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Global HSE / Practice / 01 · Silica & Disease
01
Line of Practice Silica · Disease · Surveillance

Silica risk, quantified.
Disease, prevented.

Exposure assessment, biological surveillance design, and prevention frameworks for the four industries where respirable crystalline silica is concentrated – mining, construction, manufacturing, and engineered-stone fabrication. Built in the field, calibrated to the jurisdiction.

The Brief

Silicosis is a solved disease that continues to kill 44,000 workers a year.

The science is settled. The exposure standards are in place. The control technologies – wet cutting, local exhaust ventilation, enclosed cabs, respiratory protection – have been understood for a century. And yet silicosis remains one of the most lethal occupational diseases on the planet, concentrated in the workforces with the least institutional voice to demand its prevention.

This is not a knowledge problem. It is a system design problem. The places where workers die of silica disease are not the places where the science is absent – they are the places where the science has not been translated into a functioning prevention system, with surveillance, accountability, and enforcement.

Our practice exists to close that translation gap. We work directly with mining houses, ministries, regulators, and international agencies to design, embed, and audit the silica-and-disease prevention systems that actually move the disease curve – measured in cases avoided, not reports filed.

Principle · 01
Exposure is measured, not estimated.

Personal sampling, gravimetric and crystalline-silica analysis, and full-shift sampling protocols. If the dose is not measured, the control is not engineered.

Principle · 02
Surveillance is designed, not improvised.

Medical surveillance protocols, ILO chest-radiograph reading, lung-function trajectories, and TB co-morbidity tracking built to detect cases at a stage where the disease is still reversible or arrestable.

Principle · 03
Accountability is built in, not added later.

Prevention systems without accountability infrastructure produce documentation. We design the data layer, the reporting cadence, and the regulatory feedback loop that makes prevention auditable.

What we deliver

Six lines of silica advisory work, in the field.

Each engagement is shaped to the jurisdiction, sector, and workforce. The services below are the recurring shape of the work – assembled, sequenced, and embedded according to the brief.
i.
Silica exposure assessment programmes
Personal full-shift sampling, gravimetric and X-ray-diffraction analysis, job-exposure matrices, and engineering-control validation across underground, surface, and processing operations. Built to ILO and ACGIH protocols, calibrated to local regulatory thresholds.
Deliverables Sampling plan Exposure register Control roadmap
ii.
Medical surveillance system design
End-to-end surveillance protocols baseline and periodic examinations, ILO B-reader chest radiology, spirometry trajectories, TB screening, case definition, and longitudinal follow-up. This includes referral pathways and worker-compensation linkage.
Deliverables Surveillance protocol Reading panel Case registry
iii.
Engineered-stone & fabrication advisory
Targeted advisory for the emerging engineered-stone silicosis crisis workshop redesign, wet-process specification, RPE programmes, worker registries, and policy response for regulators contending with accelerated-onset disease in young fabricators.
Deliverables Workshop audit Worker registry Regulator brief
iv.
TB co-morbidity programmes
Integrated silica-and-tuberculosis programmes for high-burden mining populations, where radiological features overlap and misdiagnosis is structural. Joint case definition, diagnostic pathway design, and surveillance-data integration across occupational and public-health systems.
Deliverables Joint protocol Reader training Data linkage spec
v.
AI-enabled screening infrastructure
Implementation advisory for AI-assisted radiograph reading at population scale model evaluation, deployment governance, equity audit, and integration with existing ILO classification workflows. Built on the practice's CIHR research with UBC and UCT.
Deliverables Model evaluation Governance brief Deployment plan
vi.
Regulator & policy support
Technical drafting and consultation support for ministries developing silica-and-disease regulation OEL setting, surveillance mandates, compensation-scheme design, and tripartite stakeholder consultation. Including evidence briefs and parliamentary submissions.
Deliverables Regulatory text Evidence brief Consultation plan
The Method

How a silica engagement actually runs.

Every engagement – whether a single mine, a national framework, or a multi-country programme – moves through the same four stages. The deliverable changes; the method does not.
01
Stage · Diagnose
Map the exposure landscape

Site walk-through, document review, regulatory baseline, and gap analysis against ILO and ACGIH benchmarks. The brief is the gap.

02
Stage · Measure
Quantify the dose

Personal sampling campaign, surveillance baseline, and case-finding. The dose, not the perception of the dose, becomes the basis for design.

03
Stage · Engineer
Design the prevention system

Engineering controls, surveillance protocols, governance, and accountability infrastructure. Calibrated to the jurisdiction and workforce.

04
Stage · Embed
Make it institutional

Capacity-building, regulatory hand-off, and data infrastructure. The system improves independently after the practice leaves.

Recent & current

Three engagements, in shape.

Public, anonymised, or partner-cleared examples of the work. Each is a different scale of intervention – single sector, regional, and multi-country.
Sectors served

Where the silica work happens.

Silica advisory engagements have been delivered across every industrial setting where respirable crystalline silica is a primary occupational hazard.
Gold & deep-shaft mining
Southern Africa · India
Platinum & PGM mining
RSA · Zimbabwe
Coal & thermal mining
RSA · Indonesia · Vietnam
Diamond & gem mining
SADC region
Engineered stone fabrication
EU · Canada · GCC
Construction & demolition
UAE · KSA · Singapore
Tunnelling & civil works
Hong Kong · KSA NEOM
Quarrying & aggregates
Caribbean · West Africa
Foundries & metal casting
India · Vietnam
Sandblasting ops.
GCC shipyards
Ceramics & refractories
Asia · EU
Cement & aggregates
Africa · MENA
Dr. Nayab Sultan
We do not have a silicosis knowledge problem. We have a silicosis system-design problem – and that is an entirely fixable thing.
Dr. Nayab Sultan
Director · Principal Consultant
Engage the practice

Speak with the director about a silica programme.

Every silica engagement begins with a 45-minute consultation. We discuss the workforce, the regulatory environment, and what a credible prevention system would look like in your jurisdiction.