Silicosis and the legal process: a guide for medical practitioners

Introduction: industries at risk of exposure 

Silicosis is one of the oldest occupational diseases and has been known about for more than a century. Nevertheless, it continues to affect workers in high‑risk sectors including stone masonry, stone fabrication, construction, mining, and tunnelling.  

In November 2024, the Health and Safety Executive (HSE) reported 35 new cases of silicosis assessed for Industrial Injuries Disablement Benefit (IIDB) in 2023. An average of 12 deaths per year from silicosis has been recorded over the decade to 2023.  

In recent years, a growing concern is the rise of cases linked to the cutting and fabrication of engineered stone (often also referred to as quartz or artificial stone), commonly used in kitchen worktops.  

Engineered stone may contain up to 90–95% crystalline silica. Even short periods of intense exposure can result in acute, life‑threatening silicosis where effective dust suppression and respiratory protection are absent. 

Cases of silicosis related to engineered stone have been reported globally since 2010. However, in a paper published in Thorax in August 2024, the lead author, Dr Johanna Feary (honorary consultant in occupational lung disease at the Royal Brompton Hospital), identified the first UK cases of silicosis related to engineered stone in young men. The numbers since then have continued to rise.  

This article is intended to assist medical practitioners in understanding the legal framework that underpins civil compensation claims for patients diagnosed with silicosis. Early awareness of this process is crucial, particularly given the progressive nature of the disease and the strict statutory time limits that apply to legal claims. 

Key elements of a civil claim for silicosis 

To succeed in a silicosis personal injury claim, three key elements must be established. 

1. Duty of care 

The first step is to demonstrate that the patient was owed a duty of care at the time of exposure to respirable crystalline silica (RCS). In most cases, this arises within the context of employment, which can often be verified through the patient’s National Insurance contributions record, obtained from HMRC. 

Employers owe a common law duty to take reasonable care for the health and safety of their employees. This duty is supplemented by statutory and regulatory obligations governing exposure to hazardous substances and safe systems of work. 

Where a patient believes they were working on a self‑employed basis, or worked informally, establishing a duty of care may require closer analysis. It may still be possible to demonstrate an employer–employee relationship by examining: 

1. The level of control the employer had over their work
2. Whether there was an obligation to offer work
3. How integrated the employee was within the business 

Employment histories can also be complex, especially where individuals have worked for small or family‑run businesses operating through multiple corporate entities. Careful review of the patient’s work timeline is therefore essential. 

2. Breach of duty 

The second element is demonstrating that the employer breached their duty of care by failing to protect the worker from hazardous silica exposure. 

In silicosis claims, this commonly involves detailed evidence of: 

• The nature, intensity, and duration of silica exposure 
• The availability and adequacy of dust suppression and extraction methods 
• The provision and enforcement of suitable respiratory protective equipment 
• The quality of training, supervision, and health surveillance 

A comprehensive witness statement from the patient is critical and should be supported by contemporaneous photographs, videos, or documentary materials where possible. 

3. Causation 

Medical evidence is pivotal in establishing whether occupational exposure materially contributed to the development of silicosis. 

Legal causation does not require identifying a single period of exposure as the sole cause. Instead, it must be shown that the exposure in question materially increased the risk of developing the disease.  

Medical experts are asked to consider: 

1. The patient’s working conditions and exposure history 
2. The protective measures in place  
3. Their clinical findings regarding a diagnosis of silicosis 
4. How they have distinguished a diagnosis of silicosis from tuberculosis or sarcoidosis, which are common differential diagnoses   
5. Their opinion on whether the employer’s breach of duty caused or materially contributed to the patient’s silicosis 
6. The patient’s prognosis and treatment 

Limitation periods: why early legal advice matters 

Compensation claims are subject to strict limitation periods. Court proceedings must generally begin within three years of: 

• The date of disease onset; 
• The date the patient was first informed of the diagnosis; or 
• The date of death (if the deceased was unaware of the disease more than three years before passing) 

Even a respiratory disability assessed at just 1% could trigger the limitation period. While courts have discretion to allow claims to proceed outside these limits, this cannot be relied upon. For this reason, patients should be encouraged to seek legal advice promptly, even if symptoms are mild. 

State benefits for silicosis patients  

In addition to civil claims, patients with silicosis may be eligible for state benefits, including:  

1. Industrial Injuries Disablement Benefit (IIDB): a no‑fault, periodic payment based on the extent of respiratory disablement. This may require medical assessment. 
2. Pneumoconiosis Workers’ Compensation Act (PWCA): a one‑off lump sum payment which is usually available where a previous employer has gone out of business.  

The Department for Work and Pensions (DWP) will examine the patient’s employment history and may contact former employers as part of its assessment, which may be a sensitive issue for some patients. 

Applications for these benefits can be complex due the evidence required. They are best completed with the help of specialist support organisations or solicitors. Regional asbestos support groups often provide valuable assistance and guidance too. 

What patients can expect when meeting a solicitor 

During an initial legal consultation, patients will be asked about:  

1. Their employment history and work activities  
2. Their medical history  
3. The materials they worked with and the exposure circumstances 
4. The protective measures used  
5. The timeline of their symptom onset and diagnosis  

Following the meeting, a formal witness statement is prepared, and relevant medical and employment records are obtained. Investigations are also undertaken to identify potential defendants. 

Case funding 

Most lawyers will be willing to act on a “no win no fee” basis and there are safeguards in place to ensure that key damages are protected. Usually, the funding agreement will be entered into after the initial meeting and witness statement has been signed by the patient. 

Conclusion 

Medical practitioners play a pivotal role in the identification, diagnosis, and management of silicosis. By understanding the legal process, clinicians can provide holistic guidance and encourage patients to seek timely legal advice. Whether directing patients to asbestos support groups or specialist solicitors, early intervention can make a significant difference in securing justice and support for those affected.