Complications

Complication
Timeframe
Likelihood
long term
medium

People who have been exposed to silica and coal are at increased risk of developing COPD, including emphysema and chronic bronchitis. The risk is even greater in people who also smoke cigarettes and have these exposures.[26][31]​​[35][57]

The combination of cigarettes and mineral dust or metal exposure increases the risk of COPD to a greater degree than each factor in isolation.

Overview of COPD

long term
medium

Individuals with chronic silica exposure are at increased risk of developing chronic renal failure. Studies have shown an associated elevated serum creatinine, increased risk of dialysis, and increased risk of death from renal failure.[35][57][59][60][61]

Chronic kidney disease

long term
low

Patients who have developed silicosis typically have had a high exposure to silica and are at the highest risk of developing lung cancers (of all histologic types).[35][56][57]

Silica and beryllium are carcinogens, and people who have been exposed, with or without radiographic changes, are at increased risk.

The risk is presumed to be greatest in current smokers and is also higher in ex-smokers compared with those who have never smoked cigarettes. However, the level of increased risk has not been quantified for the combined exposure.

Identifying an effective screening modality for lung cancer, particularly among silica- or beryllium-exposed workers who smoke cigarettes, is highly desirable given their increased risk. Some clinicians perform periodic spiral CT scans, although trials to evaluate whether they are beneficial have not yet been completed.

Non-small cell lung cancer

long term
low

Patients who have developed silicosis typically have had a high exposure to silica and are at the highest risk of developing lung cancers (of all histologic types).[35][56][57]

Silica and beryllium are carcinogens, and people who have been exposed, with or without radiographic changes, are at increased risk.

The risk is presumed to be greatest in current smokers and is also higher in ex-smokers compared with those who have never smoked cigarettes. However, the level of increased risk has not been quantified for the combined exposure.

Identifying an effective screening modality for lung cancer, particularly among silica- or beryllium-exposed workers who smoke cigarettes, is highly desirable given their increased risk. Some clinicians perform periodic spiral CT scans, although trials to evaluate whether they are beneficial have not yet been completed.

Small cell lung cancer

long term
low

Occurs as a consequence of reduced arterial oxygen with the development of pulmonary hypertension.

Oxygen therapy is used to prevent, and oxygen, diuretics, and pulmonary vasodilators to treat.

variable
high

Antibiotics are recommended in any patient with pneumoconiosis who develops symptoms such as a change in sputum production, fever, and increasing dyspnea.

Recommended regimens are similar to those recommended in any patient with chronic lung disease developing acute chest infection.

variable
low

Patients with coal workers' pneumoconiosis, silicosis, or just silica or coal exposure are at increased risk for rheumatoid arthritis.[35][57]

Patients with silicosis or just silica exposure are also at increased risk for other connective-tissue diseases and vasculitides.[35][57]

Referral to a rheumatologist is warranted.

variable
low

Patients with silicosis, or just silica exposure, are at increased risk for connective-tissue diseases and vasculitides, including systemic scleroderma.[35][57]

Referral to a rheumatologist is warranted.

variable
low

Patients with silicosis, or just silica exposure, are at increased risk for connective-tissue diseases and vasculitides, including ANCA-positive Wegener granulomatosis.[35][57][58]

Referral to a rheumatologist is warranted.

variable
low

Patients with silicosis are at increased risk of active tuberculosis (TB) if they are exposed to Mycobacterium tuberculosis.

Silicosis is considered a high-risk condition when consideration is given for treating the patient for latent TB.[62]

Use of this content is subject to our disclaimer