Global workplace health and safety policies for silicosis elimination and way forward

Silicosis is an incurable occupational lung disease caused by prolonged exposure to respirable crystalline silica (RCS). It is the oldest known occupational disease, yet its elimination remains a global public health concern. Workers in traditional industries such as mining and construction, as well as newly emerging industries such as artificial stone cutting, are at high risk. It is estimated that approximately 230 million workers are exposed to silica dust worldwide, of which 34 million workers are in China and India alone, indicating a huge occupational risk to workers. Silicosis is associated with severe comorbidities, including tuberculosis, chronic obstructive pulmonary disease (COPD), kidney diseases, and lung cancer. Despite international initiatives like the Global Programme for the Elimination of Silicosis (GPES) and national policies, the disease persists due to gaps in awareness, surveillance, enforcement, and preventive interventions. This review critically examines the current state of knowledge, challenges in silicosis elimination, and policy frameworks to mitigate exposure and provide a roadmap for future action.