More young men ‘will die’ of kitchen revamp disease as cases go undetected

A similar screening programme in Australia, – where around 1,000 stonemasons have been diagnosed with silicosis since 2015 – uncovered the scale of the epidemic there and led to the country becoming the first in the world to ban quartz, also known as engineered stone.

Dr Jo Feary, a consultant at London’s Royal Brompton hospital, where most of the UK’s more than 50 quartz silicosis patients are being treated, said she was seeing new patients every month and expects more cases. At least four of the men have died since the first cases emerged in mid-2023.

“You have people who are diagnosed with sarcoidosis by respiratory clinicians who we need to try and increase awareness about how similar sarcoidosis and silicosis are,” she told The i Paper.

In a recent paper on 32 UK patients with quartz-induced silicosis, Dr Feary and other respiratory doctors described how cases were going unrecognised due to asymptomatic early disease, inadequate screening, a lack of awareness among medics and the disease being mistaken for sarcoidosis.

Of the 19 referred from respiratory specialists, seven had been treated for sarcoidosis for between six months and five years prior to referral to the Brompton’s occupational lung disease clinic.

Early diagnosis is important to help prevent progressive disease, the paper said, with 15 of the cases showing signs of acute and accelerated silicosis, indicating very high exposure to silica dust.

Last year, The i Paper spoke to Ryan Fenton, whose diagnosis at the age of 47 came completely out of the blue and was only detected after he suffered a mini-stroke in December 2022.

Doctors scanned him and told initially told him he had sarcoidosis, but a biopsy was sent to the Royal Brompton Hospital who told Mr Fenton he had silicosis.

“Anything that would help detect early disease, I would welcome and would include a screening programme,” said Dr Feary.

“I think it would need to be carefully designed so it wouldn’t necessarily be what they did in Australia, and I don’t know what it would look like, but I feel that something like a screening programme could be really useful.”

In Australia as part of screening programmes funded by regional governments, silica field teams went on the road to identify smaller workplaces and track down tradespeople at risk of exposure to silica dust.

Officials would leaf through old yellow pages, scour the internet and knock on doors in an “enforcement blitz”, said Dr Ryan Hoy, whose research team at Melbourne’s Monash University helped develop Victoria’s state screening programme.

Of the more than 50 UK cases of engineered stone-induced silicosis Dr Feary has been treating at the Brompton only two had access to occupational health.

There was, therefore, a need to help stonemasons who don’t have access to workplace health checks, with many of the men diagnosed describing working for companies that flout safety measures.

“So if we want to detect early disease, then we need to think about a way to do that that doesn’t just involve occupational health screening or occupational health surveillance,” Dr Feary said.

“From a pragmatic point of view, a screening programme would be the way to detect those patients.”

Prof Neil Greenberg, president of the Society of Occupational Medicine (SOM), also supported a screening programme and called for mandatory occupational health provision for all workers in the industry.

“If you’re working in an industry that uses asbestos, you have to have occupational health professionals advise you and do the surveillance,” he said.

“And so we would say, because the kitchen countertop industry is one which exposes people to the risk of a serious illness – silicosis, it’s like asbestos – then there should be similar mandates that they must have access to occupational health.”

He also called for an education campaign for GPs to ensure a patient who goes to their doctor with possible early of silicosis is assessed properly.

“Most GPs don’t think about silicosis as being something that affects young men and young people,” he said

“If someone comes in and they’re talking about asthma symptoms or smoking related symptoms, the GP might just write it off as that when actually underneath it all is because they’ve been working with these kitchen tops.”

Professor Victoria Tzortziou Brown, president of the Royal College of GPs,  said the GP curriculum stresses the importance of history-taking in relation to occupation, alongside smoking and other “red-flag symptoms”.

However, diagnosing less common respiratory conditions in general practice can be challenging, she said, as early symptoms can overlap with more common conditions such as asthma, infections or smoking-related illness.

Dr Feary said while increased awareness of occupational medicine and lung disease generally is to be welcomed there was no criticism of GPs.

“I’ve got no evidence to say that GPs are missing things,” she said.

A spokesperson for the Department of Work and Pensions (DWP) said silicosis “remains a ministerial priority”, but said there were strong laws to protect workers from hazardous substances like artificial stone.

“We support the Health and Safety Executive to ensure silicosis remains a priority in their regulatory work,” the DWP spokesperson said.