Crystalline silica is a basic component of soil, sand, granite, and many other minerals. When it becomes respirable through activities such as chipping, cutting, drilling, or grinding, it can have serious health effects on both the pulmonary and renal systems. Consistent exposure to respirable silica can result in shortness of breath, fever, bluish skin at the ear lobes or lips due to reduced oxygen intake. The silica dust particles embed themselves in the alveolar sacs in the lungs and cannot be cleared by mucous or coughing. As the disease progresses, a worker may experience fatigue, loss of appetite, extreme shortness of breath, chest pain, and respiratory failure. The silica breathed in as small particles can also cause small vessel vasculitis. The inflammation in the vessels causes a reaction which can lead to autoimmune diseases (e.g. rheumatoid arthritis) and indirectly affect the kidneys. Silica particles can also damage small vessels that perform key functions in the kidneys. Some worker health studies show 5% excess risk of end-stage kidney disease, others note 2% excess risk of death due to kidney disease.
OSHA’s final rule on crystalline silica exposure provides for the minimum testing and monitoring with a focus on the pulmonary system. The medical surveillance exam is to screen for tuberculosis, chronic obstructive pulmonary disease (COPD), silicosis, and other health related effects from exposure to silica. Therefore, a physical exam, tuberculosis testing, and a single-view chest x-ray with b-read are included per OSHA requirements. OSHA has raised the bar on pulmonary function testing and is requiring all spirometry be performed by a specially trained technician. Concentra’s silica surveillance baseline exam is designed to meet the OSHA requirements including pulmonary function testing with spirometry performed by a NIOSH Certified technician. The worker’s health history and work environment are key to assessing health risk and are discussed in every medical surveillance exam.
To learn more about OSHA’s final rule on crystalline silica exposure and testing, attend Concentra’s seminar on September 6th.
Concentra, a division of Select Medical, is a national health care company focused on improving the health of America’s workforce, one patient at a time. Through its affiliated
clinicians, the company provides occupational medicine, urgent care, physical therapy, and wellness services from more than 300 medical centers in 40 states. With more than 30 years of experience and nationally recognized clinicians in occupational medicine, Concentra is focused on keeping your workforce healthy and productive, while reducing the overall cost of health care for your company and your employees. Learn more about our occupational health services.
Ronda McCarthy, M.D., MPH, FACOEM, (2017) © Concentra, Inc. All rights reserved.