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Identification of early-stage silicosis through health screening of stone benchtop industry workers in Victoria, Australia
  1. Ryan F Hoy,
  2. Deborah C Glass,
  3. Christina Dimitriadis,
  4. Jessy Hansen,
  5. Fiona Hore-Lacy,
  6. Malcolm R Sim
  1. School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences. Monash University, Melbourne, Victoria, Australia
  1. Correspondence to Dr Ryan F Hoy, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences. Monash University, Melbourne, VIC 3004, Australia; ryan.hoy{at}


Objectives The popularity of high silica content artificial stone has been associated with emergence of severe, progressive silicosis as a major health issue affecting workers in the stone benchtop industry. This population-based health assessment programme has been implemented with the aim of identifcation of silica-associated disease at a preclinical stage.

Methods All current and former workers from the stone benchtop industry in the State of Victoria are offered free health assessments. Primary evaluations include a standardised questionnaire, physical examination, spirometry and gas transfer assessment and International Labour Organisation-categorised chest X-ray. Secondary evaluations include high-resolution CT chest, blood tests and a respiratory physician evaluation.

Results At the end of the first 12 months, 86/239 (36%) workers who had completed secondary evaluation were diagnosed with silicosis (65 simple silicosis and 21 complicated silicosis). 22 had worked in the industry for less than 10 years at the time of diagnosis. Of those with simple silicosis, 80% of workers reported breathlessness only with strenuous exercise (modified Medical Research Council score of 0), and lung function was well preserved (prebronchodilator forced vital capacity mean 99.8% predicted (SD 13.6), diffusion capacity of the lung for carbon monoxide mean 96.2% predicted (SD 18.0)). Antinuclear antibodies were detected in 37% with silicosis and 24% without silicosis.

Conclusion Early results from this comprehensive health assessment programme have indicated a high proportion of referred artificial stone benchtop workers have silicosis, including many with early-stage disease. The common finding of antinuclear antibodies suggest significant potential for autoimmune disease in this occupational group.

  • silicosis
  • occupational health practice
  • health screening

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  • Contributors RFH, DCG and MRS designed the study. RFH, DCG, CD, JH, FH-L and MRS acquired, analysed, interpreted the data and did the statistical analysis. All authors were responsible for critical revision of the manuscript for important intellectual content.

  • Funding This project was funded by WorkSafe Victoria and prepared by the Monash Centre for Occupational and Environmental Health, Monash University. The opinions, findings and conclusions expressed in this publication are those of the authors and not necessarily those of WorkSafe Victoria.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Deidentified data are stored in a secure location and in accordance with the study protocol, and ethics approval is only accessible to research team members.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.