Clinical specialists have issued a stark warning that the true number of tradespeople affected by silicosis, and those likely to die as a result, could be far higher than previously anticipated.  

The warning follows yesterday’s landmark roundtable at Westminster, led by Ian Lavery MP, and supported by Arco, the UK’s leading health and safety experts. 

This ‘invisible’ national health crisis has been driven by widespread underreporting, missed diagnoses and a lack of routine health surveillance for those working in high-risk industries, according to various specialists.  

Bringing together Members of Parliament, clinicians, regulators and industry leaders, the roundtable shone a necessary spotlight on the growing threat of silicosis, an entirely preventable but incurable disease that is linked to the cutting of engineered stone.  

Despite there being just 52 confirmed cases of silicosis in the UK today, clinical leaders warned that the true number is likely to be far higher, with many workers avoiding reporting risks and red flags due to employer loyalty, and through fear of losing their income altogether.  

Dr Johanna Feary, an academic consultant in occupational lung disease at Royal Brompton Hospital, told attendees that the disease is often invisible in its early stages, meaning many workers are not diagnosed until irreversible damage has already been done.  

Among those most commonly affected, she explained, are men in their 20s and 30s, with deaths from silicosis reported as young as 28.

She said: “These are people who have no access to health surveillance.

“They’re working where exposure is incredibly high, and they are a vulnerable population. A high proportion of them, I suspect, will die from their disease.  

“To date, 9% of the people that I’ve seen have died, and there are a number being assessed for a lung transplant. Silicosis is asymptomatic in the early stages, so waiting for symptoms to appear before testing people means we’re going to miss cases.” 

This harrowing evidence from Dr Feary has prompted growing calls for a national screening programme for workers exposed to respirable crystalline silica (RCS), to enable earlier detection and intervention. 

According to industry and clinical leads, much of the risk is concentrated in smaller workshops and ‘micro-businesses’, where workers are frequently exposed to hazardous silica dust with little or no health monitoring.  

Evidence shared during the roundtable revealed only a small minority of affected workers had ever undergone any form of workplace health surveillance, with some missing out on any form of monitoring for several decades.   

Roundtable speakers described a fragmented system where occupational health data is poorly integrated with NHS records, depriving clinicians of the true picture of a patient’s working life and silica dust exposure history. As a result, silicosis is often misdiagnosed or overlooked entirely.  

Dr Feary added: “We have a real problem in that silicosis looks like other lung conditions; it looks like TB and it looks like sarcoidosis, and so unless people get asked about what they do for a job, their silicosis will get misdiagnosed as other conditions.  

“I really think we need a national screening programme which is properly funded, and properly rolled out, to ensure that these workers get the checks that they deserve.  

“I think that’s the only way that we’re going to get people early and save lives.”  

Arco, the UK’s leading health and safety supplier, and a key driving force behind the facilitation of yesterday’s roundtable, emphasised that while the risks are well understood, the real challenge lies in translating policy into practical action on the ground.  

Christian Halford, technical quality director at Arco, highlighted the need for a solutions-led approach focused on improving diagnosis, strengthening occupational health and ensuring workers are better protected through training, appropriate PPE and real-time monitoring.  

He stressed that while measures such as water suppression can significantly reduce exposure, there is no single fix for the nationwide crisis.  

“Exposure can be reduced, but only if the right controls are properly implemented,” he said. “The focus needs to be on practical solutions that reduce exposure on the ground.”  

Ian Lavery, MP, emphasised the importance of clear government direction and stronger regulatory oversight to address the growing silicosis crisis.  

He welcomed recent HSE guidance banning dry cutting, and mandating water suppression, but warned that greater awareness of exposure risks and more robust regulation would be needed to ensure workers are adequately protected across high-risk industries.  

He also identified several priority areas, including making silicosis a notifiable disease through the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR), strengthening the integration of occupational health within wider healthcare systems, and improving training, education and early detection.  

He said: “I think from what I’ve heard today, and excuse me for saying this, but these are serious issues. It’s all mismatched.  

“You’ve got all the jigsaw pieces in the box, but nobody put them together. You might have the four corners, but that’s what this is.”  

The All-Party Parliamentary Group (APPG) for Respiratory Health will now take these proposals forward, with Ian Lavery in particular signalling his intention to raise the issue in Parliament and apply pressure on necessary government departments.  

The roundtable concluded with a clear message: silicosis is entirely preventable, but without immediate and coordinated action across government, healthcare and industry, the UK risks a sharp rise in cases in the coming years. 

Jim Shannon MP, Chair of the APPG for Respiratory Health, said: “Silicosis is a devastating yet entirely preventable occupational health issue affecting workers throughout the UK, across construction, mining, tunnelling and other silica-related industries. 

“The true scale of the problem is not yet fully understood. Silicosis is a serious, progressive and incurable disease and despite its increasing prevalence, challenges around diagnosis, reporting and prevention persist. 

“This roundtable provided an invaluable opportunity to review the current landscape, consider the barriers to effective prevention, and crucially, explore both practical and policy solutions that could effectively reduce exposure to respirable crystalline silica dust and, importantly, improve patient outcomes. 

“I am delighted that Arco has partnered with the APPG on this initiative and contributed their expertise in workplace risk measurement and prevention. Insights gathered from the roundtable will inform a follow-up report, with the ambition to support improvements to worker protection, regulatory approaches and critically, improved patient outcomes.  

“We hope to support a more coordinated, collaborative and effective response to reducing the unnecessary risks associated with silicosis and protecting the health and wellbeing of the UK workforce by uniting those working in key roles across policy, healthcare and industry.”  

To find out more, visit: https://www.arco.co.uk/pr/what-is-silicosis