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Peer-reviewedCC BY-NC 4.0Thoracic Research and Practice

Artificial Stone Silicosis: New Face of an Old Disease

  1. 1National University Health System, Singapore
  2. 2Department of Occupational and Environmental Medicine, Singapore General Hospital, Singapore
  3. 3Saw Swee Hock School of Public Health, National University of Singapore, Singapore; University of Occupational and Environmental Health, Japan

Abstract

Artificial stone (AS) silicosis has emerged as a major global occupational health concern, challenging the perception of silicosis as a disease of the past. Driven by the fabrication of AS products containing high concentrations of crystalline silica (>90%), this rapidly progressive form disproportionately affects younger workers and develops after a much shorter exposure duration (median 7–19 years) than in classic silicosis. As cases continue to emerge worldwide, clinicians and occupational health practitioners are increasingly likely to encounter affected workers in clinical practice. This review provides a clinically focused synthesis of the current evidence on the epidemiology, pathophysiology, clinical manifestations, diagnosis, and management of AS silicosis. Compared with traditional silicosis, the unique physicochemical properties of AS dust may amplify lung toxicity and promote a self-perpetuating inflammatory response. This frequently results in rapid development of progressive massive fibrosis, with disease progression often continuing after exposure cessation. Diagnosis is often delayed because of overlapping clinical features and the limited sensitivity of conventional screening tools, highlighting the importance of early clinical recognition, detailed occupational history-taking, and the use of high-resolution computed tomography where appropriate. Lung transplantation remains the only definitive treatment for advanced disease, underscoring the importance of prevention. Effective prevention requires strong workplace controls, systematic medical surveillance, and appropriate regulatory measures. Clinicians play a key role in early detection, patient education, and mandatory disease reporting. Coordinated action across clinical, occupational, and policy domains is essential to improve recognition, strengthen preventive measures, and avert further cases of this highly preventable occupational disease.

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BibTeX
@article{samantha2026artificial,
  title = {{Artificial Stone Silicosis: New Face of an Old Disease}},
  author = {Heng Sieh Yen Samantha and Tan Kian Wei Alvin and Koh Soo Quee David},
  journal = {Thoracic Research and Practice},
  year = {2026},
  month = nov,
  doi = {10.4274/thoracrespract.2026.2026-6-19},
  url = {https://doi.org/10.4274/thoracrespract.2026.2026-6-19},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Artificial Stone Silicosis: New Face of an Old Disease
AU  - Heng Sieh Yen Samantha
AU  - Tan Kian Wei Alvin
AU  - Koh Soo Quee David
PY  - 2026
DA  - 2026/11/03
JO  - Thoracic Research and Practice
DO  - 10.4274/thoracrespract.2026.2026-6-19
UR  - https://doi.org/10.4274/thoracrespract.2026.2026-6-19
AB  - Artificial stone (AS) silicosis has emerged as a major global occupational health concern, challenging the perception of silicosis as a disease of the past. Driven by the fabrication of AS products containing high concentrations of crystalline silica (>90%), this rapidly progressive form disproportionately affects younger workers and develops after a much shorter exposure duration (median 7–19 years) than in classic silicosis. As cases continue to emerge worldwide, clinicians and occupational health practitioners are increasingly likely to encounter affected workers in clinical practice. This review provides a clinically focused synthesis of the current evidence on the epidemiology, pathophysiology, clinical manifestations, diagnosis, and management of AS silicosis. Compared with traditional silicosis, the unique physicochemical properties of AS dust may amplify lung toxicity and promote a self-perpetuating inflammatory response. This frequently results in rapid development of progressive massive fibrosis, with disease progression often continuing after exposure cessation. Diagnosis is often delayed because of overlapping clinical features and the limited sensitivity of conventional screening tools, highlighting the importance of early clinical recognition, detailed occupational history-taking, and the use of high-resolution computed tomography where appropriate. Lung transplantation remains the only definitive treatment for advanced disease, underscoring the importance of prevention. Effective prevention requires strong workplace controls, systematic medical surveillance, and appropriate regulatory measures. Clinicians play a key role in early detection, patient education, and mandatory disease reporting. Coordinated action across clinical, occupational, and policy domains is essential to improve recognition, strengthen preventive measures, and avert further cases of this highly preventable occupational disease.
SN  - 2979-9139
ER  -