• Occupational Lung Disease

Silicosis is the most ancient form of occupational lung disease, being known to have caused disability and the premature death of workers for many millennia.1 Despite this, silicosis continues to be a global health problem,2 accounting for almost 13 000 deaths worldwide in 2019.3 Those at risk of this disease commonly work in industries that involve either cutting through silica-containing material (eg, in construction, quarrying, mining, tunnelling and stone masonry) or using sand/clay for manufacturing (eg, in the production of building materials, ceramics and metal objects).2 4

Over the past four decades, outbreaks of silicosis have also been reported in novel workplace settings, affecting individuals working with slate pencils (1980s), denim jeans (2000s), dental supplies (2004) and jewellery/precious stones (2010s).5 The article by Feary et al provides a detailed account of the first cases of artificial stone (AS) silicosis in the UK,6 an epidemic already affecting hundreds of workers around the world.2 5 7–9 Many of the issues raised by Feary et al are common to other silicosis outbreaks, having been repeatedly documented throughout history.

In 1843, Dr Calvert Holland, a hospital physician in my home …