Accelerated Silicosis—An Emerging Epidemic Associated with Engineered Stone. Comment on Leso, V. et al. Artificial Stone Associated Silicosis: A Systematic Review. Int. J. Environ. Res. Public Health 2019, 16 (4), 568, doi:10.3390/ijerph16040568

The systematic review by Leso et al. (16 February 2019) is a timely contribution to the body of knowledge concerning silicosis. It highlights the lack of quality data necessary to inform both occupational health risk management and the clinical management of workers exposed to respirable crystalline silica. This communication highlights current activity being undertaken in Queensland, Australia, that will further inform our knowledge concerning this entirely preventable disease. We are about half-way through a government-funded, case-finding program involving over 800 workers from the engineered stone bench-top fabrication industry. As of 15 February 2019, 99 confirmed cases of silicosis associated with engineered stone work were identified; nearly all were asymptomatic. The empirically observed false negative rate of ILO CXRs in this high-risk group appeared significantly greater than 10%. From pooled data, we hope to develop an appropriate index of exposure to trigger health surveillance using low-dose chest HRCT. Once a worker develops symptoms of silicosis, apart from lung transplantation, there are no treatment options currently available.