This is the last article on lung disease associated with the fracking process. You can review the previous articles over the last 3 weeks on our web site @

Medical follow up of workers exposed to high concentrations of silica dust in the fracking industry should begin now. Workers should be x-rayed annually to look for evidence of accelerated disease, particularly if the worker has worked at one of the jobs with the highest exposure such as: sand mover operator, T-belt operator, blender operator, or hydration unit operator. Another group of workers should not be missed, and they are sand miners. Because of the increased demand for sand in fracking operations, more sand mines have opened and these workers are also at risk of developing silicosis and associated diseases. Whenever possible x-rays taken on these workers should be interpreted by a so-called “B” reader. A “B” reader is a radiologist who has been specially trained and certified to be able to pick out evidence of silicosis and other occupational lung diseases on x-rays.

Because it takes 20 or more years for disease to develop and because the use of large amounts of sand began in the 2000’s, it may be 5-10 years before we see the evidence of these exposures. How many of these workers we, as physicians, will see in the future may depend on how well the industry responds to recommendations by OSHA for controlling silica exposure at the drilling sites and sand mines.