There are similarities in the symptoms of asbestosis and silicosis, but many key differences worth understanding.

Asbestosis and silicosis have a lot in common – yet they are not the same thing. There are slight, but notable differences between the two. Let’s start with the commonalities first.

Both asbestosis and silicosis affect the lungs, causing respiratory distress.

Asbestosis and silicosis are both caused by the inhalation of tiny particles that attach to the lungs. Asbestosis is caused by asbestos and silicosis develops from exposure to silica, two substances that are made of crystalline. 

Asbestosis and silicosis can take years to become symptomatic and, often, both are fatal.

The two diseases can also progress well after dust exposure has ceased. Perhaps most concerning, the two diseases are caused by exposure to relatively commonplace on-the-job materials.

So, what makes asbestosis and silicosis different?

One of the main differences between asbestosis and silicosis is that asbestosis is located in the lower lung, while silicosis is located in the upper lung. Silicosis is classified as a respiratory disease that causes long-term scarring of the lung tissue, whereas asbestosis is considered to be a form of pulmonary fibrosis. Silicosis and asbestosis each have distinct radiological presentations as well. 

Radiological imaging (including X-rays) appears differently for silicosis and asbestosis.

According to Loyola University, radiological features of silicosis include:

  • Military nodules
  • Egg shell calcification of lymph nodes
  • Progressive massive fibrosis
  • Upper lobe distribution of abnormality

Radiological presentations with asbestosis include:

  • Pleural plaques, calcified pleural plaques
  • Diffuse interstitial fibrosis, honeycombing
  • High incidence of lung cancer and mesothelioma

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Silicosis: A Brief History & On-the-Job Exposure

Silicosis has been a recognized disease for more than 400 years, well before asbestosis was coined. The Treatise of Mining, a manuscript written by Georgius Apricola in 1556, details accounts of the disease affecting stonecutters and miners.

Silica is a material that is naturally found in stone (such as granite), rock, sand, and clay. When crystalline silica dust particles are released into the air, they can be ingested and subsequently cause silicosis. The dust attaches to the lungs, leading to inflammation and, over time, fibrosis. 

Silica buildup causes breathing issues, including shortness of breath, coughing and wheezing. Because the lungs are no longer functioning properly and it is difficult to inhale enough air, fatigue is also common.

Silicosis has a latency, meaning its symptoms take time to appear.

Over the years, advances in equipment used to cut away at rock and stone, and to grind and sand it, have caused the number of silicosis cases to skyrocket. Today, roughly 2.3 million U.S. workers are exposed to silica in the workplace and close to 59,000 U.S. workers will develop silicosis each year.

Silicosis can develop from working in a number of occupations, including construction, shipbuilding, railroad and foundry work, mining, ceramics, building tombstones, sandblasting and more. Anyone working around crystalline silica dust can easily be exposed to it, and grinding, cutting, sawing, or chipping away at the material in some way may cause it to be swallowed.

Three types of silicosis

There are three types of silicosis – acute, chronic and accelerated. Chronic silicosis results from long-term exposure to relatively small amounts of silica dust. The acute form of the disease appears after exposure to larger amounts of silica over a shorter period of time. Inflammation, scarring, and symptoms progress faster in accelerated silicosis than in the first two forms.

Dr. Anthony Lanza’s Role in Asbestosis & Silicosis Research

Dr. Anthony J. Lanza, a noted physician, researcher, and professor, was among one of first persons to report on silicosis, and he would become a leading American authority on matters related to both diseases during the 20th century.

Pioneering tuberculosis research conducted by Dr. Lanza

In the early 1900s, Lanza became fascinated with finding out why tuberculosis (TB) was killing underground miners in Montana at a rate 10 times the national average. Hired by the Montana Tuberculosis Association, between 1916 and 1918, the doctor examined more than 1,000 of these miners and found several hundred had developed lung disease. 

Lanza’s theories on tuberculosis

Lanza surmised that miners who suffered with silicosis were more likely to contract TB and/or those who had silicosis and contracted TB were less likely to be able to fend off the disease. Today, it is well-known in the medical community that silicosis reduces immunity, so the connection between the two is not surprising.

Lanza goes to work for Metropolitan Life insurance company.

Lanza was also employed as the Associate Medical Director of Metropolitan Life Insurance Company (MetLife). In 1929, the asbestos industry approached MetLife and asked that a study be done to determine the risks associated with asbestos. So, Lanza and his colleagues conducted the first epidemiological study of asbestos workers in the U.S.

At the instruction of asbestos company executives, Dr. Lanza deleted the results of health research showing asbestos could cause cancer.

From 1929 to 1931, Lanza and his team took X-rays of workers in five asbestos plants and mines in the United States and Canada. They discovered that many of the workers had enlarged hearts and fibrosis – and that these numbers increased as time spent in the plants and mines increased.

At the time the report was submitted for approval, New Jersey had been considering adding silicosis to the list of coverable conditions under workers’ compensation claims. Lanza had originally stated that asbestosis was clinically milder than silicosis but altered the write-up in 1934 after several other studies suggested otherwise. 

Lanza’s report raised concerns in the asbestos industry that asbestosis would be documented as being as dangerous as the other lung disease, and thus need to also be covered, and the doctor was asked to modify it to suggest, once again, that asbestosis wasn’t as serious. Unfortunately, these editorial changes were accepted, and the final version was published in 1935. The changes would cause the severity of asbestos exposure to be overlooked for the next several decades.

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If you may have been exposed to asbestos, speak with your healthcare provider about tests and screening to help detect the presence of asbestos fibers and asbestos-related damage.






















State- and Self-Monitoring for Asbestosis & Silicosis









Many states now require that cases of asbestosis and silicosis be reported in order to monitor disease trends and develop and improve measures to fend off these diseases. Self-monitoring, however, is the best way to catch and treat the diseases early on. 





The latency of asbestos illness means it can take decades for symptoms to appear.





There is a latency in symptom presentation in both diseases. So, even though precautions have been put into place over the years to limit exposure, those who work or have worked directly with silica and/or asbestos are still at risk of developing asbestosis and/or silicosis. 





Shortness of breath, a chronic cough and fatigue are some of the most common early symptoms. Individuals employed in high-risk occupations should get tested if they are experiencing any of these warning signs.





















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1 Egilman D, Bird T, Lee C. Dust diseases and the legacy of corporate manipulation of science and law. Int J Occup Environ Health. 2014 Apr-Jun;20(2):115-25. doi: 10.1179/1077352514Z.000000000104. Epub 2014 Mar 4. PMID: 24999846; PMCID: PMC4090870.

2 Wagner GR. Asbestosis and silicosis. Lancet. 1997 May 3;349(9061):1311-5. doi: 10.1016/S0140-6736(96)07336-9. PMID: 9142077.