This deadly disease should be relegated to the dustbin of history. Instead, it’s surging

Joanna McNeill could always taste the dust on her lips during her long shifts in a portable office at a quarry in Melbourne’s east.

There were holes in the floor, she said, that let it in. When she got home and blew her nose, there would be dust in the tissue.

“But I never thought anything of it,” McNeill, 36, said.

Joanna McNeill and daughters Matilda, 7, and Charlee, 5. Credit: Eddie Jim

At the rock quarry, the tasks of the administration worker, then in her late 20s, included organising detailed safety meetings and ordering personal protective equipment such as masks. Despite all those meetings, she had never heard of silicosis – until she was diagnosed with it in 2019 and Googled the condition.

“Nothing good comes up,” she said. “It’s a death sentence.”

Silicosis is a progressive and debilitating occupational lung disease caused by the inhalation of crystalline silica dust, which is present in many types of rocks. Exposure to silica can also cause other conditions, including lung cancer, tuberculosis, kidney disease and chronic obstructive pulmonary disease.

Engineered stone, widely used in kitchen benchtops, can cause silicosis. Workers can be protected by using water when cutting to suppress dust.Credit: Eddie Jim

Australian doctors have reported a large increase in the number of silicosis cases in the past decade, including cases among tradies in their early 20s and deaths among those in their 40s.

The cutting of popular kitchen benchtops and vanities made of engineered stone is largely behind the resurgence of silicosis, though cases are also emerging from other industries including tunnelling and mining.

A joint investigation between this masthead and 60 Minutes exposed the stories of workers battling the debilitating symptoms of silicosis while state-based regulators failed to effectively police workplaces to guard against the dangers associated with ingesting dust from engineered stone.

Many workers at risk of silicosis are still not being properly protected in their workplaces. The Lung Foundation Australia is launching on Friday an awareness campaign called Another One Fights the Dust aimed at tradies, many of whom they say are uninformed about silica dust.

They hope the campaign will increase pressure on employers to provide safe workplaces. It will include a quiz workers can take about lung health hazards in the workplace.

The federal government continues to sit on a report from Safe Work Australia, completed last month, investigating a ban on engineered stone.

A spokesperson for Workplace Relations Minister Tony Burke said the relevant federal, state and territory ministers would meet in October to discuss the report’s recommendations and decide on the next steps.

The Lung Foundation is calling for a ban on the importation of some or all engineered stone products by July 2024, if there are no “acceptable improvements” in safety compliance in the sector.

Artificial stone contains up to 95 per cent silica, compared to less than 40 per cent silica in natural stone.

The foundation’s senior manager of occupational lung disease, Elizabeth Early, said there had been no signs of improvement.

“Most of the data we have indicates that the prevalence of silicosis is increasing in all states and territories,” Early said.

In NSW, 64 cases of silicosis and 10 deaths from the disease were recorded in 2021 and 2022. The year before there were 57 cases detected and seven deaths.

Most of the new cases in NSW were diagnosed among clay, concrete, glass and stone-processing-machine operators, but there were also cases among bricklayers, stonemasons, earthmoving plant operators and other construction and mining labourers.

Professor Deborah Yates is horrified Australian workers continue to be unprotected from silica dust, developing an “entirely preventable” disease that she says should have been left behind in the 20th century.

The respiratory physician at St Vincent’s Hospital in Sydney said workers could be protected from silica by using water to suppress dust, proper ventilation and other methods – but this wasn’t always happening.

“The obligation is on the employer to ensure that the workplace is safe … There are laws that have been in place for many years, but essentially, they just haven’t been followed.”

Many workers were also still unaware they were being exposed to a health hazard, she said. She estimated that fewer than 10 per cent of her patients with silicosis had heard of the condition before their diagnosis.

Yates said that when she first saw silicosis in England early in her career, it was in patients who had been exposed to silica before World War II. At the time, she thought she would never see bad cases of the disease again.

“We should not be seeing even a single case nowadays. It’s distressing … We know how this can be prevented and to see people dying of it is just terrible.”

McNeill had just returned from maternity leave when she was diagnosed with silicosis after a lung biopsy.

It has changed her entire life. Her marriage broke down and she is now extremely vulnerable to infections, leaving her unable to work and regularly in hospital. It brings constant anxiety about picking up bugs. Her daughters – Matilda, 7, and Charlee, 5 – worry about her too.

“It’s not going to stop,” McNeill said.

“It’s something that is going to be constantly progressing … Whether pneumonia gets me and that’s what kills me, because I can’t fight any more because my immunity is down, or it’s something else that’s going to attack my lungs, there’s nothing good about it.”

McNeill, now a passionate advocate for reform, said she still spoke to Australian quarry workers who did not know about silicosis.

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