A tale of two exposures: consumers and those who supply them

Some of my occupational medicine colleagues and I did not share completely in the general euphoria following the rescue of the trapped Chilean miners, taking note that Mario Gomez (at 63, the eldest of the group) was reported to have silicosis. This is a progressive and life-threatening lung disease that evolves after prolonged exposure to silica-containing rock dust. The condition would have long pre-dated the mine entrapment, although from the reports it was unclear how long ago the diagnosis was established and why a miner with silicosis continued to work underground. Ironically, two days after the miner liberation story, the Tate Modern in London announced that it was limiting patron access to a conceptual art exhibit in which museum-goers had been encouraged to walk on ceramic simulacra of sunflower seeds. It seems that the Tate was worried that porcelain pulverized underfoot, aka silica dust, might somehow do harm to modern art culture vultures.

The juxtaposition of these two exposure scenarios and the steps taken or, more importantly, not taken to ameliorate risk underscore the double-standards that exist when it comes to what a consumer will permit to happen to the person who supplies goods to be purchased versus what the very same consumer tolerates when it comes to perceived threats to their own personal health. Thus, while the October 13th the New York Times (under the header "Defying Predictions, Miners Kept Healthy") noted almost in passing that maybe not all the miners were had picture perfect lungs (http://www.nytimes.com/2010/10/14/world/americas/14medical.html), the Tate's website (October 15th update) offered the mea culpa: "Although porcelain is very robust, we have been advised that the interaction of visitors with the sculpture can cause dust which could be damaging to health following repeated inhalation over a long period of time. In consequence, Tate, in consultation with the artist, has decided not to allow members of the public to walk across the sculpture." (http://www.tate.org.uk/modern/exhibitions/unileverseries2010/default.sh…).

Because metal mining, such as the Chilean operation, often involves extracting ores that are imbedded in quartz-containing rock, silica exposure and the silicosis lung disease it causes is an endemic problem in that that industry. Unfortunately, potential sources of silica go far beyond mining, occurring wherever silica-containing rocks or crystals or sand are cut, blasted, polished, or pulverized. This is hardly a new story. Anyone wanting a brief primer on the subject can watch a 1938 United States Department of Labor 11-minute film on the subject, "Stop Silicosis" (http://video.google.com/videoplay?docid=4394311547848240314#)

What is new, sadly, are there ever new and novel ways in which unsuspecting laborers are ensnared in the silica trap. Several years ago, for example, an epidemic of silicosis erupted among young workers in Turkey who sandblasted blue jeans for the Western market, trading in their health so that the denim would have a saleable distressed look for the consumer export market. A 2007 medical report documented more than a 100 such cases, many of which had started work at age fifteen or younger. None of this seemed to impact consumer demand, since once on the store shelves, there was no remaining silica exposure risk.

The latest emerging silicosis outbreak can be traced to the consumer demand for the latest and best in kitchen counter tops. Keeping up with the Joneses nowadays means having to choose among a myriad of surface choices, including semi-synthetic quartz conglomerates. These materials, such as Silestone® and CaesarStone®, are made using polymers to bond together crushed rock with a high percentage of quartz. When sheets of this material are cut to custom-fit an order, if this is done by cutting with power blades and without dust control, exposure levels can be deadly. For example, in June of this year, a Spanish court opened an investigation into conditions at a small factory where 6 of 11 employees working with these materials developed silicosis. It is unlikely that the price being paid by those working with these attractive accoutrements enters into the equation made by someone in the market for a high-end kitchen makeover. Au contraire, the debate on the kitchen design websites is whether consumer risk from granite countertop-released radon (a remote, although theoretically possible concern) should drive product preference.