf.md/wp-content/blogs.dir/78/files/sites/78/2016/09/Pathology-Secrets-3rd-Edition.pdf> accessed 13 May 2020.
 Seaton A et al., Accelerated Silicosis in Scottish Stonemasons. Lancet. 1991 Feb 9;337(8737):341-4. <https://www.thelancet.com/journals/lancet/article/PII0140-6736(91)90956-P/fulltext> accessed 13 May 2020.
 ‘Silica – the next asbestos?’ (B&CE) <https://bandce.co.uk/corporate-responsibility/our-purpose/influencing-change/silica-the-next-asbestos/> accessed 18 March 2020.
 ‘Construction statistics, Great Britain: 2018’ (18 October 2019 ONS) <https://www.ons.gov.uk/businessindustryandtrade/constructionindustry/articles/constructionstatistics/2018> accessed 13 May 2020.
 Jim Shannon MP, ‘The Reader: “New asbestos” threatens another wave of workers’ (11 March 2020 The Evening Standard) <https://www.standard.co.uk/comment/letters/the-reader-new-asbestos-threatens-another-wave-of-workers-a4384471.html> accessed 13 May 2020.