HomeArticlesBusiness & InvestHealthGold Coast Doctor finds himself on the frontline in the battle to combat Silicosis

Gold Coast Doctor finds himself on the frontline in the battle to combat Silicosis

Tim Baker | April 2019

A Gold Coast doctor is leading the charge to find life-saving treatments for silicosis, an occupational lung disease that looms as a major health crisis.

In seven years working as a Respiratory Physician, Dr David Deller had seen four cases of silicosis. In the past six months he has seen 55 cases at his Benowa clinic, in an epidemic he believes may prove worse than asbestos associated disease. Silicosis is brought on by exposure to silica dust, most frequently among stone masons. The spike in cases has been attributed to the popularity of engineered stone bench tops over the past decade, and the widespread practice of dry cutting the material without face masks.

“I now have 55 diagnosed cases, one of the biggest cohorts in the world in one clinic. Most of my patients are under 35, a lot have very young families. That’s the tragedy of it,” Dr Deller says.

“It’s the next epidemic. In some ways it may be worse than the asbestos epidemic – it’s a younger age group and more rapid progression. In its most acute form, known as progressive massive fibrosis, it can prove fatal.”

“Those most severely affected have significant symptoms of breathlessness, chronic cough, chronic bronchitis,” he says, though many diagnosed with the condition have had no symptoms. Dr Deller urges anyone who has had significant exposure to silica dust to be screened.

Dr Deller had no special interest in silicosis, or research for that matter, when patients began being referred to him in increasing numbers. Suddenly, he found himself at the frontline of learning how to tackle the disease, forming international alliances with doctors and researching new treatments. “Many physicians would have never seen this disease,” he says. “We need local, national and international collaboration. Within a month of discovering the problem we organised a large symposium in Brisbane, we have another one in June, and we are rapidly upskilling locally to deal with this epidemic.”

Workcover Queensland has screened around 400 workers in the industry and approximately 25% have shown evidence of silica related disease. “We’re the first jurisdiction in the country to have widespread screening … Now we need funding for research,” he says.

“It’s going to be helpful for the rest of the country, who are watching us to know how to approach the problem. Victoria has just started screening, and NSW will follow soon. We’re probably 12 months ahead of the rest of the country. We need to start investigating whether we can intervene and save lives.”

Dr Deller will soon publish his initial findings and will travel to the US in May for a major conference to discuss the topic. “We’ve never seen an epidemic like this. We’ve had to upskill in the area and become very knowledgeable very quickly, and that means going outside of Australia. There’s a US group we’re meeting with in May. We email with them every week, we meet with experts in Sydney and Melbourne and share information with doctors in Spain, Italy and Israel. We’ve quickly banded together to form a national approach to silicosis. The problem won’t just be local.”

Engineered stone products became popular in Australia over the past two decades, which explains why we are seeing a spike ten years on. “Silicosis requires at least a few years of exposure, plus a latency period. It’s not a coincidence we’re seeing it now,” says Dr Deller.

Marble typically contains 2% silica, and granite around 20%, while engineered stone products, made from crushed stone bonded with resin, contain up to 90% silica. It poses no threat to households where it has been installed, but the danger, much like asbestos, lies in the cutting and handling of the product.

Gold Coast stone mason Anthony White was the first reported fatality from the current wave of cases, when he passed away last month. “Anthony was quite heroic, he has saved lives by taking it to the media. It’s a disaster and we need to keep it in the media,” says Dr Deller.

While there is no existing cure for the condition, it is hoped that some patients’ conditions may stabilise once they are no longer exposed to silica dust and many are being re-trained in new fields. A procedure known as a whole lung lavage, where the lung is rinsed with a saline solution, has potential to remove up to 50% of silica from the lung and trials of some anti-fibrotic drugs are planned to see if they may assist. But the most severe cases are likely to require lung transplants, a huge burden on the health care system that it is not currently equipped for.

“Our focus is monitoring the group that we have to determine if there’s progression or not and develop treatments that’s going to give them a benefit,” he says. “If we can get the funding, we are likely to find some solutions for them.”

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