We thank Barber and colleagues1 for their interest in our paper.2 It is excellent that the Surveillance of Work-related Occupational Respiratory Disease (SWORD) database could be interrogated; in Australia we have no such centralised resource. We were concerned that two-thirds of their cases of silicosis were diagnosed in men of working age; we agree that in the absence of specific information about occupational exposures within the category of ‘stonemason’, it is difficult to be entirely sure that none of these were related to artificial stone processing.
The letter highlights the challenge of differentiating silicosis from sarcoidosis in young workers with progressive lung opacities. Compared with chronic and acute silicosis, the histopathological features of accelerated silicosis are yet to be clearly defined.3 This is partly due to the modest number of reported cases, but also the fact that this is a condition that produces progressive pathological findings....
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