Silicosis is a common condition among India’s poorer working population. As such, the overwhelming majority of the burden of the disease is carried by those least financially able to avail the treatment needed to manage the condition.
Though schemes such as Ayushman Bharat are allowing some of those affected to access treatment, the availability of said treatment varies depending on the area. With much of the affected population living in remote areas, treatment is all but unavailable — regardless of the cost.
Prevalence of silicosis in India
Silicosis is a noncommunicable disease (NCD) in which respirable crystalline silica (RCS) particles cause irreversible damage to the lungs. This is due to inhalation of the particles causing minute scar tissue to form within the lungs, gradually diminishing breathing capacity — often leading to fatal lung conditions or comorbidities resulting in death.
The disease is notable where heavy industry is commonplace. It is usually associated with mine workers, construction workers, or anyone working in an industry in which regular contact with particulate silicon is expected. For many of these workers the health effects of breathing in dust containing silica are not understood, others understand the risks but simply cannot afford to give up work or move elsewhere.
Silicosis has the potential to destroy communities due to its very localised effects based on the surrounding industry. The Madarangajodi village in Keonjhar district is a prime example of this. The most common occupation in the village is mining. This has led to a disproportionate number of deaths due to silicosis and resulted in the village being known locally as the “village of widows”.
It is estimated that across India, between three and ten million individuals are at risk of developing the condition. The true extent is all but unknown, as many individuals will never be diagnosed with the condition — eventually dying from comorbid conditions made worse by the presence of silicosis, such as pneumonia.
The symptoms that occur through silicosis are a result of scar tissue build up within the lungs caused by silica particles. This scarring is irreversible, as more and more lung tissue is damaged, lung function can become severely impaired. The condition can lead to an inability to perform simple functions due to breathlessness, and even lead to premature death through heart failure. Exposure to RCS is also considered a risk factor for developing chronic obstructive pulmonary disease (COPD) – one of India’s deadliest NCDs.
Common symptoms can include a persistent cough, shortness of breath, chest pain, or, in later stages, the darkening of the skin or a blue tint appearing on areas of the body such as the lips. In cases of acute silicosis — where large volumes of silica are inhaled in a short time period — breathing can entirely stop due to severely impacted lung function.
Prevention and treatment
Prevention in the case of silicosis is simple — though not always something those affected may be able to adhere to. The most simple prevention strategy is to simply avoid silica dust. For those depending on jobs in industries affected by the dust, this may not be possible.
Proper safety equipment, including masks fitted with respirators can also make the condition less likely to develop. However, many employers simply do not provide the necessary equipment. In this case, legal oversight into workers conditions in these industries could go a long way in reducing disease cases.
For those who develop the condition, there are no means to cure the disease. Instead, symptom management is the most common means of treatment, including the use of inhaled steroids to reduce the buildup of mucus, and oxygen tanks to assist with breathing. However, in these instances treatment is life-long, often inaccessible, and likely expensive. For those who use oxygen tanks, their capacity to work is diminished, resulting in further economic hardship.