If he had his druthers, Gerry O'Malley would still be a bricklayer today. The work could be exceptionally demanding, but the rewards more than made up for the daily hardships. Passing by the brick facades of the public buildings and private homes that he helped construct during his 25 years of bricklaying in Detroit fills him with immense satisfaction. O'Malley also takes pride in having poured countless gallons of concrete, spreading it, smooth as cream, over walkways, plazas, and roads that will sustain countless vehicles and pairs of feet for generations. He'd still be pouring concrete and laying brick, except for one simple fact: He can barely breathe.

O'Malley, 57, was recently diagnosed with a full-blown case of asbestosis, a crippling lung disease caused, in his case, by inhaling construction dust that contained asbestos. Today he is the executive vice president of the International Union of Bricklayers and Allied Craftsworkers in Washington, DC. But even in the less strenuous duties of his office job, O'Malley is hampered by asbestosis, which is irreversible. As his breathing becomes more and more labored, the ex-bricklayer wheezes constantly. Sometimes he can't manage to catch his breath at all.

"I can't do what I used to," says O'Malley, speaking by telephone from his office in Washington. "I wish that we had had better protection. And I wish the manufacturers would have divulged that there was asbestos in the material."

Because coming in contact with asbestos -- a known cancer hazard -- poses a grave health risk, bricklayers generally try to avoid it at all costs. When some exposure is inevitable, such as in demolition jobs, workers are expected to follow strict safety regulations.

But there is a material bricklayers work with on a daily basis that can prove equally dangerous when inhaled as a dust: silica. This pernicious substance, found in brick, concrete products, stone, rock, and abrasives, can cause a lung disease known as silicosis, which is often progressive and sometimes fatal. Like asbestosis, the disease has no known treatment or cure.

To protect workers from exposure to both asbestos and silica, the Occupational Safety and Health Administration (OSHA) has established a set of rigorous standards for handling materials containing them. Employees engaged in demolition in a site suspected of containing asbestos, for example, must wear respirators and full-body protective suits. To minimize the hidden perils of the all but invisible silica dust, for example, workers must douse water over the entire area when cutting, grinding, blasting, or sweeping. The only sure way to avoid coming into contact with silica is to enforce protections when its presence on a work site is suspected.

"Silica dust is a very big problem," says O'Malley. "It's probably the most hazardous, but it's not that well recognized. It's not like a hole you can walk around. It's a danger that will get you down the road."

Like asbestosis, silicosis can lie dormant in a person's lungs for years, setting off inflammation that may eventually make it difficult to draw a breath. Moreover, it is an elusive disease often misdiagnosed by physicians, says Frank J. Hearl, former deputy director of the division of respiratory disease studies at the National Institute for Occupational Safety and Health laboratories in Morgantown, West Virginia. According to NIOSH recommendations, exposure levels that exceed 50 micrograms per cubic meter of silica dust -- the equivalent of a dime's weight of dust spread throughout a volume 30 feet deep and the length and width of a football field -- are potentially harmful.

Currently, there is some controversy among scientists about safe levels of exposure, with some experts holding the belief that silicosis can occur at even more minute levels of contamination. Bricklayers and other workers who cut brick, concrete, or rock are well advised to consider silica dust a toxic substance and to take all proper precautions when handling it, according to Hearl. Their lives could hang in the balance.

"Some workers tend to be cavalier or [ignorant] about it," Hearl says. "If you see a dust cloud, you don't know if there's silica in it. But there's a pretty good indication there is -- if you're disturbing any kind of rock."

A 1997 study by Dr. Gregory R. Wagner, director of NIOSH's Division of Respiratory Disease Studies, found that between 1979 and 1992, at least 4,882 Americans died from complications of silicosis. During the same period, more than 8,700 Americans died from asbestosis, according to the study. Wagner concluded that the vast majority of the diseases could have been prevented through proper information, education, and prevention. His study also notes many little-known ways in which today's workers are exposed to dust containing the dangerous substances.

So-called "quickie saws" are the biggest culprits, says O'Malley. These are portable power-saws that can quickly and effectively cut through concrete, bricks, rocks and other equally daunting materials. Because they're light and easy to wield, O'Malley says, bricklayers tend to use them for a wide variety of tasks, appropriate and inappropriate -- and forgo personal protection and engineering controls. Both O'Malley and Hearl concur that workers should be well informed of the health risks involved with the "quickie saw."

In addition, workers should be familiar with the kind of tests and monitoring they need. People with silicosis, for example, have an increased risk of tuberculosis; they should be given a tuberculin skin test periodically and treated if infected. Workers exposed to asbestos and silica should talk to their personal physicians about scheduling periodic medical examinations that include chest x-rays and pulmonary function tests. A doctor may also order a bronchoscopy – a test that uses a fiberoptic scope to obtain lung fluid and tissue samples. If workers have been exposed to asbestos, they should also be tested for traces of hidden blood in the feces. Workers who smoke and are exposed to asbestos run the greatest risk: They have a markedly higher rate of lung cancer and should be offered assistance and a treatment program to help them stop smoking.

Bricklayers' biggest health concerns are dust and scaffolding safety, according to a survey by the International Union of Bricklayers and Allied Craftsworkers. The survey also found that back strains, ruptures, and herniated disks -- caused by overexertion when lifting, as well as "bending, climbing, crawling, reaching, and twisting" -- were the most common injuries among bricklayers and other masons.

For bricklayer Randy Johnson, hauling 45-pound blocks and spending long hours on his hands and knees didn't catch up with him until he hit his late 30s. He remembers a time when all he'd have to do was take the occasional day off work to rest his sore back and legs. Then, when he turned 39, Johnson's back just gave out.

"One day I got up to go to work and I couldn't even walk," says Johnson, now 48. "There were times when I'd get sore and lay with an ice pack on my legs all night and it would take care of itself eventually. But this time, it never let up."

Eventually Johnson was diagnosed with two herniated disks in his spine, a condition in which the semi-liquid material in a disc between the vertebrae squeezes through its fibrous outer coating, sometimes impinging on a nerve and causing pain. On his doctor's recommendation, Johnson had immediate surgery. Despite the successful operation, when the bricklayer returned to work, his back still gave him trouble. He noticed a marked improvement, though, after he began attending regular sessions with a physical therapist. There, he learned work methods that alleviated the pressure on his back and legs while doing his job. One crucial change he made was to avoid twisting his body in the process of moving bricks from one spot to another.

"When you're in between the building and the material that's behind you, typically we'll just twist because it's quicker," Johnson says. "Instead of twisting, they showed me how to step around and move your whole body with your feet. I've never had back problems since." Johnson also started doing stretches every morning before work. "It made such a difference," he says.

Back problems are among the most common work-related ailments to afflict US workers. But bricklayers are particularly vulnerable because so much of their work involves bending and reaching, says Thomas M. Cook, an occupational health professor at the University of Iowa. In a 1996 study, Cook found that nearly 73 percent of bricklayers suffered some degree of lower back pain. These problems accounted for the most lost work time and the majority of physician visits; next in line came disorders involving shoulders, elbows, wrists or hands, necks, and knees.

Recent studies indicate that the majority of bricklayers' back problems can be traced to the long hours they spend stooping and lifting, says Cook. Bricklayers, like other workers, function best when working with the hands at about waist level.

Other movements the study advises bricklayers to avoid:

A continuously adjustable scaffold -- as opposed to a fixed scaffold -- can be a bricklayer's best friend on the job. That's because it keeps the work at waist level, says Laird Donaldson, a regional training director in Seattle, Washington, with the International Masonry Institute, an industry organization that provides nationwide safety training for bricklayers and masons. But Donaldson also warns that no matter how secure the scaffold appears, bricklayers should always take extra precautions when working above ground level.

Retired bricklayer Gary Kazda can attest to that. As he was laying concrete block along the interior wall of Washington University's Suzallo Library, Kazda tumbled just a few feet when the scaffold collapsed under him. But a 40-pound block of concrete, which had been resting on the scaffold beside him, came crashing down on his leg, causing a serious fracture.

One day, months after that incident, Kazda and his crew had another close call. This time, luckily, someone noticed in time that the 60-foot scaffold wasn't balanced correctly. As it turned out, the structure was missing its braces. "It could've been a bad collapse," Kazda says. "On the job, you just gotta pay attention to things like that."

-- Cassandra Sweet is a freelance writer in Seattle.

Further Resources

For more information about protecting yourself from silica dust, musculoskeletal problems and falls, visit the Occupational Safety and Health Administration's Web site at http://www.osha.gov . The International Union of Bricklayers and Allied Craftsworkers has a Web site that offers useful information and links as well. http://www.bacweb.org

References

First published March 8, 2001
Last updated March 11, 2008
Copyright © 2001 Consumer Health Interactive