Expert Insights on Silicosis: Key Takeaways from RTM’s Timely Workers’ Day “Diari Rawat”

On May 1st, 2025, a date dedicated to celebrating workers across the nation – Workers’ Day (Hari Pekerja) – the national broadcaster RTM, through its health discussion program “Diari Rawat,” aptly turned its focus to a critical occupational health issue: the severe lung disease, Silicosis.

Joined by Respiratory Consultant Dr. Shazatul Syakirin Sirol Aflah from the Ministry of Health Malaysia, and Public Health Medicine Specialist and Occupational Health Expert Professor Dr. Victor Hoe from Universiti Malaya, the discussion highlighted the dangers of inhaling silica dust and the challenges surrounding this chronic lung disease. Their insightful conversation, broadcast on this important day, shed light on this often-underestimated, irreversible condition affecting workers. Here are the key takeaways:

What is Silicosis?

Silicosis is not an infection, but a lung disease caused by inhaling fine silica dust particles, commonly found in industries like mining, quarrying, smelting, and construction. These particles settle in the lungs, causing inflammation and, over time, the formation of irreversible scar tissue known as fibrosis. This scarring causes the lung tissue to harden and lose its ability to function correctly.

The Problem of Underdiagnosis

Both experts stressed that while the potential for silicosis in Malaysia is high, reported cases to the Department of Occupational Safety and Health (JKKP) are remarkably low. A major reason for this is the delayed onset of symptoms, which can appear many years, sometimes even 30 years, after a worker has stopped being exposed or retired. By then, individuals often forget their detailed work history, making it difficult for doctors to link their symptoms to past jobs.

Symptoms and Diagnostic Challenges

Symptoms typically include difficulty breathing, prolonged cough, chest pain, and fatigue. However, these are non-specific and common to many lung conditions. On X-rays, silicosis can appear as white spots in the upper parts of the lungs, similar to tuberculosis, which is a more common initial diagnosis in Malaysia. This similarity, coupled with the difficulty in obtaining a comprehensive work history, contributes significantly to underdiagnosis.

The Progressive Nature and Complications

Once silica particles are in the lungs, they can remain and continue to cause scarring that progresses and worsens over time, even after exposure ends. Silicosis also significantly increases the risk of other serious diseases, particularly tuberculosis and lung cancer. Dr. Shazatul noted that a silica-exposed worker who smokes has a nearly 30 times higher risk of lung cancer compared to a non-exposed non-smoker.

No Cure, Prevention is Key

Crucially, the experts highlighted that there is currently no cure for silicosis. Treatment focuses on managing symptoms and complications like infections. While procedures like whole lung lavage can help in severe acute cases, they are not a cure and their effectiveness is not definitively proven.

Therefore, prevention is the most important step. This involves avoiding exposure to silica dust, using appropriate Personal Protective Equipment (PPE), and ensuring good workplace ventilation. Dr Hoe added that recent research suggests “fresh” silica dust (newly generated from cutting/grinding, especially artificial stone which can be up to 90% silica) may be more hazardous due to electrostatic charges.

Know Your Rights

Occupational safety laws have been in place for decades, with the Factory and Machinery Act 1967 and the amended OSHA 1994 (2022) placing responsibility on employers to provide a safe environment, PPE, and medical surveillance. However, the OSHA 2022 amendment stresses that everyone has a role. Workers must be aware of hazards, understand risks, use safety measures, and know their rights. If a workplace is unsafe or symptoms arise, workers should report this and discuss it with their employer.

For those diagnosed, even retirees, compensation may be available through PERKESO (SOCSO), but it is vital to inform doctors of your full work history so that the illness can be recognised as work-related.

In conclusion, awareness, prevention, and early identification (by informing healthcare providers of occupational history) are crucial in combating silicosis, a silent threat with long-lasting consequences.