Artificial Stone Silicosis: New Face of an Old Disease

Artificial stone (AS) silicosis has emerged as a major global occupational health concern, challenging the perception of silicosis as a disease of the past. Driven by the fabrication of AS products containing high concentrations of crystalline silica (>90%), this rapidly progressive form disproportionately affects younger workers and develops after a much shorter exposure duration (median 7-19 years) than in classic silicosis. As cases continue to emerge worldwide, clinicians and occupational health practitioners are increasingly likely to encounter affected workers in clinical practice. This review provides a clinically focused synthesis of the current evidence on the epidemiology, pathophysiology, clinical manifestations, diagnosis, and management of AS silicosis. Compared with traditional silicosis, the unique physicochemical properties of AS dust may amplify lung toxicity and promote a self-perpetuating inflammatory response. This frequently results in rapid development of progressive massive fibrosis, with disease progression often continuing after exposure cessation. Diagnosis is often delayed because of overlapping clinical features and the limited sensitivity of conventional screening tools, highlighting the importance of early clinical recognition, detailed occupational history-taking, and the use of high-resolution computed tomography where appropriate. Lung transplantation remains the only definitive treatment for advanced disease, underscoring the importance of prevention. Effective prevention requires strong workplace controls, systematic medical surveillance, and appropriate regulatory measures. Clinicians play a key role in early detection, patient education, and mandatory disease reporting. Coordinated action across clinical, occupational, and policy domains is essential to improve recognition, strengthen preventive measures, and avert further cases of this highly preventable occupational disease.