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The silent victims of silicosis

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(LEFT) Nagaland Pollution Control Board officials measure dust and noise in a stone crusher site. (RIGHT) A victim of silicosis. Most quarry workers suffering from silicosis do not even know what disease they are inflected with. (DIPR Photos) Silicosis is a form of occupational lung disease caused by inhalation of crystalline silica dust, and is marked by inflammation and scarring in forms of nodular lesions in the upper lobes of the lungs. It is a type of pneumoconiosis, from pneumo (lung) and konis (dust).Silicosis particularly the acute form is characterized by shortness of breath, cough, fever, and cyanosis (bluish skin). It may often be misdiagnosed as pulmonary edema (fluid in the lungs), pneumonia or tuberculosis. In India, a large number of quarry workers die a slow death without any compensation from their employers, having no proof to link their illness to the conditions of work. Dr. T.K. Joshi, a consultant at the Department of Occupational and Environmental Medicine at the Maulana Azad Medical College, Delhi, explained that silica is perhaps the most toxic particulate matter that can destroy human life. He explained that crystalline silica dust causes a fibrogenic reaction in the lungs. The ability to breathe is compromised. Blood vessels get obstructed and one could have heart failure. It also has the unique ability to destroy macrophages in the lungs. Therefore, immunity is compromised. In crowded places like India, it is impossible not to be exposed to tubercule bacilli. Those who have silicosis will also get TB, but the difference is that TB can be cured whereas silicosis is irreversible. In fact, in the United Kingdom, TB is officially considered an occupational disease for miners. Here, doctors are not even taught to take note of occupational history. In fact, there is a certain technique for doctors to be able to read X-rays for diagnosing silicosis. Therefore the need of specially trained doctors to be posted in industrial and mining belts is very important and needed. Unlike other industries such as coal mining, stone quarries/crushers are small units with unorganized workers.

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Where, occupational diseases are concerned, proof of damage lies in proof of exposure, assuming that adequate measures are not in place. In Shankargarh, a type of cough similar to Tuberculosis was so common that it came to be called Shankargarh-wali TB. By all indications, Shankargarh-wali TB is probably silicosis, an incurable disease that develops over a period of time, mostly among workers in silica-related industries. Many of its symptoms are similar to those of tuberculosis. In fact, TB is often a direct result of silicosis as reported by Frontline magazine. There is substantial research that proves the links between occupation and silicosis. The National Institute of Occupational Health, Ahmedabad, had compiled reports which revealed a pattern in the incidence of silicosis: 54.5 per cent in units making slate pencils, 21 per cent in stone quarries, 38 per cent in agate-polishing units and 12 per cent in stone crushing units. There is little doubt that silicosis is a killer and the responsibility of warning workers against the risk of disease should lie with quarry owners and contractors. They must ensure that workers get respiratory protection and that silica dust is suppressed at source, through the sprinkling of water, or with vaccum/negativesuction pumps, and workers exposed over long periods of time must be adequately compensated. Some State governments have passed legislation to tackle silicosis as an occupational disease. Silica is now mentioned in the Factories Act as a hazardous material that workers can be exposed to. The Rajasthan Silicosis Rules, 1955, and the Rajasthan Workmens Compensation (occupational diseases) Rules, 1965, are in place (under Section 32 of the Workmen Compensation Act, 1923). Occupational diseases have now been classified under various categories, with pneumoconiosis covering silicosis as well as asbestosis or any disease accompanied by pulmonary tuberculosis. Union Minister for Health & Family Welfare, Gulam Nabi Azad informed the Lok Sabha that prolonged exposure to silica dust might cause silicosis and silico-tuberculosis in stone quarries and stone crushing factories. The government has no information as to whether cases of silicosis are increasing in the country. No death caused by silicosis has been reported to the Directorate General of Mines Safety by mine management during the last three years and the current year. In case of stone crushing units, no case of silicosis has been reported from the States except two cases of silicosis from the State of Gujarat. The Minister gave a brief account on the steps taken by the Government to prevent air pollution explaining that-Model Rules have been framed on manipulation of stone or any other material containing free silica under Section 87, of the Factories Act, 1948. The said Schedule contains provisions relating to precautions in manipulation such as damping the stone, providing water spray, enclosing the process, isolating the process, providing localized exhaust ventilation and maintenance of the floors etc. for prevention and control of particulates; Stringent National Ambient Air Quality Standards have been notified recently under the Environment (Protection) Act, 1986; The Coal Mines Regulations, 1957 and Metalliferous Mines Regulations, 1961 provide for wet drilling & use of dust extractors in metal mines, wet cutting & use of dust extractors In coal mines with periodic monitoring of work environment for measures to keep respirable dust within permissible limits, monitoring of airborne dust through regular sampling and analysis, taking control measures where permissible limits exceed and use of personal protective equipments like dust respirators; Emission standards have also been notified under the Environment (Protection) Act, 1986 in respect of suspended particulate matter (SPM) to reduce / contain dust from stone crushers. In addition, the units are also required to adopt following control measures-Dust containment cum

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suppression system for the process equipment; Construction of wind breaking walls; Construction of the metalled roads within the premises; Regular cleaning and wetting of the ground within the premises; Growing of a green belt along the periphery of units. Scenario in Nagaland With rapid developmental activities in the recent times, demand for stone chips etc have given rise to mushrooming of stone crushing industry an unprecedented growth. Due to unregulated quarrying, our environment and roads are damaged. On the other hand it has been observed that nothing is done to control the air pollution at the quarries or the stone crushing sites where the labourers and their children are dangerously exposed to the dust. The labourers do not wear any protective musk. Moreover, some stone crushers are located in populate residential areas and the neighbours have to endure and suffer the consequences of the dust and noise emitted from the stone crushers. A strategy to locate this mushrooming industry away from settlements with strict guidelines to operate should be formulated in order reduce environmental pollution and health risks. (Source: Nagaland Pollution Control Board) A DIPR feature

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