Silicosis: An evolving risk

Silicosis claims numbers remain relatively modest in the UK, however a rise in hospital cases and media focus suggests the potential for an increase in claims, especially those linked to engineered stone.

This is particularly relevant for insurers who need to be aware of the evolving risk and where appropriate adjust their underwriting practices accordingly.

Executive summary

Defendants and Insurers have long been aware of the risk of silica related disease, principally silicosis. In recent years claim numbers have been relatively modest, which appears largely because of changing and improving working practices such as decreasing heavy industry, improved regulation and improved risk control measures within the UK.

Despite the above there has been increasing concern and media coverage, fuelled in part by a spike of silicosis cases in Australia associated with engineered stone (which ultimately led to a ban of the material) [1], that a resurgence of silicosis claims will occur.

It is noteworthy that claims for silicosis reported within the public domain, and generally those claims seen by Clyde & Co, involve smaller enterprises (i.e. stone masons etc.) whose working practices and risk control measures are frequently found to be lacking. Such shortfalls are, from experience, readily identifiable on closer inspection either of the company’s premises or its risk control documentation (should it exist).

Consequently, we advise implementing a cautious approach when scrutinising and writing such risks including the disclosure and close review of risk control documentation and where necessary a site inspection at the time of proposal.

Background to Silicosis 

Exposure to respirable crystalline silica (RCS), which is found in stone, rocks, sands and clays, is linked to a myriad of different medical conditions. As the HSE advises [2]: 

The impact of engineered stone  

Although claim numbers have not significantly increased, nor have applications for related Industrial Injuries Disablement Benefit (IIDB) (discussed below), there has been an increase in reports of individuals suffering and some dying from silicosis and silicosis-related illness diseases globally. [3]

Artificial (or “sintered”) stone has become an increasingly popular material and often contains very high levels of crystalline silica. It is commonly used to fabricate kitchen and bathroom worktops, involving cutting and polishing of the material in situ. 

Those working with engineered stone, (i.e., engaged in cutting, grinding etc.) are potentially exposed to very high concentrations of airborne RCS which in some cases is reported to result in accelerated silicosis in younger workers.  

Countries such as Australia, saw a significant spike of cases associated with the use of engineered stone, which led to its ban. Spain has recently reported 96 new silicosis cases, with 335 registered cases by the month of June. [4]

Interestingly the HSE acknowledges the potential increased risk to employees from working with engineered stone and the need for further research: 

Earlier this year an article published in the BMJ5 detailed [5] UK cases of silicosis connected with kitchen worktops, which a number of news outlets have reported. The article states: 

The i Paper also reported that up to 10 cases of silicosis linked to artificial stone have been identified in the UK. Further, Dr Carl Reynolds, a respiratory consultant at Imperial College London, is reported to have said that patients with diseases due to artificial stone dust exposure were becoming more common. 

Claims and claimant behaviours 

A number of claimant firms are seeking to champion awareness of the associated risk of those working with engineered stone.  

Leigh Day has this year announced that it is pursuing the first claim for silicosis in the UK associated with engineered stone. In an article published in The i Paper Daniel Easton, a partner with Leigh Day [6], indicated: 

The BBC has also recently reported on the risk to those working with RCS and a number of cases where claimants were represented by Irwin Mitchell solicitors.  

Irwin Mitchell indicated that after an increase in reported silica cases it has launched a “National Register for Stoneworkers” to record incidents of contact with RCS. [7] 

Irwin Mitchell’s website states [8]: 

Occupational exposure limits and the use of engineered stone 

Research by Imperial College London has concluded the risk of contracting acute lung condition silicosis could be reduced if the occupational exposure limits to silica dusts were halved. [9]  

The UK’s current Workplace Exposure Limit (WEL) is 0.1mg/m3, in contrast to Australia’s limit of 0.05mg/m3.[10]

As the UK’s WEL exceeds much of the rest of the world, with rising scrutiny, it may only be a matter of time before the UK WEL is reduced, thereby increasing the potential of a breach of duty by policyholders.  
That said, in our experience, claims for silicosis rarely involve work environments with low levels of silica exposure, as risk control measures are absent or inadequate. Consequently, a successful defence to breach of duty will be unlikely, regardless as to whether the WEL is reduced further.   

The HSE stats 

Despite the above, the suggested increase in silicosis cases (potentially associated with exposure from engineered stone) is not necessarily reflected within the latest HSE statistics.  

On 20 November 2024 the HSE reported [11] that there were 35 new cases assessed for IIDB in 2023 compared with 30 in 2022 and 25 in 2021. Whilst this demonstrates a modest increase, annual new cases reduced over the 10 years prior to the coronavirus pandemic, with annual averages of 27 new cases per year during the period 2015-19 compared with 50 during the period 2010-2014.  This shows a marked decrease in cases.   

However, the HSE also noted that in recent years prior to the coronavirus pandemic, chest physicians in the THOR network have typically reported around 20 to 30 estimated new cases each year. There were 12 cases reported in 2023 compared with 36 in 2022, though reporting by physicians is known to have been affected by the coronavirus pandemic in 2020, 2021 and 2022. There has been an average of 12 deaths per year from silicosis over the 10 years to 2023. 

Interestingly the HSE states that there had been 6 cases of silicosis attributable to artificial stone reported within THOR (SWORD) by the end of 2023. Additional cases attributed to artificial stone from 2024 onwards will be reported by the HSE once statistics for 2024 have been finalised during 2025.  

Therefore, there has been a modest, albeit significant, increase in cases which could align with the increased use of engineered stone, such as quartz workstations.  

Interestingly, and importantly, the HSE suggests that the current available statistics likely significantly underestimate the incidence of silicosis: 

Other Silica related illnesses 

Silicosis is not the only silica related disease which is being pursued by the claimant fraternity. We have past and current experience of claims where other autoimmune related conditions are alleged to have been caused by exposure to silica. 

Whilst these claims may be to some degree fact specific, the concern is that claimant firms are seeking to (i) broaden the scope for claims and in turn increase claim numbers and (ii) increase claim values.  

What does this mean for Insurers when managing and writing risks? 

As above it appears that claims numbers have reduced, largely, due to the change in working practices and regulation within the UK.  

However, and based on Clyde & Co’s anecdotal experience, at present, cases are often pursued against smaller companies (stone masons etc.) whose working practices and risk control measures are frequently lacking. Such shortfalls are readily identifiable on closer inspection either of the company’s premises or its risk control documentation (should it exist).  

Further, there appears to be significant scrutiny on identifying possible silicosis cases and with regard to acute exposure (and resultant illness) from engineered stone, which will likely result in an increase, however modest, in claims.  

Consequently, underwriters may be assisted by deploying an overly cautious approach when scrutinising and writing such risks.

[1]Ban on kitchen stone linked to lung disease discussed at UK-Australia summit
[2]Silicosis - Lung disease
[3]Liu X, Jiang Q, Wu P, Han L, Zhou P. Global incidence, prevalence and disease burden of silicosis: 30 years' overview and forecasted trends. BMC Public Health. 2023 Jul 17;23(1):1366. doi: 10.1186/s12889-023-16295-2.  
[4]Cases of silicosis are on the rise in Spain: artificial stone countertops are suspected
[5] Artificial stone silicosis: a UK case series
[6] UK 'set for rapid rise in cases' of fatal lung disease linked to kitchen revamps
[7] 'Our husbands were killed by silica dust inhaled at work' - BBC News
[8] Silicosis Compensation Claims Solicitors | Irwin Mitchell
[9] Reducing workplace dust limits could significantly reduce silicosis cases | Imperial News | Imperial College London
[10] ibid.
[11] Silicosis and coal workers’ pneumoconiosis statistics in Great Britain, 2024